Abstract:
OBJECTIVES:Patient safety event (PSE) reporting is a critical element for healthcare organizations that are striving for continuous quality improvement. Although resident physicians routinely provide the majority of direct patient care, the level of their participation in PSE reporting historically has been low. In addition, as part of the Accreditation Council for Graduate Medical Education's Next Accreditation System, the Clinical Learning Environment Review site visit assesses residents' engagement in PSE reporting at each accredited academic institution. The objective of this study was to understand the common barriers to PSE reporting and design an intervention to increase the number of PSE reports by resident physicians. METHODS:We surveyed 304 residents and fellows to assess attitudes toward the PSE reporting system and identify barriers to submitting online PSE reports. Based on this analysis of barriers, we piloted interventions with the internal medicine residency program and measured their effect on resident PSE reporting. RESULTS:Of the survey respondents, 58% had never submitted a PSE report. The most commonly identified barriers were too much time required to submit a report (38% of all respondents), lack of education on how or what to report (37%), lack of feedback or change after reporting (19%), and concern for repercussions or lack of anonymity (13%). Based on this analysis of barriers, we piloted interventions with the internal medicine residency program to educate residents about PSE reporting through a reminder message in their orientation e-mail, informational slides at the end of conferences that described what and how to report, a pocket card with reporting instructions, and leadership encouragement during walk rounds by chief medical residents and the program director. Compared with the 10 weeks before the start of the intervention, the number of PSE reports submitted by internal medicine residents more than doubled, from 16 to 37 reports (P < 0.01). This increase in resident PSE reporting was sustained for 20 weeks despite the interventions lasting only 8 weeks. CONCLUSIONS:A resident-driven intervention that fostered a culture of encouragement for PSE reporting through leadership support and targeted education increased the number of PSE reports submitted by internal medicine residents at our health system. Hospitals and health systems should seek to understand the common barriers to PSE reporting from this important group of direct patient care providers and administer structured educational programs to encourage their participation.
journal_name
South Med Jjournal_title
Southern medical journalauthors
Stewart DA,Junn J,Adams MA,Spencer-Segal JL,Perdoncin E,Lopez K,Kim CSdoi
10.14423/SMJ.0000000000000486subject
Has Abstractpub_date
2016-07-01 00:00:00pages
395-400issue
7eissn
0038-4348issn
1541-8243pii
SMJ50218journal_volume
109pub_type
杂志文章abstract::Diabetic ketoacidosis can be effectively and economically treated by using low-dose intravenous insulin and 2 to 3 liters of isotonic saline at 500 ml/hr to replace extracellular fluids, followed by 2 to 4 L of 5% glucose in 0.45% saline with potassium chloride and/or potassium phosphate to replace intracellular fluid...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198707000-00017
更新日期:1987-07-01 00:00:00
abstract::A technic incorporating the simultaneous elevation of multiple adjacent thoracoabdominal pedicale flaps, based in opposite directions, has been successfully used on four patients with extensive degloving injuries of the hand. In all cases, the hand was later divided into individual digits. A five-year follow-up of thr...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197803000-00024
更新日期:1978-03-01 00:00:00
abstract::With ever-increasing costs confronting health care facilities, much attention is being focused on various cost-containment projects. Although it is generally assumed that a radiology department quality control program will increase costs, institutional savings may also result. A comprehensive quality control program i...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198002000-00020
更新日期:1980-02-01 00:00:00
abstract::A patient with thioridazine-hydrochloride-associated agranulocytosis is described and eight previously reported cases are reviewed. This complication is most likely due to a direct toxic effect on the bone marrow. As in our case, markers for an immunologically mediated mechanism have not been found. Thioridazine-hydro...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197701000-00051
更新日期:1977-01-01 00:00:00
abstract:OBJECTIVE:To determine the association of utilization of health maintenance tables (HMTs) as a provider reminder tool within the electronic medical record with the completion of women's preventive health services. METHODS:Guidelines from the US Preventive Services Task Force and the Advisory Committee on Immunization ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000001160
更新日期:2020-10-01 00:00:00
