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BACKGROUND Variation in clinical practice in the perioperative environment and intensive care unit is a major challenge facing modern medicine. The objective of the present study was to analyse intraoperative crystalloid administration practices at two academic medical centres in the USA. METHODS We extracted clinical data from patients undergoing(More)
Measuring and providing performance feedback to physicians has gained momentum not only as a way to comply with regulatory requirements, but also as a way to improve patient care. Measurement of structural, process, and outcome metrics in a reliable, evidence-based, specialty-specific manner maximizes the probability of improving physician performance. The(More)
Realistic scheduling of operating room cases decreases costs, optimizes utilization and improves staff and patient satisfaction. Currently limited data exists to establish anesthesia-controlled time benchmarks based on specific subspecialty service. In this multicenter retrospective analysis of cases performed during a 53 month period at two large(More)
The balance between reducing costs and inefficiencies with that of patient safety is a challenging problem faced in the operating room suite. An ongoing challenge is the creation of effective strategies that reduce these inefficiencies and provide real-time personalized metrics and electronic feedback to anesthesia practitioners. We created a sample report(More)
OBJECTIVE To determine whether use of intermediate acting neuromuscular blocking agents during general anesthesia increases the incidence of postoperative respiratory complications. DESIGN Prospective, propensity score matched cohort study. SETTING General teaching hospital in Boston, Massachusetts, United States, 2006-10. PARTICIPANTS 18,579 surgical(More)
There is a growing emphasis on both cost containment and better quality health care. The creation of better methods for alerting providers and their departments to the costs associated with patient care is one tool for improving efficiency. Since anesthetic medications used in the OR setting are one easily monitored factor contributing to OR costs,(More)
OBJECTIVES To confirm the utility of a 10-point Surgical Apgar Score to rate surgical outcomes in a large cohort of patients. DESIGN Using electronic intraoperative records, we calculated Surgical Apgar Scores during a period of 2 years (July 1, 2003, through June 30, 2005). SETTING Major academic medical center. PATIENTS Systematic sample of 4119(More)
As another publishing year come to a close at the Journal of Medical Systems, it is clear that as a scientific community, the need for a more detailed understanding of the impact of medical systems has never been greater. Technologies that were emerging just a short time ago including radio frequency identification (RFID), wireless body area networks(More)
OBJECTIVE An accurate computable representation of food and drug allergy is essential for safe healthcare. Our goal was to develop a high-performance, easily maintained algorithm to identify medication and food allergies and sensitivities from unstructured allergy entries in electronic health record (EHR) systems. MATERIALS AND METHODS An algorithm was(More)
BACKGROUND Deep brain stimulation (DBS) is a proven treatment for various movement disorders resistant to medical management. Complications such as postsurgical infection can negate benefits and increase patient morbidity. We sought to better define risk factors for infection. METHODS We performed a review of DBS cases at our institution from January 1996(More)