ffihe arc of history is increasingIL clear; health care is shifting focus from the volume of services delivered to the value created for patients, with "value" defined as the outcomes achieved relative to the costs.1 But progress has been slow and halting, partly because measurement of outcomes that matter to patients, aside from survival, remains limited. And for many conditions, death is a ra...

PURPOSE To examine the usefulness of three types of benchmarking for interpreting patient outcome data. DESIGN This study was part of a multiyear, multihospital longitudinal survey of 10 patient outcomes. The patient outcome used for this methodologic presentation was central line infections (CLI). The sample included eight hospitals in an integrated healthcare system, with a range in size fr...

Teleophthalmology is gaining importance as an effective eye care delivery modality worldwide. In many developing countries, teleophthalmology is being utilized to provide quality eye care to the underserved urban population and the unserved remote rural population. Over the years, technological innovations have led to improvement in evidence and teleophthalmology has evolved from a research too...

INSTRUCTIONS The following case study, “Diagnosis and Management of Hereditary Hemochromatosis,” is accompanied by a continuing medical education (CME) evaluation that consists of 5 multiple-choice questions. After reading the case study, carefully consider each of the questions in the CME evaluation on page 51. Then, circle your selected answer to each question on the CME evaluation form on pa...

INSTRUCTIONS The following case study, “Minor Depression in the Elderly,” is accompanied by a continuing medical education (CME) evaluation that consists of 5 multiple-choice questions. After reading the case study, carefully consider each of the questions in the CME evaluation on page 51. Then, circle your selected answer to each question on the CME evaluation form on page 52. In order to rece...

INTRODUCTION Infectious vaginitis is a common clinical syndrome diagnosed in more than one quarter of women attending clinics for sexually transmitted diseases (STDs) [1] and with increasing frequency in private practice [2]. Effective management of the syndrome depends on an acceptably accurate etiologic diagnosis, as the most effective therapies are narrowspectrum medications that target the ...

Key points Many gastrointestinal diseases are symptomdriven, so the patient’s perspective is particularly important in this area. Patient-reported outcomes (PROs) provide essential information that objective measures and clinician assessment may fail to capture. PROs can be measured in a scientific, reliable, and valid manner. Generic, disease-specific and treatmentspecific PRO instruments exis...

In 2004, a 551-bed nonprofit hospital launched a pilot of the unit-based clinical nurse leader (CNL) role to support staff nurses and their patients. Thus far, the role has demonstrated great promise in promoting individual patient-centered outcomes, although the pilot has identified potential adaptations to enhance aggregate outcomes. These include decreasing the patient-to-CNL ratio, increasi...

Background: While outcomes of primary anatomic total shoulder arthroplasty (aTSA) are generally favorable, resultsafter revision procedures are less reliable. This study examines the functional outcomes, complications, and implantsurvival in patients who underwent revision of aTSA to aTSA.Methods: Patients who underwent revision aTSA were identified from 2008-2015. Demographic, clinical, surgic...