Background. Influenza vaccination of health care workers has been recommended since 1984. Multiple strategies to enhance rates have suggested, but national remained low. Methods. BJC HealthCare is a large Midwestern organization with ∼26,000 employees. Because organizational below target levels, influenza was made condition employment for all employees in 2008. Medical or religious exemptions could be requested. Predetermined medical contraindications include hypersensitivity eggs, prior...

A gap exists between patients' desire to be told about medical errors and present practice. Little is known how physicians approach disclosure. The objective of the study was describe disclose patients.Mailed survey 2637 surgical in United States (Missouri Washington) Canada (national sample). Participants received 1 4 scenarios depicting serious that varied by specialty (medical scenarios) obvious error would patient if not disclosed (more apparent vs less apparent). Five questions measured...

Patients are often not told about harmful medical errors. The malpractice environment is considered a major determinant of physicians' willingness to disclose errors patients. Yet, little known the environment's actual effect on error disclosure attitudes and experiences.Mailed survey 2637 physicians (62.9% response rate) in United States (Missouri Washington) Canada, countries with different environments.Physicians' experiences were similar across country specialty. Of physicians, 64%...

Purpose To measure trainees' attitudes and experiences regarding medical error disclosure. Method In 2003, the authors carried out a cross-sectional survey of 629 students (320 in their second year, 309 fourth year), 226 interns (159 medicine, 67 surgery), 283 residents (211 72 total 1,138 trainees at two U.S. academic health centers. Results The response rate was 78% (889/1,138). Most (74%; 652/881) agreed that is among most serious care problems. Nearly all (99%; 875/884) errors should be...

To better understand the degree to which risk-standardized thirty-day readmission rates may be influenced by social factors, we compared results for hospitals in Missouri under two types of models. The first type model is currently used Centers Medicare and Medicaid Services public reporting condition-specific hospital patients. second an “enriched” version with census tract–level socioeconomic data, such as poverty rate, educational attainment, housing vacancy rate. We found that inclusion...

Objective To determine the occurrence and type of medical errors in an intensive care setting using a voluntary reporting method. Design Prospective, single-center, observational study. Setting The unit (19 beds) at urban teaching hospital. Patients Adult patients requiring least 48 hrs care. Interventions Prospective errors. Measurements Main Results During 6-month period, 232 events were reported involving 147 patients. A total 2598 patient days surveyed yielding 89.3 per 1000 days. source...

Preventing hospital falls and injuries requires knowledge of fall injury circumstances. Our objectives were to determine whether reported circumstances differ among hospitals identify predictors fall-related injury.Retrospective cohort study. Adverse event data on compared according characteristics. Logistic regression was used adjusted odds ratios (aORs) with 95% confidence intervals (CIs) for risk factors injury.Nine in a Midwestern healthcare system.Inpatients who fell during...

To characterize pediatricians' attitudes and experiences regarding communicating about errors with the hospital patients' families.Cross-sectional survey.St Louis, Mo, Seattle, Wash.University-affiliated community pediatricians pediatric residents.Anonymous 68-item survey (paper or Web-based) administered between July 2003 March 2004.Physician error communication.Four hundred thirty-nine attending physicians 118 residents participated (62% response rate). Most respondents had been involved...

Medical Education 2011: 45: 372–380 Objectives The disclosure of harmful errors to patients is recommended, but appears be uncommon. Understanding how trainees disclose and their practices evolve during training could help educators design programmes address this gap. This study was conducted determine would medical errors. Methods We surveyed 758 (488 students 270 residents) in internal medicine at two academic centres. Surveys depicted one error scenarios that varied by apparent the...

<h3>Objective</h3> To determine whether and how pediatricians would disclose serious medical errors to parents. <h3>Design</h3> Cross-sectional survey. <h3>Setting</h3> St Louis, Missouri, Seattle, Washington. <h3>Participants</h3> University-affiliated hospital community pediatric residents. <h3>Main Exposure</h3> Anonymous 11-item survey administered between July 1, 2003, March 31, 2004, containing 1 of 2 scenarios (less or more apparent the child's parent) in which respondent had caused a...

To increase patient safety event reporting in three intensive care units (ICUs) using a new voluntary card-based system and to compare evaluate observed differences among healthcare workers across ICUs.Prospective, single-center, interventional study.A medical ICU (19 beds), surgical (24 cardiothoracic (17 beds) at 1,371-bed urban teaching hospital.Adult patients admitted these study ICUs.Use of new, internally designed, program solicit anonymous errors concerns.During 14-month period, 714...

Background: Satisfaction with health care is one of the most widely assessed measures hospital quality, yet studies that account for clustering effects are uncommon. We constructed a multilevel model to identify predictors willingness recommend while controlling due and unit. also examined differences in by Purpose: The aim this study was factors both influence patient perceptions potentially modifiable delivering care. Methodology: Our sample includes Hospital Consumer Assessment Healthcare...

With increasing emphasis in healthcare on patient satisfaction, many satisfaction studies have been administered. Most assume that all patients combine their experiences (such as nursing care, physician etc.) the same way to arrive at satisfaction; however, no research has conducted prior present study investigate how patients' health conditions influence they experiences. This aims determine seriously ill differ from less during combining process. Data were collected five large hospitals...

Antibiotic use was examined among randomly and prospectively selected cohorts of 79 patients with a positive blood culture 88 given aminoglycosides for variety reasons. Appropriateness antibiotic judged daily each agent according to specific criteria misuse. For culture, 14.3% antibiotic-days were inappropriate in some regard, while aminoglycosides, 10.2% thought be inappropriate. The patterns misuse similar the two groups despite disparate selection criteria. unnecessary antibiotics single...

Objectives The aim of this study was to evaluate specific medications and patient characteristics as risk factors falling in the hospital. Methods This is a case-control comparing demographic, health, mobility, medication data for 228 patients who fell between June 29, 2007, November 14, at large tertiary care hospital 690 randomly selected control patients. Logistic regression used identify fall factors. Results Independent included history falls (odds ratio [OR], 2.7; 95% confidence...

A hospital's experience with an automated system for screening drug orders potential dosage problems is described. DoseChecker was developed by the hospital pharmacy department in collaboration a local university. Pharmacy, laboratory, and patient demographic data are transferred nightly from mainframe to database server; uses these user-defined rules (1) identify patients receiving any of 35 targeted medications, (2) evaluate appropriateness current dosages, (3) generate alerts potentially...

To determine the number and efficacy of respiratory isolation facilities in St. Louis hospitals to assess mechanisms place for evaluating function hospital ventilation systems.A prospective multi-hospital surveillance study using direct observation a standardized questionnaire.Seven (including university-affiliated large teaching, private community, nonteaching adult hospitals, one pediatric teaching hospital) Louis, Missouri.Actual direction airflow rooms designated was measured...