abstract::We report the case of an 18-year old man with hemolytic-uremic syndrome (HUS) having a classic clinical presentation and diagnostic renal pathology without evidence of microangiopathic hemolytic anemia (MAHA) by peripheral blood smear. Indirect evidence of hemolysis was suggested by mild anemia, elevation of serum lac...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199603000-00018
更新日期:1996-03-01 00:00:00
abstract::We have described a patient with small cell cancer of the lung manifested as the Eaton-Lambert syndrome. Primary therapy proved effective in reversing the syndrome, whereas anticholinesterase agents did not. This case illustrates the value of primary therapy for the tumor-produced syndrome and the need to avoid losing...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198502000-00020
更新日期:1985-02-01 00:00:00
abstract::Disorders of the foregut are an increasingly common cause of symptoms in Western populations. This review summarizes recent advances in the understanding and treatment of gastroesophageal reflux disease, dyspepsia and celiac disease. ...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/01.smj.0000242808.91797.3d
更新日期:2007-03-01 00:00:00
abstract::An example of a blind-ending branch of a bifid ureter in a woman presenting with a urinary tract infection is reported. Definition, diagnosis, and treatment of this anomaly are discussed. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197907000-00031
更新日期:1979-07-01 00:00:00
abstract:BACKGROUND:Nontubercular mycobacteria (NTM) are increasingly recognized to cause lung disease in immunocompetent patients. We studied the occurrence of pulmonary infection due to NTM in immunocompetent men. METHODS:We retrospectively analyzed all sputum mycobacterial cultures at our institution over a 5-year period. C...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:2001-07-01 00:00:00
abstract::Most of the surgical procedures proposed for the treatment of fecal incontinence associated with prolapse are associated with considerable morbidity and mortality. We used a modified Thiersch procedure with a Silastic mesh implant (Dow-Corning 501-3) on a series of 12 patients over a period of 2 1/2 years. Nine patien...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198603000-00012
更新日期:1986-03-01 00:00:00
abstract::We report four cases of group A streptococcal vulvovaginitis in prepubertal children. All cases were acute in onset. This illness presents with nonspecific signs and symptoms of labial inflammation. In a suburban community, streptococcal vulvovaginitis in prepubescent girls may be more common then genital infections d...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198204000-00017
更新日期:1982-04-01 00:00:00
abstract::Sarcoidosis rarely involves the genitourinary system or the spinal cord. This report describes a case of sarcoidosis with a scrotal mass, a mass compressing the spinal cord, and lesions in the liver and spleen. This case illustrates an uncommon manifestation of sarcoidosis, which may mimic disseminated testicular canc...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/01.SMJ.0000163306.54629.35
更新日期:2005-09-01 00:00:00
abstract::In three patients with SIADH, mannitol or glycerol promoted a rapid free water diuresis. Use of osmotic agents requires less laboratory and clinical monitoring than use of furosemide, is appropriate treatment, and in fact may be the treatment of choice in some patients with symptomatic hyponatremia from SIADH. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198503000-00028
更新日期:1985-03-01 00:00:00
abstract::This descriptive study prospectively examined the performance and supervision of interpretive and procedural skills during an internal medicine clerkship. Students (N = 150) documented having done 7 required and 12 elective skills. Preceptors of required skills were interns (44%), residents (29%), attending physicians...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199606000-00009
更新日期:1996-06-01 00:00:00
abstract::Perioperative consultations may play a major role in the care of surgical patients in an era of prospective payments. Since insurance reimbursement policy favors limitations in the number of consultants on a case, general medicine ("holistic") consultation services may become preferred perioperative consultants in the...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198903000-00004
更新日期:1989-03-01 00:00:00
abstract::Squamous cell carcinoma of the cervix is a common malignancy, but like other genital malignancies, it rarely metastasizes to the heart, even in advanced stages. This case illustrates several points, including the presentation of a cardiac metastasis mimicking ischemic cardiac disease on electrocardiogram. The diagnosi...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/00007611-199302000-00019
更新日期:1993-02-01 00:00:00
abstract:OBJECTIVES:To evaluate the statewide experience in mode of delivery for pregnancies complicated by stillbirth by annual delivery volume and presence of graduate medical education programs. METHODS:This is a descriptive study of all stillbirths without known congenital anomalies or aneuploidy born in our state from Jul...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000001180
