Quality Health Care, Patient Safety, & Best Practices

Addresses the development of health policy and the integrity of the healthcare delivery system. Emphasizes patient-oriented health care, evidence-based medical practice, the collective and individual safety of patients, and the best practices to achieve excellence in health care.

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SMJ Article | Original Article

Association of the All-Patient Refined Diagnosis-Related Groups Severity of Illness and Risk of Mortality Classification with Outcomes

Objectives: Diagnosis-related groups (DRGs) is a patient classification system used to characterize the types of patients that the hospital manages and to compare the resources needed during hospitalization. The DRG classification is based on International Classification of Diseases diagnoses, procedures, demographics, discharge status, and complications or comorbidities and compares hospital...

SMJ Article | Perspectives

Could Clinician Sensitivity to Cultural and Historical Considerations Help Reduce COVID-19 Deaths among Blacks?

During the course of the coronavirus disease 2019 (COVID-19) pandemic, many magazines and newspapers have published articles reflecting on lessons learned during the crisis. One of the most sobering lessons that data on the pandemic have highlighted is the fractured state of health equity in the United States. The staggering...

Posted in: Infectious Disease120

SMJ Article | Multidisciplinary Clinical Case Study

Early Impacts of the COVID-19 Pandemic on Telehealth Patterns in Primary Care, Mental Health, and Specialty Care Facilities in Texas

Objectives: Since the onset of the coronavirus disease 2019 (COVID-19) pandemic, many US clinics have shifted some or all of their practice from in-person to virtual visits. In this study, we assessed the use of telehealth among primary care and specialty clinics, by targeting healthcare administrators via multiple channels. Methods:...

Posted in: Infectious Disease120

SMJ Article | Original Article

CME Article: Improving the Quality of Inpatient Discharge Instructions: An Evaluation and Implementation of Best Practices

Objectives: Little is known about whether improving the quality of written discharge instructions can result in improved readmission rates and whether there are differences in the quality of discharge instructions based on provider and patient characteristics. We set out to determine provider characteristics associated with high quality discharge instructions and...

SMJ Article | Original Article

HIT-It or Quit It: Heparin-Induced Thrombocytopenia Testing Appropriateness Using 4T Scoring and Inappropriate Testing Cost Analysis

Objectives: The American Society of Hematology’s 4T scoring system is a validated tool to assess a patient’s probability of having heparin-induced thrombocytopenia (HIT) before testing is performed. There is no benefit to testing patients with a low probability 4T score for HIT. This study aimed to assess for inappropriate HIT...

Posted in: Hematology10

SMJ Article | Original Article

Transgender-Competent Health Care: Lessons from the Community

Objectives: Transgender (trans) individuals experience high discrimination levels when accessing medical and mental health care, resulting in poorer health outcomes compared with the general population and other minority populations. A community-based research design was used to elicit direct input from the trans community about critical trans-knowledgeable care components to address...

SMJ Article | Perspectives

Implementing a Second-Level Observation Unit at a Large Academic Medical Center

The two-midnight rule, 30-day readmission penalties, and denials related to short-stay hospitalizations have led to the creation of alternative healthcare delivery models.

SMJ Article | Original Article

Discharge Summary Completion Timeliness and the Association of 30-Day Readmission

Objective: This study aimed to review the association between timeliness to completion of a discharge summary to 30-day readmission to the hospital. Methods: This was a retrospective chart review of 109 patients discharged from Mayo Clinic Hospital. Results: Twenty-four of these patients were readmitted within 30 days. The time to...

SMJ Article | Review Article

Bedside Manner 2020: An Inventory of Best Practices

Abstract: Bedside manner, a doctor’s deportment with a patient, encompasses all aspects of the patient interaction, including all verbal and nonverbal communication strategies. Bedside manner can be a powerful adjunct for healing. In academic medical centers, trainees generally learn bedside manner by observing their attendings and mentors—in other words, as...

SMJ Article | Letter to the Editor

Discharge against Medical Advice

To the Editor: Discharge against medical advice (AMA) is a process by which a patient chooses to leave the hospital before a physician’s recommended discharge. Leaving AMA may expose a patient to the risk of an inadequately treated medical problem and possible readmission. Patients discharged AMA are at elevated risk...

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