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Prolonged emergency department (ED) visits are associated with a number of adverse outcomes for patients as well as lower patient satisfaction scores and increased costs. Several factors that influence the length of ED visits are out of the control of hospital employees, but some opportunities exist to improve performance. For this study, the ED department of a 150-bed hospital in the southeastern United States wanted to improve door-to-discharge time. To do so, a subprocess of door-to-discharge time was targeted, door-to-order. After analyzing the process, the team created standard orders for the 10 most common presenting conditions in the ER with preapproval, allowing nurses to submit the orders without the provider first visiting the patient. Following the process change, daily feedback was added to increase utilization of the preapproved orders. Reductions in door-to-order times and door-to-discharge were observed and patient satisfaction remained stable. Implications for future research in this area are discussed.  相似文献   
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Differences in patient characteristics, including age, sex, and race influence the safety and effectiveness of drugs, biologic products, and medical devices. Here we provide a summary of the topics discussed during the opening panel at the 2018 Johns Hopkins Center for Excellence in Regulatory Science and Innovation symposium on Assessing and Communicating Heterogeneity of Treatment Effects for Patient Subpopulations: Challenges and Opportunities. The goal of this session was to provide a brief overview of FDA-regulated therapeutics, including drugs, biologics and medical devices, and some of the major sources of heterogeneity of treatment effects (HTE) related to patient demographics, such as age, sex and race. The panel discussed the US Food and Drug Administration's role in reviewing and regulating drugs, devices, and biologic products and the challenges associated with ensuring that diverse patient populations benefit from these therapeutics. Ultimately, ensuring diverse demographic inclusion in clinical trials, and designing basic and clinical research studies to account for the intended patient population's age, sex, race, and genetic factors among other characteristics, will lead to better, safer therapies for diverse patient populations.  相似文献   
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While much recent theorizing into affect has challenged the primacy of discourse in understanding social life, this paper is premised on the intertwining of affective experience with discursive meaning. Furthermore, appreciating the entwining of affect and discourse facilitates broader understanding into the illness experience, medical decision‐making and experiences of healing. Today, the biomedical discourse carries particular affective weight that can saturate experiences of affliction. Cultural understandings of disease similarly shape affect that may emerge in affliction. Social meaning, more specifically stereotypes pertaining to identities, interweave with emotion also in the context of medical practice. The doctor‐patient relationship is an affect‐laden encounter where the entwining of affect with social assumptions carries important, yet poorly understood, repercussions for treatment decisions and for the furthering of health inequalities. Both the elusiveness and the power of affect that unfolds in relation to discursive meaning rest on the way in which affect dwells in and resounds through the body.  相似文献   
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偏见是个体以不正确或不充分的信息为依据,并对其他人形成先入为主的负性判断,泛化至群体中则会表现为人们对某群体产生片面或错误的认知。文章从消极刻板印象、期望差异与归因偏差这三个角度解释了医患群体产生偏见的心理机制,在此基础上讨论偏见对医患关系造成的消极影响,并结合社会现实提出减少医患双方偏见的方法。  相似文献   
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Ethnic Monitoring in higher education has been limited and piecemeal. It often fails to explore the relationships between ethnicity and student progress and achievement, and to account for any ethnic inequalities revealed. In this paper an approach to ethnic monitoring that utilizes quantitative and qualitative methods is discussed. We argue that such an approach gives a clear statistical picture of group progress and achievement, identifies social, economic and institutional factors that might account for ethnic inequalities, and highlights the processes of racism and discrimination in higher education. All of these aspects are vital to a thorough understanding of ethnic inequalities in the higher education sector in the United Kingdom.  相似文献   
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