更新日期:2020-12-01 00:00:00
abstract::An elderly man with previous tuberculosis exsanguinated from esophageal rupture of an atherosclerotic thoracic aneurysm. Because the patient refused angiography, the source of bleeding was discovered only at autopsy. Selected clinical and pathologic aspects of the case are discussed in relation to the different causes...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197907000-00042
更新日期:1979-07-01 00:00:00
abstract::This is a systematic review of the available literature and our own personal experience regarding the optimal management of the rhinoplasty patient. The routine utilization of nasal splinting, casting and perioperative antibiotics is supported. The management of a number of common early complications is also discussed...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/SMJ.0b013e3181807a79
更新日期:2008-09-01 00:00:00
abstract::The term "top of the basilar" has been used in reference to a group of signs and symptoms of midbrain, diencephalic, and posteroinferior hemispheric dysfunction. It has been attributed to ischemia in the territory of second- and third-order vessels that arise from the uppermost portion of the basilar artery. We report...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198807000-00009
更新日期:1988-07-01 00:00:00
abstract:BACKGROUND:Echocardiographic demonstration of valvular infection now ranks with positive blood cultures as one of the two major clinical criteria for diagnosis of infective endocarditis (IE), according to new, more accurate guidelines for diagnosis. Because early detection of IE and its complications is essential for d...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:
更新日期:1999-08-01 00:00:00
abstract::We have described a patient with unilateral adrenal hyperplasia, a rare cause of primary aldosteronism, and reviewed the literature on this subject. The treatment of this disorder appears to be surgical. Whether its pathogenesis is related to the more common varieties of primary aldosteronism is open to speculation. ...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/00007611-198901000-00021
更新日期:1989-01-01 00:00:00
abstract:OBJECTIVES:Studies have shown that the overutilization of laboratory tests ("labs") for hospitalized patients is common and can cause adverse health outcomes. Our objective was to compare the ordering tendencies for routine complete blood counts (CBC) and chemistry panels by internal medicine residents and hospitalists...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000000592
更新日期:2017-01-01 00:00:00
abstract::We studied 56 patients with primary gastrointestinal lymphoma to determine the manifestations, diagnostic and treatment methods, and patient outcomes. We identified 27 cases of primary gastric lymphoma and 29 cases of lymphoma involving the remainder of the gastrointestinal tract. Initial symptoms were nonspecific and...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198508000-00004
更新日期:1985-08-01 00:00:00
abstract::Acute calcareous deposits of the hand and wrist have been infrequently reported. A review of the literature and five recent cases indicate that these painful lesions will respond rapidly to immobilization and medication. Differentiation from infection is important. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198002000-00009
更新日期:1980-02-01 00:00:00
abstract::We have reported a case of Meige's syndrome in a middle-aged man who eventually had a cerebellar degeneration syndrome. The extrapyramidal symptoms preceded cerebellar signs and symptoms by 5 years. Most patients with idiopathic Meige's syndrome show some improvement with high-dose anticholinergic therapy. Our patient...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199103000-00019
更新日期:1991-03-01 00:00:00
abstract::A survey of death certificates of victims with laryngeal cancer in Oklahoma for the period 1950 to 1970 attempts to corroborate findings of the current literature. Sex-race specific death rates per 100,000 for white, nonwhite, and American Indian populaces displayed a distinct sex and racial pattern: respectively, 38....
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197607000-00033
更新日期:1976-07-01 00:00:00
abstract::Solitary abscesses of the spleen may occur as a consequence of septicemia from various septic foci, particularly intra-abdominal sites. A variety of causative organisms, including the clostridia, have been isolated. We have described a patient with multiple myeloma who had a solitary splenic abscess due to Clostridium...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198710000-00029
更新日期:1987-10-01 00:00:00
abstract::We have discussed the pathology of the diverse, numerous neoplasms associated with the central and peripheral types of von Recklinghausen's disease, as exemplified by two case reports. While overlap can occur between these two major types, characteristically this does not occur. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198008000-00036
更新日期:1980-08-01 00:00:00