Case Outcomes in a Communication-and-Resolution Program in New York Hospitals.

Objective: To determine case outcomes in a communication-and-resolution program (CRP) implemented to respond to adverse events in general surgery.

Study Setting: Five acute-care hospitals in New York City.

Study Design: Following CRP implementation, hospitals recorded information about each CRP event for 22 months.

Implementing hospital-based communication-and-resolution programs: lessons learned in New York City.

In 2010 five New York City hospitals implemented a communication-and-resolution program (CRP) in general surgery. The program's goals were to improve reporting of serious adverse events to risk management, support clinical staff in discussing these events with patients, rapidly investigate why injuries occurred, communicate to patients what was discovered, and offer apologies and compensation when the standard of care was not met. We report the hospitals' experiences with implementing the CRP over a twenty-two-month period.

How policy makers can smooth the way for communication-and- resolution programs.

Communication-and-resolution programs (CRPs) in health care organizations seek to identify medical injuries promptly; ensure that they are disclosed to patients compassionately; pursue timely resolution through patient engagement, explanation, and, where appropriate, apology and compensation; and use lessons learned to improve patient safety. CRPs have existed for years, but they are being tested in new settings and primed for broad implementation through grants from the Agency for Healthcare Research and Quality. These projects do not require changing laws.

Demographic patterns of a widespread long-lived tree are associated with rainfall and disturbances along rainfall gradients in SE Australia.

Predicting species distributions with changing climate has often relied on climatic variables, but increasingly there is recognition that disturbance regimes should also be included in distribution models. We examined how changes in rainfall and disturbances along climatic gradients determined demographic patterns in a widespread and long-lived tree species, Callitris glaucophylla in SE Australia. We examined recruitment since 1950 in relation to annual (200-600 mm) and seasonal (summer, uniform, winter) rainfall gradients, edaphic factors (topography), and disturbance regimes (vertebrate grazing [tenure and species], fire).