June 2015, Volume 108 - Issue 6

Improving Healthcare Quality in the United States: A New Approach

Kathryn A. Nix, BS, John S. O’Shea, MD, MPA

Abstract: 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...

(pp 359-363)

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

Kam A. Newman, MD

Abstract: 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...

(pp 318-319)

Coping Strategies Used by Adult Patients with Inflammatory Bowel Disease

Nimisha K. Parekh, MD, MPH, Kristin McMaster, MSW, Douglas L. Nguyen, MD, Shamita Shah, MD, Alissa Speziale, MD, Jocelyne Miller, MD, Gil Melmed, MD

Abstract: 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...

(pp 337-342)

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

Michelle Zeller, MD, MHPE, Sayra Cristancho,PhD, Joy Mangel, MD, Mark Goldszmidt, MD, MHPE

Abstract: 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...

(pp 310-317)

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

Marília Berlofa Visacri, MS, Graziele Baldan Ferrari , Pâmela Dias, BS, Rafaela Pimentel MS, Cinthia Madeira de Souza, BS, Anna Paula Lourenço Costa , Eder de Carvalho Pincinato, MS, Carmen Silvia Passos Lima, MD, PhD, Priscila Gava Mazzola, PhD, Patricia Moriel, PhD

Abstract: 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...

(pp 343-349)

Incorporating Patient Satisfaction Metrics in Assessing Multidisciplinary Breast Cancer Care Quality

Jennifer L. Harper, MD, Anna-Maria A. De Costa, MD, PhD, Elizabeth Garrett-Mayer, PhD, Katherine R. Sterba, PhD

Abstract: 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...

(pp 372-376)

Commentary on the Special Quality and Safety in Health Care Issue

Mark S. Williams, MD, MBA, JD

Abstract: 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...

(pp 306-307)

Commentary on Quality and Patient Safety

Ajoy Kumar, MD

Abstract: 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...

(pp 308-309)

Inverted Pyramid of Inpatient Consultation in the Academic Hospital

C. Matthew Stewart, MD, MPH

Abstract: 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...

(pp 370-371)

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

Neal Lyons, PharmD, Shannon Rankin, PharmD, Preeyaporn Sarangarm, PharmD, Charles Washington, MD, Steven J. Weiss, MD, Amy A. Ernst, MD

Abstract: 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...

(pp 332-336)

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

E. Allen Liles, MD, Carlton R. Moore, MD, MS, Jacob Stein, MPH

Abstract: 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,...

(pp 354-358)

Practical Strategies to Improve Patient Adherence to Treatment Regimens

Imran Aslam, MD, Steven R. Feldman, MD, PhD

Abstract: 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...

(pp 325-331)

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

Sherine Salib, MD, MRCP, Elizabeth M. Glowacki, MA, Lindsay A. Chilek, MS, Michael Mackert, PhD

Abstract: 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...

(pp 320-324)

Clinical Excellence in HIV Care

Michael Fingerhood, MD

Abstract: 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,...

(pp 350-353)

Influence of Back Pain on Patient Satisfaction Scores

Eric D. Shirley, MD, Ahmed S. Mohamed, MD, Kevin Neal, MD

Abstract: 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...

(pp 377-380)

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

G. Richard Holt, MD, MSE, MPH, MABE, DBioethics

Abstract: 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...

(pp 305)

Cost and Utilization: Hospitalized Patients on a Family Medicine Service

Maribeth Porter, MDMS, Vanessa A. Diaz, MD, MS, Jennifer K. Gavin, BS, Ashleigh Zacarias, MD, Lori Dickerson, PharmD, William J. Hueston, MD, Peter J. Carek, MD, MS

Abstract: 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...

(pp 364-369)