The impact of electronic health record implementation and use on performance of the Surgical Care Improvement Project measures.

Objective: To examine the impact of electronic health record (EHR) deployment on Surgical Care Improvement Project (SCIP) measures in a tertiary-care teaching hospital.

Data Sources: SCIP Core Measure dataset from the CMS Hospital Inpatient Quality Reporting Program (March 2010 to February 2012).

Study Design: One-group pre- and post-EHR logistic regression and difference-in-differences analyses.

Increasing demands for quality measurement.

Measurement of health care quality and patient safety is rapidly evolving, in response to long-term needs and more recent efforts to reform the US health system around "value." Development and choice of quality measures is now guided by a national quality strategy and priorities, with a public-private partnership, the National Quality Forum, helping determine the most worthwhile measures for evaluating and rewarding quality and safety of patient care. Yet there remain a number of challenges, including diverse purposes for quality measurement, limited availability of true clinical measures leading to frequent reliance on claims data with its flaws in determining quality, fragmentation of measurement systems with redundancy and conflicting conclusions, few high-quality comprehensive measurement systems and registries, and rapid expansion of required measures with hundreds of measures straining resources.

Implementing a Smoke-free Campus: a Medical Center initiative.

A large 2-campus Medical Center in Western New York, along with several other large area hospitals, planned for and simultaneously implemented successful "Smoke-Free Campus" initiatives in November of 2006. This coordinated initiative required that each system plan accordingly for the development and implementation of policies, training of employees, clinicians, support staff and provision of tobacco treatment services (directly or via referral). In order to efficiently and competently inform each of these aspects of a system-wide initiative, accurate information was needed on the prevalence of tobacco use among employees, staff, faculty, and clinicians in each system.

Can aviation-based team training elicit sustainable behavioral change?

Objective: To quantify effects of aviation-based crew resource management training on patient safety-related behaviors and perceived personal empowerment.

Design: Prospective study of checklist use, error self-reporting, and a 10-point safety empowerment survey after participation in a crew resource management training intervention.

Setting: Seven hundred twenty-two-bed university hospital; 247-bed affiliated community hospital.

Programmable infusion pumps in ICUs: an analysis of corresponding adverse drug events.

Background: Patients in intensive care units (ICUs) frequently experience adverse drug events involving intravenous medications (IV-ADEs), which are often preventable.

Objectives: To determine how frequently preventable IV-ADEs in ICUs match the safety features of a programmable infusion pump with safety software ("smart pump") and to suggest potential improvements in smart-pump design.

Design: Using retrospective medical-record review, we examined preventable IV-ADEs in ICUs before and after 2 hospitals replaced conventional pumps with smart pumps.

Costs of intravenous adverse drug events in academic and nonacademic intensive care units.

Background: Adverse drug events (ADEs), particularly those involving intravenous medications (IV-ADEs), are common among intensive care unit (ICU) patients and may increase hospitalization costs. Precise cost estimates have not been reported for academic ICUs, and no studies have included nonacademic ICUs.

Objectives: To estimate increases in costs and length of stay after IV-ADEs at an academic and a nonacademic hospital.

Using administrative data to improve compliance with mandatory state event reporting.

Background: The New York Patient Occurrence and Tracking System (NYPORTS) is a mandatory adverse event reporting system that was redesigned in 1998. Analysis of the first full year of its use showed large regional and hospital variation in reporting frequency not due to hospital or case mix differences. In early 2001, New York State mandated that all hospitals conduct retrospective review for unreported adverse incidents for the previous 2 years.