A Brief History of Quality Improvement in Health Care and Spinal Surgery.

While medical and technological advances continue to shape and advance health care, there has been growing emphasis on translating these advances into improvement in overall health care quality outcomes in the United States. Innovators such as Abraham Flexner and Ernest Codman engaged in rigorous reviews of systems and patient outcomes igniting wider spread interest in quality improvement in health care. Codman\u27s efforts even contributed to the founding of the American College of Surgeons. This society catalyzed a quality improvement initiative across the United States and the formation of the Joint Commission on Accreditation of Hospitals. Since that time, those such as Avedis Donabedian and the Institute of Medicine have worked to structure the process of improving both the quality and delivery of health care. Significant advances include the defining of minimum standards for hospital accreditation, 7 pillars of quality in medicine, and the process by which quality in medicine is evaluated. All of these factors have affected current practice more each day. In a field such as spinal surgery, cost and quality measures are continually emphasized and led to large outcome databases to better evaluate outcomes in complex, heterogeneous populations. Going forward, these databases will be instrumental in developing practice patterns and improving spinal surgery outcomes

Some philosophical enquiries on E-learning: preparing the tomorrow business school

Emerging digital technologies and increasing interest in the computerized delivery of higher education have led to e-learning through electronic mail, the Internet, the World Wide Web (WWW), and multimedia. The major objective of this research outlet is to examine the e-learning evolution in business schools. Our research intentions are to investigate: 1. if universities understand the market dynamics (regarding to segmentation and crossing the chasm); 2. mapping the s-curve to student needs and 3. how business schools will change the value map. From the analysis of existing empirical evidence and our research results from 140 business students of the University of Ioannina (Greece) and 50 business students of the University of Winchester (UK), we can summarize that: a. value is created when new technology is matched to student need; b. but student needs change: as the technology evolves existing students develop new needs and in addition the technology may appeal to new kinds of students, with new kinds of needs and c. understanding the structure of student needs may be particularly important at times of potential discontinuity, when existing students may reject new technologies (for excellent reasons!).  The authors suggest that business schools interested in being productive should invest in implementing performance tools for all educational methods in order to accomplish the educational objectives. Further research in this crucial field of the evolution of e-learning in business schools is the examination of anticipated benefits and the experiences by early e-learning adopters, return on investment and expectations for the future

Team-Based Competencies: Building a Shared Foundation for Education and Clinical Practice

Highlights discussions from a February 2011 conference on the need for collaborative health care, factors supporting and restraining change, and strategies for advancing interprofessional collaboration in education and practice

Reducing Medication Errors Through Workflow Redesign

Lack of medication reconciliation at the point of transitions between skilled nursing facilities/nursing homes (SNF/NHs) and acute care hospitals (ACHs) is a common point of origin for medical errors that cause harm to patients. The goal of this quality improvement initiative was to improve medication reconciliation at the point of transition from the SNF/NH to the ACH which in turn would reduce medication errors, adverse drug events, and medication-induced injury to the vulnerable elderly population. We implemented a workflow redesign process to reconcile the accuracy of residents’ medications at the time of transfer from the SNF/NH to the ACH. After the initiation of a medication reconciliation protocol, 72% (n=13/18) of the medication administration records (MARs) had no medication errors

The iron law of democratic socialism: British and Austrian influences on the young Karl Polanyi

This article has been made available through the Brunel Open Access Publishing Fund.A central thesis of Karl Polanyi's The great transformation concerns the tensions between capitalism and democracy: the former embodies the principle of inequality, while democracy represents that of equality. This paper explores the intellectual heritage of this thesis, in the ‘functional theory’ of G.D.H. Cole and Otto Bauer and in the writings of Eduard Bernstein. It scrutinizes Polanyi's relationship with Bernstein's ‘evolutionary socialism’ and charts his ‘double movement’ vis-à-vis Marxist philosophy: in the 1910s he reacted sharply against Marxism's deterministic excesses, but he then, in the 1920s, engaged in sympathetic dialogue with Austro-Marxist thinkers. The latter, like Bernstein, disavowed economic determinism and insisted upon the importance and autonomy of ethics. Yet they simultaneously predicted a law-like expansion of democracy from the political to the economic arena. Analysis of this contradiction provides the basis for a concluding discussion that reconsiders the deterministic threads in Polanyi's oeuvre. Whereas for some Polanyi scholars these attest to his residual attraction to Marxism, I argue that matters are more complex. While Polanyi did repudiate the more rigidly deterministic of currents in Marxist philosophy, those to which he was attracted, notably Bernstein's ‘revision’ and Austro-Marxism, incorporated a deterministic fatalism of their own, in respect of democratization. Herein lies a more convincing explanation of Polanyi's incomplete escape from a deterministic philosophy of history, as exemplified in his masterwork, The great transformation

When the Hurlyburly\u27s Done / When the Battle\u27s Lost and Won: Service, Suffering, and Survival of Civil War and Great War Veterans

Marching in the Gettysburg Liberty Parade in May 1918 was a drum corps consisting entirely of Civil War veterans. As local citizens demonstrated their patriotism—notably with the Kaiser hanging in effigy—the old soldiers helped keep the pace for two thousand citizens who turned out to vigorously support the Great War. It was no doubt a moving moment, the nation\u27s largest veteran demographic encouraging and supporting the next generation of soldiers to fight for cause and country in a very different war waged on a very different continent. Though fifty years separated the trenches of Petersburg from those of the western front, for one moment, the men who fought in the nation\u27s bloodiest war marched alongside doughboys who were training, on a battlefield of that war, to fight in France