Identifying medication misadventures: poor agreement among medical record, physician, nurse, and patient reports.

Study Objective: To analyze and compare four different methods of detecting medication misadventures in order to determine the optimal system for reporting clinically observed medication misadventures.

Design: Prospective cohort study.

Setting: Forty-eight-bed general internal medicine inpatient ward at a large academic teaching hospital with a decentralized pharmacy system.

Is there a July phenomenon? The effect of July admission on intensive care mortality and length of stay in teaching hospitals.

Background: It has been suggested that inexperience of new housestaff early in an academic year may worsen patient outcomes. Yet, few studies have evaluated the "July Phenomenon," and no studies have investigated its effect in intensive care patients, a group that may be particularly susceptible to deficiencies in management stemming from housestaff inexperience.

Objective: Compare hospital mortality and length of stay (LOS) in intensive care unit (ICU) admissions from July to September to admissions during other months, and compare that relationship in teaching and nonteaching hospitals, and in surgical and nonsurgical patients.