Influence of house-staff experience on teaching-hospital mortality: The “July Phenomenon” revisited

2011 ◽  
Vol 6 (7) ◽  
pp. 389-394 ◽  
Author(s):  
Carl van Walraven ◽  
Alison Jennings ◽  
Jenna Wong ◽  
Alan J. Forster
Keyword(s):  
Hospital Mortality ◽  
Teaching Hospital ◽  
House Staff ◽  
July Phenomenon

Dr. Bergman Replies

PEDIATRICS ◽  
1977 ◽  
Vol 59 (5) ◽  
pp. 791-791
Author(s):  
Abraham B. Bergman
Keyword(s):  
Medical Care ◽  
Teaching Hospital ◽  
House Staff ◽  
Improve Quality ◽  
Frequent Type ◽  
Quality Of Medical Care ◽  
Attending Physicians

I couldn't agree more that various methods designed to assess the quality of medical care should be subjected to scientific scrutiny. My point was that hospitals and physicians have been propelled into an orgy of frenetic, expensive busywork without evidence that these activities will indeed improve quality or even save money. The most frequent type of audit in our (teaching) hospital is house staff and attending physicians asking each other several hundred times a day, "why did you do this?"

scholarly journals A Study of Clinical Profile and Complications In Patients with ST-Elevation Myocardial Infarction Attending In College of Medical Sciences Teaching Hospital, Bharatpur (Chitwan), Nepal.

2021 ◽  
Vol 18 (1) ◽  
pp. 33-37
Author(s):  
Pradeep Thapa ◽  
Prakash Aryal ◽  
Rajani Baniya
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Chest Pain ◽  
Hospital Mortality ◽  
Teaching Hospital ◽  
Clinical Profile ◽  
St Elevation Myocardial Infarction ◽  
Medical Sciences ◽  
Acute Stemi ◽  
St Elevation

Background and Aims: ST-Elevation Myocardial Infarction (STEMI) is a leading cause of morbidity and mortality. This study aims to summarize the clinical profile and complications of patients with STEMI in a teaching hospital. Methods: This was a prospective hospital based descriptive and observational study conducted at College of Medical Sciences Teaching Hospital (CoMSTH), Bharatpur from January 2017 to July 2018 in 110 patients with a diagnosis of acute STEMI. Results: Out of 110 patients the mean age of presentation was 59.31 years and 64.5% were male. Typical chest pain (90%) was the most common presenting symptom and 45.5% patients presented within six hours of chest pain. Most common traditional risk factors were hypertension and smoking which were present in 44 (40%) cases, followed by diabetes in 33 (30%), dyslipidemia in 22 (20%). Majority of patients (49.1%) were in killips class I, and only 9 (8.2%) patients were in cardiogenic shock (killips class IV). Inferior wall was the most common in 30% patients followed by anteroseptal wall MI (23.6%), anterior wall MI (11.8%) and combined (anterior and inferior) in 10%. Revascularization with primary Percutaneous Coronary Intervention (PCI) was done in 46 (41.8%) patients, thrombolysis was done in 41 (37.3%) patients. Arrhythmias (39.1%) followed by heart failure (24.5%) were the common complications. The overall in-hospital mortality was 16 (14.5%). Conclusions: Patients with acute STEMI at College of Medical Sciences Teaching Hospital (CoMSTH) were predominantly male with hypertension and smoking as the commonest risk factors. Arrhythmias were the most common complications and in-hospital mortality rate was 14.5%.

Initiation of Sepsis Alert Protocol at a Community Teaching Hospital: Its Effect on Hospital Mortality of Septic Patients and Diurnal Differences in Adherence to the Protocol

CHEST Journal ◽  
2010 ◽  
Vol 138 (4) ◽  
pp. 389A
Author(s):  
Nutan Bhaskar ◽  
Rajesh Patel ◽  
Divya Ramaraju ◽  
Latha Achanta ◽  
Richard Eisenstaedt
Keyword(s):  
Hospital Mortality ◽  
Teaching Hospital ◽  
Community Teaching

scholarly journals Strengthening sepsis care at a tertiary care teaching hospital in New Delhi, India

