An important responsibility of hospitals is to assure the quality medical care they provide. One key pillars assurance a committee local peers determine professional competence physicians. On occasion, incompetence or disruptive behavior clinician found have caused patient harm. The peer review holds deficient physician accountable and hospital uses their authority impose swift corrective actio...

In response to public concern over abuses in human medical experimentation, the dominant approach to the ethics of clinical research during the past 30 years has been regulation, particularly via institutional review board review and approval of scientific protocols and written consent forms. However, the effectiveness of regulatory mechanisms in ensuring the ethical conduct of clinical researc...

First of all, in this paper, the topology and operation of the three-phase three-level Z-source inverter based on neutral-point-clamped (Z-NPC) are studied. Moreover, different combinations of permissible switching states and control signals are explained for this inverter. In this paper, the topology of the three-phase three-level Z-NPC inverter is extended for an n-level state. Also, a combin...

The outbreak of HIV in the early 1980s saw widespread activism among patients and community supporters. The author, a young physician in San Francisco at the time, describes how coming of age as a clinician in the midst of this activism affected her concept of the patient-physician relationship. The insistence of a particular patient, Robert, on specifying his treatment goals illustrates that e...

BACKGROUND Patient-clinician communication is thought to be central to care outcomes, but when and how communication affects patient outcomes is not well understood. OBJECTIVE We propose a conceptual model and classification framework upon which the empirical evidence base for the impact of patient-clinician communication can be summarized and further built. DESIGN We use the proposed model...

BACKGROUND Variability in processes of care and outcomes has been reported widely in high-income settings (at geographic, hospital, physician group and individual physician levels); however, such variability and the factors driving it are rarely examined in low-income settings. METHODS Using data from a cross-sectional survey undertaken in 22 hospitals (60 case records from each hospital) acr...

Evaluating clinician satisfaction with an electronic medical record (EMR) system is an important dimension to overall acceptance and use, yet project managers often lack the time and resources to formally assess user satisfaction and solicit feedback. This article describes the methods used to assess clinician satisfaction with an EMR and identify opportunities for improving its use at a 300-ph...

CMS is investigating techniques that might help identify costly physician practice patterns. One method presently under evaluation is to compare resource use for certain episodes of care using commercially available episode grouping software. Although this software has been used by the private sector to classify insured individuals' medical claims into episodes of care, it has never been used w...

Shared decision-making (SDM) promotes family and clinician collaboration, with ultimate goals of improved health and satisfaction. This clinical report provides a basis for a systematic approach to the implementation of SDM by clinicians for children with disabilities. Often in the discussion of treatment plans, there are gaps between the child's/family's values, priorities, and understanding o...