Physicians prescribe fewer analgesics during night shifts than day shifts.

Adequate pain management is one of the biggest challenges of the modern healthcare system. Physician perception of patient subjective pain, which is crucial to pain management, is susceptible to a host of potential biases. Here we explore the timing of physicians' work as a previously unrecognized source of systematic bias in pain management.

A framework for analyzing data from the electronic health record: verbal orders as a case in point.

Background: Investment in health care information technology is resulting in a large amount of data electronically captured during patient care. These databases offer the opportunity to implement ongoing monitoring and analysis of processes with important patient care quality and safety implications to an extent that was previously not feasible with paper-based records. Thus, there is a growing need for analytic frameworks to efficiently support both ongoing monitoring and as-needed periodic detailed analyses to explore particular issues.

A review of verbal order policies in acute care hospitals.

Background: Although verbal and telephone orders (VOs) are commonly used in the patient care process, there has been little examination of the strategies and tactics used to ensure their appropriate use or how to ensure that they are accurately communicated, correctly understood, initially documented, and subsequently transcribed into the medical record and ultimately carried out as intended. A systematic review was conducted of hospital verbal and telephone order policies in acute care settings.

Methods: A stratified random sample of hospital verbal and telephone order policy documents were abstracted from critical access, rural, rural referral, and urban hospitals located in Iowa and Missouri and from academic medical centers from across the United States.