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BACKGROUND Concern about patient safety has promoted efforts to improve safety climate. A better understanding of how patient safety climate differs among distinct work areas and disciplines in hospitals would facilitate the design and implementation of interventions. OBJECTIVES To understand workers' perceptions of safety climate and ways in which(More)
OBJECTIVE To examine the relationship between measures of hospital safety climate and hospital performance on selected Patient Safety Indicators (PSIs). DATA SOURCES Primary data from a 2004 survey of hospital personnel. Secondary data from the 2005 Medicare Provider Analysis and Review File and 2004 American Hospital Association's Annual Survey of(More)
OBJECTIVE To compare safety climate between diverse U.S. hospitals and Veterans Health Administration (VA) hospitals, and to explore the factors influencing climate in each setting. DATA SOURCES Primary data from surveys of hospital personnel; secondary data from the American Hospital Association's 2004 Annual Survey of Hospitals. STUDY DESIGN(More)
BACKGROUND Contrast left ventriculography is a method of measuring left ventricular function usually performed at the discretion of the invasive cardiologist during cardiac catheterization. We sought to determine variation in the use of left ventriculography in the Veterans Affairs (VA) Health Care System. METHODS AND RESULTS We identified adult patients(More)
BACKGROUND Mineralocorticoid receptor antagonists (MRAs) have been shown to reduce morbidity and mortality in patients with heart failure (HF) with reduced ejection fraction but are associated with hyperkalemia. We sought to evaluate the frequency, variation, and predictors associated with serum potassium monitoring in patients with HF initiated on an MRA(More)
Importance High-intensity statin therapy is recommended for the secondary prevention of atherosclerotic cardiovascular disease (ASCVD). Nevertheless, statin therapy in general, and high-intensity statin therapy in particular, is underused in patients with established ASCVD. Objective To determine the association between all-cause mortality and intensity(More)
BACKGROUND The November 2013 American College of Cardiology/American Heart Association cholesterol guidelines recommend the use of high-intensity statins for patients with atherosclerotic cardiovascular disease (ASCVD). We sought to determine how these guidelines are being adopted at the Veterans Affairs (VA) Health System and identify treatment gaps. (More)
Left ventriculography, imaging of the left ventricle with a contrast injection, was one of the first methods of measuring left ventricular function and wall motion and is usually performed at the discretion of the cardiologist during cardiac catheterization (eg, coronary angiography). The procedure may increase reimbursement, although the amount is small(More)
BACKGROUND The objective of this study was to determine how often providers did not obtain a recommended measure of left ventricular ejection fraction (LVEF) following a high B-type natriuretic peptide (BNP) value when the LVEF was not known to be low (<40%). Such patients may benefit from life-prolonging treatment. METHODS We identified consecutive(More)