Medical errors--is total quality management for the battlefield desirable?

There has recently been a great deal of discussion in both the lay press as well as the medical press regarding the incidence of errors that occur during medical practice. There have been many discussions of how quality control measures from industry can be applied to the health care system. Indeed both civilian and "brick and mortar" military medical treatment facilities are adapting these techniques.

The dynamics and ethics of triage: rationing care in hard times.

Triage of medical care, whether necessary because of routine daily limitations or forced by exceptional circumstances, such as for soldiers injured in combat or civilians in mass casualty situations, is increasingly coming under scrutiny. The decisions that limit access to fundamental and even life-or-death treatments are fraught with controversy. These decisions are difficult for the medical provider to make and are even more difficult for the patient to understand.

Differences in length of stay between coronary bypass and valve procedures.

Objective: Emphasis on cost reduction, national standardization of medical care, and quality improvement initiatives have led to reduced postoperative hospital stays after cardiac surgery. The present study was designed to verify the observation that valve patients have longer lengths of stay than bypass patients and to identify possible reasons.

Methods: The inpatient records of 26 consecutive patients who underwent valve procedures at our institution were reviewed and compared with the records of 25 consecutive coronary bypass patients.