Making Comfort Count: Using Quality Improvement to Promote Pediatric Procedural Pain Management.

Background And Objectives: Pediatric procedural pain management (PPPM) is best practice but was inconsistent in our large multisite general academic medical center. We hypothesized that quality improvement (QI) methods would improve and standardize PPPM in our health system within inpatient pediatric units. We aimed to increase topical anesthetic use from 10% to 40%, improve nursing pediatric pain knowledge, and increase parent satisfaction around procedures for children admitted to a general tertiary academic medical center.

Identification of patients with arthritis and arthritis-related functional limitation using administrative data.

Objective: To develop algorithms on the basis of administrative data to identify patients with arthritis and arthritis-related functional limitation (AFL).

Study Design And Setting: In this retrospective study, 361 enrollees of a health plan underwent a clinical examination to confirm arthritis and assessment of functional limitation on the basis of responses to the health assessment questionnaire. Administrative data were obtained on these subjects and included arthritis drugs dispensed, as well as outpatient and emergency department diagnoses and procedures (including radiographic studies, arthritis procedures, and laboratory tests).

Polypharmacy with oral antidiabetic agents: an indicator of poor glycemic control.

Objective: To evaluate antidiabetic drug treatment patterns and glycemic control among patients diagnosed with type 2 diabetes mellitus.

Study Design: Retrospective study using the automated databases of a 200 000-member HMO.

Methods: The study population consisted of patients > or =18 years of age with documented type 2 diabetes mellitus from January 1, 2002, through December 31, 2002.

The costs associated with adverse drug events among older adults in the ambulatory setting.

Background: Reducing the rate of adverse drug events in the ambulatory setting may require large investments in quality improvement efforts and technologic innovations. Little evidence is available on the potential resulting savings.

Objective: The objective of this study was to estimate the costs associated with adverse drug events among older adults in the ambulatory setting.