Hospital implementation of health information technology and quality of care: are they related?

Recently, there has been considerable effort to promote the use of health information technology (HIT) in order to improve health care quality. However, relatively little is known about the extent to which HIT implementation is associated with hospital patient care quality. We undertook this study to determine the association of various HITs with: hospital quality improvement (QI) practices and strategies; adherence to process of care measures; risk-adjusted inpatient mortality; patient satisfaction; and assessment of patient care quality by hospital quality managers and front-line clinicians.This work was supported by a grant from the Commonwealth Fund. We are indebted to Anthony Shih and Anne-Marie Audet of the Fund for their advice, support, and constructive suggestions throughout the design and conduct of the study. We thank our colleagues - Raymond Kang, Peter Kralovec, Sally Holmes, Frances Margolin, and Deborah Bohr - for their valuable contributions to the development of the QAS, the CPS, and the database on which the analytic findings reported here were based. We also thank 3 M (TM) Health Information Systems' for use of its All Patient Refined Diagnosis Related Groups (APR-DRGs) software. We especially wish to thank Jennifer Drake for her contributions not only to survey development, but also to earlier analysis of survey findings relevant to this paper. (Commonwealth Fund)Published versio

Sister Mary Joseph's Nodule at a University Teaching Hospital in Northwestern Tanzania: A Retrospective Review of 34 cases.

Sister Mary Joseph's nodule is a metastatic tumor deposit in the umbilicus and often represents advanced intra-abdominal malignancy with dismal prognosis. There is a paucity of published data on this subject in our setting. This study was conducted to describe the clinicopathological presentation and treatment outcome of this condition in our environment and highlight challenges associated with the care of these patients, and to proffer solutions for improved outcome. This was a retrospective study of histologically confirmed cases of Sister Mary Joseph's nodule seen at Bugando Medical Centre between March 2003 and February 2013. Data collected were analyzed using descriptive statistics. A total of 34 patients were enrolled in the study. Males outnumbered females by a ratio of 1.4:1. The vast majority of patients (70.6%) presented with large umbilical nodule > 2 cm in size. The stomach (41.1%) was the most common location of the primary tumor. Adenocarcinoma (88.2%) was the most frequent histopathological type. Most of the primary tumors (52.9%) were poorly differentiated. As the disease was advanced and metastatic in all patients, only palliative therapy was offered. Out of 34 patients, 11 patients died in the hospital giving a mortality rate of 32.4%. Patients were followed up for 24 months. At the end of the follow-up period, 14(60.9%) patients were lost to follow-up and the remaining 9 (39.1%) patients died. Patients survived for a median period of 28 weeks (range, 2 to 64 weeks). The nodule recurred in 6 (26.1%) patients after complete excision. Sister Mary Joseph's nodule of the umbilicus is not rare in our environment and often represents manifestation of a variety of advanced intra-abdominal malignancies. The majority of the patients present at a late stage and many with distant metastases. The patient's survival is very short leading to a poor outcome. Early detection of primary cancer at an early stage may improve the prognosis

Study of the process e+e−→ppˉe^+e^-\to p\bar{p} in the c.m. energy range from threshold to 2 GeV with the CMD-3 detector

Using a data sample of 6.8 pb$^{-1}$ collected with the CMD-3 detector at the VEPP-2000 $e^+e^-$ collider we select about 2700 events of the $e^+e^- \to p\bar{p}$ process and measure its cross section at 12 energy ponts with about 6\% systematic uncertainty. From the angular distribution of produced nucleons we obtain the ratio $|G_{E}/G_{M}| = 1.49 \pm 0.23 \pm 0.30$

Measurement of the e+e−→K+K−π+π−e^+e^- \to K^+K^-\pi^+\pi^- cross section with the CMD-3 detector at the VEPP-2000 collider

The process $e^+e^- \to K^+K^-\pi^+\pi^-$ has been studied in the center-of-mass energy range from 1500 to 2000\,MeV using a data sample of 23 pb$^{-1}$ collected with the CMD-3 detector at the VEPP-2000 $e^+e^-$ collider. Using about 24000 selected events, the $e^+e^- \to K^+K^-\pi^+\pi^-$ cross section has been measured with a systematic uncertainty decreasing from 11.7\% at 1500-1600\,MeV to 6.1\% above 1800\,MeV. A preliminary study of $K^+K^-\pi^+\pi^-$ production dynamics has been performed

Exclusive Measurements of pp -> dpi+pi0: Double-Pionic Fusion without ABC Effect

Exclusive measurements of the reaction pp -> dpi+pi0 have been carried out at T_p = 1.1 GeV at the CELSIUS storage ring using the WASA detector. The isovector pi+pi0 channel exhibits no enhancement at low invariant pipi masses, i. e. no ABC effect. The differential distributions are in agreement with the conventional t-channel Delta-Delta excitation process, which also accounts for the observed energy dependence of the total cross section. This is an update of a previously published version -- see important note at the end of the article