Introducing the “Teamlet”: Initiating a Primary Care Innovation at San Francisco General Hospital
By Brian Yoshio Laing; Lisa Ward, MD, MScPH, MS; Thomas Yeh; Ellen Chen, MD; Thomas Bodenheimer, MD
The 15-minute visit cannot meet the health care needs of patients in primary care. In the Family Health Center, the “Teamlet” practice innovation--a clinician and a health coach--was implemented to expand the traditional medical visit into previsit, visit, postvisit, and between-visit care.
Special Report:
Gaining New Insights into Early Abdominal Aortic Aneurysm Disease
By Julie J White; Ronald L Dalman, MD, FACS, FAHA
A special report on a multidisciplinary research effort to efficiently identify and handicap suppressive therapeutic strategies for early abdominal aortic aneurysm disease--a prevalent and highly morbid condition among older people--for which there are no proven methods of reducing or eliminating enlargement.
Lawrence Patient Safety Award 2007
Implementation of a High-Alert Medication Program
High-alert medications--500,000 doses annually through Kaiser Permanente Northern California--carry a high risk of alarm, with potential clinical outcomes from administration errors. With program introduction, a statistically significant drop in errors occurred for 23 consecutive months. As of November 30, 2007, 232 days had passed without a negative event. The multidisciplinary group standardized handling, enhanced education, and developed monitoring functions.
Abdominal Lipectomy: A Prospective Outcomes Study
Nadine B Semer, MD, FACS; Wan C Ho, MD, FRCS; Sharrie Mills, MD, FACS; BM Rajashekara, MD, FACS; Jason R Taylor, MD; Nguyen B Trung, MD; Henry Young, MD; Juris Kivuls, MD, FACS
Abdominal lipectomy is performed for symptomatic, functional, and cosmetic relief for patients with excess abdominal tissue. This is the first prospective outcomes study and shows that 98.3% of 72 patients were happy to have had the surgery. Major (5.6%) and minor (27.8%) complications were comparable to other studies.
Prescribers’ and Organizational Leaders’ Preferences for Education about Heavily Marketed Drugs
David W Price, MD, FAAFP; Marsha A Raebel, PharmD; Douglas A Conner, PhD; Leslie A Wright, MA
In a study regarding heavily marketed drugs, assessment of organizational needs and of the educational needs and interests of medication prescribers demonstrated that top interest areas in both groups were: accessing unbiased drug information, comparing evidence about drugs within class, critical appraisal of drug information, off-label drug use, and addressing patient medication inquiries.
Five-Year Experience: Reflective Writing in a Preclinical End-of-Life Care Curriculum
Marcy E Rosenbaum, PhD; Kristi J Ferguson, PhD; Ann Broderick MD, MS
Analysis of 829 medical students’ reflection essays (2002-2007)--522 out-of-class and 307 in-class--identified four themes related to caring for dying patients: emotional response, communication support, shift from curing to caring, and feeling ill-prepared.
Review Articles
Natural Orifice Transluminal Endoscopic Surgery: The Future of Gastrointestinal Surgery
Lee L Swanström, MD, FACS; Yashodan Khajanchee, MD; Maher A Abbas, MD, FACS, FASCRS
Flexible endoscopy, used to perform therapeutic procedures beyond the wall of the gastrointestinal tract, is gaining prominence and application. It could provide all of the advantages of laparoscopic surgery and, with the elimination of all abdominal wall incisions, could completely eliminate the risk of wound infections. This article reviews technology, technique, challenges, and impact.
