Improving and sustaining core measure performance through effective accountability of clinical microsystems in an academic medical center.

Background: Evidence-based performance measures, known as core measures, have been established by The Joint Commission to improve the quality of care for patient populations, such as those with acute myocardial infarction (AMI), heart failure, and community-acquired pneumonia (CAP), as well as to improve the quality of surgical care--the Surgical Care Improvement Project (SCIP) measures. Hospital administrators have traditionally held academic and community physicians and hospital clinicians accountable for integrating the core measures into daily practice. Such efforts have often led to suboptimal results because of the belief that the "organization" (macrosystem) is the appropriate level at which to work to improve quality.

Implementation of a two-specimen requirement for verification of ABO/Rh for blood transfusion.

Background: This study presents our implementation of a two-specimen requirement with no prior record of ABO/Rh to verify patients' blood type before transfusion.

Materials And Methods: Blood type verification was introduced, discussed, approved, and implemented over a 12-month period (May 2007 to May 2008). Potential barriers and impact on benchmark indicators were identified and tracked.

Accelerating Biopharmaceutical Development in the Decade of Health Information Technology: Applications of EHRs for outcomes research and clinical trials recruitment.

Electronic health records hold vast potential for streamlining patient recruitment for clinical trials and improving outcomes research.