Private Equity Acquisition May Be Dangerous for Patients
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In a self-described “quasi-experimental” analysis of Medicare claims data, private equity owned hospitals were associated with a 25% increase in hospitalization-acquired adverse events when compared with non-private equity hospitals. Notably, there was a 27% increase in falls, a 38% increase in the volume of central line-associated infections, despite the placement of 16% fewer central lines, and a doubling of surgical site infections despite 8% fewer surgical procedures being performed (underpowered assertion).
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Changes in Hospital Adverse Events and Patient Outcomes Associated With Private Equity Acquisition. JAMA. 2023 Dec 26;330(24):2365-2375. doi: 10.1001/jama.2023.23147.
Making PROGRESS – Pediatric Emergencies and Healthcare Disparities
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This systematic review and meta-analysis identified multiple social determinants of health that were related to increased utilization of ED services by children from racial minority and lower socioeconomic status (SES) groups.
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Social Determinants of Health and Pediatric Emergency Department Outcomes: A Systematic Review and Meta-Analysis of Observational Studies. Ann Emerg Med. Published online December 6, 2023. doi:10.1016/j.annemergmed.2023.10.010
Snarky Sign-outs – How to Avoid Bias During Handoff
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Our words during handoff can bias our colleagues against our patients. Here's how it happens and what we can do to improve.
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Patient Factors Associated With Biased Language in Nightly Resident Verbal Handoff. JAMA Pediatr. 2023 Oct 1;177(10):1098-1100. doi: 10.1001/jamapediatrics.2023.2581.
Do We Need to Reconsider the Word… Need?
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Need in medicine describes what is missing and the necessary corrective action (i.e. you need a transfusion), but this wording allows little latitude for discussion with patients and families. However, saying, "Can we talk about what this means and what to do next?" allows for dialogue without presuming the desired course of action.
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Reconsidering the Language of Serious Illness. JAMA. 2023 Aug 15;330(7):587-588. doi: 10.1001/jama.2023.11409.
Pregnancy and Residency – Laboring for Equity
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Though incremental progress has occurred over the last several decades, inequities loom for people that wish to become pregnant during medical training.
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Pregnancy and Residency - Overdue for Equity. N Engl J Med. 2023 Mar 16;388(11):966-967. doi: 10.1056/NEJMp2215288. Epub 2023 Mar 11.
Can ChatGPT Write Journal Articles?
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ChatGPT is an artificial intelligence software that is being explored for scientific writing. While there is great potential for utilizing this in the medical field, it should not be used in isolation and requires human oversight for both concept proof and personalization.
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Can artificial intelligence help for scientific writing? Crit Care. 2023 Feb 25;27(1):75. doi: 10.1186/s13054-023-04380-2.
Diagnostic Error in EM – Pushback on the AHRQ
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Diagnostic errors in the ED occur at rates similar to those in other clinical settings. Not all errors have human causes, and not all are inevitable – this article suggests systems-level opportunities for improvement.
Bad News – You May Be Bad at Delivering Bad News
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When delivering bad news, authenticity is the name of the game.
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Delivering Bad News Badly. JAMA. 2023 Feb 14;329(6):463-464. doi: 10.1001/jama.2022.24765.
Verbal and Physical Violence in an Urban ED Setting
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Violence directed at healthcare workers (HCWs) is common in the ED setting. Studies have demonstrated workplace violence is underreported and can have long term effects on HCWs.
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Exploring verbal and physical workplace violence in a large, urban emergency department. Am J Emerg Med. 2023 Jan 27;67:1-4. doi: 10.1016/j.ajem.2023.01.036. Epub ahead of print.
Showing Vulnerability When We Miss the Diagnosis
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This op-ed piece highlights the emotional toll missed diagnoses may take on physicians. The author eloquently reflects on how this experience taught her vulnerability and ultimately strengthened her relationship with this patient.
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Elizabeth A Fleming Notes on Healing After a Missed Diagnosis. JAMA. 2022 Oct 4;328(13):1297-1298. doi: 10.1001/jama.2022.15724.