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BACKGROUND In the WalkRounds concept, a core group, which includes the senior executives and/or vice presidents, conducts weekly visits to different areas of the hospital. The group, joined by one or two nurses in the area and other available staff, asks specific questions about adverse events or near misses and about the factors or systems issues that led(More)
Serine/threonine kinase transmembrane proteins are a new family of growth factor signal transducers that includes several isoforms of the activin type II receptor and the type II receptor for transforming growth factor-beta. In an effort to clone the receptor for Mullerian inhibiting substance, a member of the transforming growth factor-beta superfamily,(More)
BACKGROUND To better understand the operating room as a system and to identify system features that influence patient safety, we performed an analysis of operating room patient care using a prospective observational technique. METHODS A multidisciplinary team comprised of human factors experts and surgeons conducted prospective observations of 10 complex(More)
Transforming growth factor beta (TGF-beta) is a multifunctional factor that regulates many aspects of cellular functions. TGF-beta signals through a heteromeric complex of the type I and type II TGF-beta receptors. However, the molecular mechanism of signal transduction by this receptor complex remains unresolved. The type II receptor belongs to a(More)
OBJECTIVE The original Leapfrog Initiative recommends selective referral based on procedural volume thresholds (500 coronary artery bypass graft [CABG] surgeries, 30 abdominal aortic aneurysm [AAA] repairs, 100 carotid endarterectomies [CEA], and 7 esophagectomies annually). We tested the volume-mortality relationship for these procedures in the University(More)
BACKGROUND As health care organizations establish patient safety agendas, attention has focused on creating less cumbersome systems for reporting errors. However, experience at Brigham and Women's Hospital (Boston) suggests that more emphasis needs to be placed on what happens after a report is submitted. FOLLOW-UP AND FEEDBACK: Follow-up includes(More)
PURPOSE A small number of physicians generate a disproportionate share of complaints from patients and of malpractice lawsuits. If these grievances relate to patients' dissatisfaction with care, it might be possible to use commonly distributed patient satisfaction surveys to identify physicians at high risk of complaints from patients and of malpractice(More)
BACKGROUND Müllerian inhibiting substance, produced constitutively by the prepubertal testes, promotes involution of the müllerian ducts during normal male sexual differentiation. In children with virilization and nonpalpable gonads, only those with testicular tissue should have detectable serum concentrations of müllerian inhibiting substance. METHODS We(More)