Influence of Back Pain on Patient Satisfaction Scores

Objectives: Patient satisfaction scores are increasing in importance. Although the influence of selected patient and physician characteristics on satisfaction scores has been identified, the impact of different pediatric diagnoses is unknown. The purpose of this study was to compare patient satisfaction scores in visits for mechanical back pain with visits for clubfoot or scoliosis. Methods: A retrospective analysis of patient satisfaction...

Special Issue on Quality Health Care, Patient Safety, and Best Practices

The editorial staff of the Southern Medical Journal is pleased to present this special issue on quality care and patient safety to the readership of the Journal. During the past decade, important issues in clinical medicine have received renewed emphasis in American health care, including evidence-based medicine, quality-of-life issues, patient safety and preventive safety nets, defining and assessing the quality of health care, patient...

Improving Healthcare Quality in the United States: A New Approach

Improving the quality of health care has been a focus of health reformers during the last 2 decades, yet meaningful and sustainable quality improvement has remained elusive in many ways. Although a number of individual institutions have made great strides toward more effective and efficient care, progress has not gone far enough on a national scale. Barriers to quality of care lie in fundamental, systemwide factors that impede large-scale...

Cost and Utilization: Hospitalized Patients on a Family Medicine Service

Objectives: The cost of hospitalizations contributes to the rising expense of medical care in the United States. Providing health insurance to uninsured Americans is a strategy to reduce these costs, but only if costs for uninsured patients are disproportionately high. This study examined hospitalization use patterns for uninsured patients compared with those with Medicaid and commercial insurance. Methods: We performed a retrospective chart...

Commentary on “Back to Anatomy: Improving Landmarking Accuracy of Clinical Procedures Using a Novel Approach to Procedural Teaching”

The importance of human gross anatomy as part of the core curriculum of medical school cannot be overstated. The knowledge of human anatomy and its clinical application has fundamental effects on all branches of medicine, and obviously there is a need for an advanced learning modality to provide adequate anatomical knowledge. The article by Zeller and colleagues in this issue of the Southern Medical Journal outlines the challenges of achieving...

Coping Strategies Used by Adult Patients with Inflammatory Bowel Disease

Objectives: Symptoms of and treatments for inflammatory bowel disease (IBD) have a significant impact on patients’ quality of life (QOL) and result in an increased prevalence of depression and anxiety disorders. Little is known about the type of coping strategies used by adult patients with IBD to better cope with their chronic illness, however. The objectives of this study were to identify the types of coping styles and their impact on the...

Back to Anatomy: Improving Landmarking Accuracy of Clinical Procedures Using a Novel Approach to Procedural Teaching

Objectives: Many believe that knowledge of anatomy is essential for performing clinical procedures; however, unlike their surgical counterparts, internal medicine (IM) programs rarely incorporate anatomy review into procedural teaching. This study tested the hypothesis that an educational intervention focused on teaching relevant surface and underlying anatomy would result in improved bone marrow procedure landmarking accuracy. Methods: This...

Quality of Life of Patients with Squamous Cell Carcinoma of the Head and Neck Receiving High-Dose Cisplatin Chemotherapy and Radiotherapy

Objectives: The aim of this study was to evaluate the quality of life (QOL) of patients with squamous cell carcinoma of the head and neck before and during treatment with high-dose cisplatin and radiotherapy. Methods: This was an observational and longitudinal prospective study conducted from June 2011 to March 2013 at the clinical oncology ambulatory unit of a public teaching hospital in São Paulo, Brazil. The University of Washington...

Incorporating Patient Satisfaction Metrics in Assessing Multidisciplinary Breast Cancer Care Quality

Objectives: The Medical University of South Carolina implemented a patient-centered multidisciplinary breast clinic program (MDBC) in August 2012. In this study, patient satisfaction with the MDBC care delivery model and communication with healthcare providers was examined to inform the refinement of the MDBC program. Methods: During the first 10 months of the MDBC, patients were asked to complete a 14-question postconsultation telephone...

Commentary on the Special Quality and Safety in Health Care Issue

This issue of the Southern Medical Journal (SMJ) is a special one. Dedicated to the topics of healthcare quality and safety, the contributions reflect the diverse and significant initiatives that are under way to improve patient care, reduce the incidence of harm, and address the larger challenges of the US healthcare...

Commentary on Quality and Patient Safety

It is well documented that when compared with 11 industrialized countries in quality of, access to, efficiency of, and equity in health care, and healthy lifestyles, the United States ranks last, despite the cost expenditure per year as a percentage of the gross domestic product.1 Furthermore, the Institute of Medicine’s landmark publication To Err is Human showed that the US healthcare system also is quite unsafe.2 Numerous healthcare policy,...

Inverted Pyramid of Inpatient Consultation in the Academic Hospital

A common scenario in inpatient medicine is an admitting team asking another medical team for advice: the inpatient consultation. For many faculty, the next steps are a mystery managed by residents because in the academic hospital, both the initial consultation requisition and the response often are initiated by residents. In any given hospital the mechanisms to find out who is on call for a particular question and how to contact that person is...

Disparity in Patients’ Self-Reported and Charted Medication Allergy Information

Objectives: The objective of this study was to compare current adverse drug/allergy reaction reporting in patient electronic medical records/charts against information gathered during patient interviews in the emergency department. Our hypothesis was that current methods for allergy reporting results in significant discrepancy between what is documented and the actual allergy history upon interviewing the patient. Methods: The study was...

Feedback on Bounce Backs: Real-Time Notification of Readmissions and the Impact on Readmission Rates and Physician Perceptions

Objectives: Readmissions are an increasing area of focus for quality improvement initiatives. Widely variable estimates exist on preventability and impact of multipronged readmission interventions. Given the rotating nature of attending physicians in academic centers, physicians often are unaware of readmissions. We present a before-and-after (uncontrolled) trial evaluating timely feedback of readmissions to hospitalist physicians. Methods: A...

Practical Strategies to Improve Patient Adherence to Treatment Regimens

Adherence is “the extent to which a patient acts in accordance with the prescribed interval, and dose of a dosing regimen.”1 Poor adherence is ubiquitous in medicine, and its ramifications are far from trivial. Nonadherence costs the United States a staggering $300 billion in the form of emergency department use, hospitalizations, and diagnostic tests.2 Nearly 50% of patients with chronic diseases do not take their medications regularly.3...

Developing a Communication Curriculum and Workshop for an Internal Medicine Residency Program

Objectives: Learning effective communication is essential for physicians. Effective communication has been shown to affect healthcare outcomes, including patient safety, adherence rates, patient satisfaction, and enhanced teamwork. The importance of these skills has become even more apparent in recent years, with value-based purchasing programs and federal measures of patient satisfaction in the form of Hospital Consumer Assessment of Healthcare...

Clinical Excellence in HIV Care

Clinical excellence in medicine is multifaceted and difficult to define. It requires an extraordinary commitment to patient care, which, it is hoped, translates into improved patient outcomes.1 In academic medicine, clinical excellence often becomes undervalued and assumed, with an emphasis on excellence in research and teaching.2-4 Based on interviews with 24 ‘‘clinically excellent’’ academic physicians, Christmas et al reported seven...