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Search results for "Department of Veterans Affairs (VA)"
Journal Article > Meeting/Conference Proceedings
Jha AK, Desroches CM, Campbell EG, et al. N Engl J Med. 2009;360:1628-1638.
Increasing the use of electronic health records (EHRs) is a major policy priority, as implementation has been slow both in the United States and in other countries. This survey of nearly 3000 US hospitals found that less than 2% had a fully functional EHR (defined as incorporating clinical documentation, laboratory and imaging results, computerized provider order entry, and clinician decision support). Survey respondents cited cost and maintenance considerations as major barriers to adopting EHRs, concerns that have been cited in prior research. Given that most outpatient practices also do not use electronic records, the authors recommend several policy initiatives to spur EHR implementation.
Journal Article > Commentary
Volpp KG, Landrigan CP. JAMA. 2008;300:1197-1199.
The Accreditation Council for Graduate Medical Education's 2003 regulations limiting housestaff duty hours have generated an expansive field of research into their impact on fatigue, workload, clinical outcomes, and patient safety. This commentary aims to put the current research into a practical context and provides eight priorities that should guide teaching institutions in their efforts to balance both physician and patient safety. The authors highlight alternative staffing models (e.g., no more 24-hour shifts), improved sign-out procedures, greater monitoring and evaluation of duty hour changes, the importance of adequate supervision and workload intensity, and better designed financial incentives to promote successful policy change. The Agency for Healthcare Research and Quality (AHRQ) has sponsored an Institute of Medicine (IOM) committee to review the important research and related issues around work hour restrictions.