2021 ◽  
Vol 10 (Suppl 1) ◽  
pp. e001335
Author(s):  
Charu Malhotra ◽  
Akshay Kumar ◽  
Ankit Kumar Sahu ◽  
Akshaya Ramaswami ◽  
Sanjeev Bhoi ◽  
...  
Keyword(s):  
Blood Culture ◽  
Hospital Mortality ◽  
Teaching Hospital ◽  
Screening Tool ◽  
Tertiary Care ◽  
Blood Cultures ◽  
Antibiotic Administration ◽  
Suspected Sepsis ◽  
Tertiary Care Teaching Hospital ◽  
Care Teaching

IntroductionFailure of early identification of sepsis in the emergency department (ED) leads to significant delays in antibiotic administration which adversely affects patient outcomes.AimThe primary objective of our Quality Improvement (QI) project was to reduce the door-to-antibiotic time (DTAT) by 30% from the preintervention in patients with suspected sepsis. Secondary objectives were to increase the blood culture collection rate by 30% from preintervention, investigate the predictors of improving DTAT and study the effect of these interventions on 24-hour in-hospital mortality.MethodsThis QI project was conducted in the ED of a tertiary care teaching hospital of North India; the ED receives approximately 400 patients per day. Adult patients with suspected sepsis presenting to our ED were included in the study, between January 2019 and December 2020. The study was divided into three phases; preintervention phase (100 patients), intervention phase (100 patients) and postintervention phase (93 patients). DTAT and blood cultures prior to antibiotic administration was recorded for all patients. Blood culture yield and 24-hour in-hospital mortality were also recorded using standard data templates. Change ideas planned by the Sepsis QI Team were implemented after conducting plan-do-study-act cycles.ResultsThe median DTAT reduced from 155 min in preintervention phase to 78 min in postintervention phase. Drawing of blood cultures prior to antibiotic administration improved by 67%. Application of novel screening tool at triage was found to be an independent predictor of reduced DTAT.ConclusionOur QI project identified the existing lacunae in implementation of the sepsis bundle which were dealt with in a stepwise manner. The sepsis screening tool and on-site training improved care of patients with sepsis. A similar approach can be used to deal with complex quality issues in other high-volume low-resource settings.

scholarly journals Clinical Outcomes of Dialysis-Treated Acute Kidney Injury Patients at the University of Port Harcourt Teaching Hospital, Nigeria

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Pedro Chimezie Emem-Chioma ◽  
Datonye Dennis Alasia ◽  
Friday Samuel Wokoma
Keyword(s):  
Acute Kidney Injury ◽  
Hospital Mortality ◽  
Clinical Outcomes ◽  
Teaching Hospital ◽  
Kidney Injury ◽  
Developed Countries ◽  
High Morbidity ◽  
Acute Glomerulonephritis ◽  
Study Objective ◽  
The University

Background. Acute kidney injury in adults is a common cause of hospitalization, associated with high morbidity and mortality especially in developing countries. In spite of RRT the in-hospital mortality rates remain high even in the developed countries. Though a proportion of our patients receive renal replacement therapy as part of their management, data on outcomes are sparse. Study Objective. To determine the clinical outcomes of dialysis-treated AKI in our hospital. Methods. A retrospective analysis of the clinical data of all adult AKI patients treated with haemodialysis at the University of Teaching Hospital during an interrupted six-year period was conducted. Analysis was done using SPSS version 17.0. Results. 34 males and 28 females with mean age of 41.3 ± 18.5 years were studied. The leading causes of AKI were sepsis (22.7%), acute glomerulonephritis (20.5%), acute gastroenteritis (15.9%), and toxic nephropathies (11.4%) and presented with mean e-GFR of 14.7±5.8 mls/min/1.73 m2. Of the 62 patients, 29 (46.8%) were discharged from the hospital, 27 (43.5%) died in hospital, while 6 (9.7%) absconded from treatment. Survivors had better Rifle grade than those who died (P<0.001). Conclusion. Hospital mortality rate of dialysis-treated AKI patients is high and the severity of renal damage at presentation may be an important factor.

Effects of the Beginning of the Academic Year on Hospital Mortality: Is the July Phenomenon Real?

2017 ◽  
Vol 1 (3) ◽  
pp. 58-60
Author(s):  
Omer Acar ◽  
Hasan Huseyin Mutlu ◽  
Mehmet Uzunlulu ◽  
Ozge Telci Caklili ◽  
Aytekin Oguz
Keyword(s):  
Hospital Mortality ◽  
Academic Year ◽  
July Phenomenon
Sign in / Sign up

Export Citation Format

Share Document