There is widespread dissatisfaction with the current modes of paying for health care. Created by Prometheus Payment, evidence-informed case rates (ECRs) are designed to create fair payments for all providers delivering care to a patient for a particular condition. ECRs would combine global fees with an allowance for complications and performance incentives.The authors model ECRs for two scenari...

The study by Hincker and colleagues indicated that the perioperative use of rotational thrombelastometry (ROTEM™) could predict thromboembolic events in 90% of the cases in non-cardiac surgery. Viscoelastic tests (VETs)--ROTEM™ and thrombelastography (TEG™)--are used mainly to predict bleeding complications. Most conventional coagulation tests, like prothrombin time and activated partial thromb...

I will never forget the frigid snowy February day when I was to make the 30 min flight to Boston from the island where I live. This local airline uses nineseat twin-engine planes, the last of which came off the assembly line in the mid1980s. The ninth passenger sits in the co-pilot’s seat. The temperature was subfreezingdwhere ice formation on the wings is a safety concern because it reduces th...

Patient safety remains a major concern in the United States and worldwide. The most recent estimate from the US Department of Health and Human Services suggests that as many as 180 000 patients may die each year due to medical care–induced harm, a figure that would make it the nation’s third leading cause of death. An even higher number of patients suffer injuries due to medical care, from the ...

The shortage of registered nurses in hospitals threatens to cripple healthcare delivery in the next three to five years. The demand for nursing care has increased while the willingness of nurses to stay at the bedside in acute-care settings has decreased. The American Academy of Nursing Workforce Commission developed and tested a process called Technology Drill Down in more than 200 medical-sur...

BACKGROUND There is limited understanding of health care providers' attitudes towards HIV-infected individuals' reproductive choices, as well as knowledge about safer conception. Our study objective was to explore provider-level factors that serve as barriers and/or facilitators to the provision of reproductive and safer conception services for men and women living with HIV. METHODS Twenty-fi...

After performing procedures involving sharps, many wards in St George's Hospital have no quick and accessible 'point of care' sharps bin for their safe disposal. Instead one must transport potentially hazardous equipment away from the bedside, risking injury and exposure to persons en route. Results from a questionnaire showed that 73% felt they were indeed poorly placed, 95% felt a portable sh...