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- Specialization of Care 1
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Cases & Commentaries
- Spotlight Case
- Web M&M
Lisa M. Bellini, MD; February 2004
Housestaff evaluate and admit a severely ill patient with lupus, suspect a viral syndrome, and do not initiate antibiotics. Despite discovery of the correct diagnosis in the morning by the attending, the patient dies.
Perspectives on Safety > Perspective
with commentary by Deborah Woodcock, MS, MBA; Robby Bergstrom, Safety of Medical Scribes, August 2019
This piece explores the role medical scribes play in health care, how to implement and evaluate a scribe program, and recommendations to reduce variations in scribe practice.
Journal Article > Study
Wong B, Kuper A, Robinson N, et al. Med Educ. 2012;46:795-806.
The effect of electronic medical records and computerized provider order entry (CPOE) on medical education is unclear. This qualitative study identified five areas in which CPOE could positively or negatively affect the educational process.
Journal Article > Review
A systematic review of the effects of resident duty hour restrictions in surgery: impact on resident wellness, training, and patient outcomes.
Ahmed N, Devitt KS, Keshet I, et al. Ann Surg. 2014;259:1041-1053.
The 2011 duty hour regulations for resident physicians were intended to improve patient safety by reducing resident fatigue. Examining the effects of duty-hours reform on surgical trainees, this systematic review concluded that there were no improvements in patient outcomes. Both perceived education and performance on certification exams have declined following reform, and more frequent handoffs have led to safety concerns. Even though some improvements in residents' quality of life were observed after the first duty-hours reform, the subsequent limitation of 16-hour shifts has not enhanced well-being. The authors express concern about current surgery residency training and urge caution prior to reforming graduate medical education further. A previous AHRQ WebM&M perspective explored the impact of duty hours on patient safety.
Journal Article > Commentary
Sanchez LT. JAMA. 2014;312:2209-2210.
This commentary spotlights concerns about physicians with disruptive behaviors and recommends strategies such as wellness committees and ongoing evaluations to identify and address them. The author underscores the importance of an established culture of safety to help clinicians develop behaviors compliant with a code of conduct as an organizational and personal responsibility.