Impact of daylight savings time on spontaneous pregnancy loss in in vitro fertilization patients.

Transition into daylight savings time (DST) has studied negative impacts on health, but little is known regarding impact on fertility. This retrospective cohort study evaluates DST impact on pregnancy and pregnancy loss rates in 1,654 autologous in vitro fertilization cycles (2009 to 2012). Study groups were identified based on the relationship of DST to embryo transfer.

Elucidating Reasons for Resident Underutilization of Electronic Adverse Event Reporting.

Reasons for resident underutilization of adverse event (AE) reporting systems are unclear, particularly given frequent resident exposure to AEs and near misses (NMs). Residents at an academic medical center were surveyed about AEs/NMs, barriers to reporting, patient safety climate, and educational interventions. A total of 350 of 527 eligible residents (66%) completed the survey; 77% of respondents reported involvement in an AE/NM, though only 43% had used the reporting system.

Finding the best examples of healthcare quality improvement in Sub-Saharan Africa.

Background: The purpose of this study was to summarise the current state of healthcare quality improvement literature focusing on sub-Saharan Africa.

Methods: Conventional methods of searching the literature were quickly found to be inadequate or inappropriate, given the different needs of practitioners in sub-Saharan Africa, and the inaccessibility of the literature.

Results: The group derived a core list of what were deemed exemplary quality improvement articles, based on consensus and a search into the "grey" literature of quality improvement.

Care fragmentation and emergency department use among complex patients with diabetes.

Objective: To evaluate the association between patterns of fragmented care and emergency department (ED) use among adult patients with diabetes and chronic kidney disease.

Study Design: Observational study in an open healthcare system.

Methods: The study sample included patients with diabetes and chronic kidney disease (mean estimated glomerular filtration rate, 20-60 mL/min) and with an established primary care provider.

Access to and utilization of healthcare: the provider's role.

Access to and utilization of healthcare are distinct, yet related, concepts that serve as a focus for health policy and quality improvement. This article identifies their similarities and differences, calling on previous research and reviews to elaborate on a current understanding of factors that influence both, with a particular focus on those related to the healthcare provider. Access describes an individual's ability to position oneself to receive healthcare services.