Preparing the books to read every day is enjoyable for many people. However, there are still many people who also don't like reading. This is a problem. But, when you can support others to start reading, it will be better. One of the books that can be recommended for new readers is experience and education. This book is not kind of difficult book to read. It can be read and understand by the new readers.

Experience and Education.

Since the publication of Standards for QUality Improvement Reporting Excellence (SQUIRE 1.0) guidelines in 2008, the science of the field has advanced considerably. In this manuscript, we describe the development of SQUIRE 2.0 and its key components. We undertook the revision between 2012 and 2015 using (1) semistructured interviews and focus groups to evaluate SQUIRE 1.0 plus feedback from an international steering group, (2) two face-to-face consensus meetings to develop interim drafts and (3) pilot testing with authors and a public comment period. SQUIRE 2.0 emphasises the reporting of three key components of systematic efforts to improve the quality, value and safety of healthcare: the use of formal and informal theory in planning, implementing and evaluating improvement work; the context in which the work is done and the study of the intervention(s). SQUIRE 2.0 is intended for reporting the range of methods used to improve healthcare, recognising that they can be complex and multidimensional. It provides common ground to share these discoveries in the scholarly literature (http://www.squire-statement.org).

https://qualitysafety.bmj.com/content/qhc/25/12/986.full.pdf

SQUIRE 2.0 (Standards for QUality Improvement Reporting Excellence): revised publication guidelines from a detailed consensus process

America's health care system has become too complex and costly to continue business as usual. Best Care at Lower Cost explains that inefficiencies, an overwhelming amount of data, and other economic and quality barriers hinder progress in improving health and threaten the nation's economic stability and global competitiveness. According to this report, the knowledge and tools exist to put the health system on the right course to achieve continuous improvement and better quality care at a lower cost.The costs of the system's current inefficiency underscore the urgent need for a systemwide transformation. About 30 percent of health spending in 2009--roughly $750 billion--was wasted on unnecessary services, excessive administrative costs, fraud, and other problems. Moreover, inefficiencies cause needless suffering. By one estimate, roughly 75,000 deaths might have been averted in 2005 if every state had delivered care at the quality level of the best performing state. This report states that the way health care providers currently train, practice, and learn new information cannot keep pace with the flood of research discoveries and technological advances.About 75 million Americans have more than one chronic condition, requiring coordination among multiple specialists and therapies, which can increase the potential for miscommunication, misdiagnosis, potentially conflicting interventions, and dangerous drug interactions. Best Care at Lower Cost emphasizes that a better use of data is a critical element of a continuously improving health system, such as mobile technologies and electronic health records that offer significant potential to capture and share health data better. In order for this to occur, the National Coordinator for Health Information Technology, IT developers, and standard-setting organizations should ensure that these systems are robust and interoperable. Clinicians and care organizations should fully adopt these technologies, and patients should be encouraged to use tools, such as personal health information portals, to actively engage in their care.This book is a call to action that will guide health care providers; administrators; caregivers; policy makers; health professionals; federal, state, and local government agencies; private and public health organizations; and educational institutions.

Best Care at Lower Cost: The Path to Continuously Learning Health Care in America

ContextMedical errors are associated with feelings of distress in physicians, but little is known about the magnitude and direction of these associations.ObjectiveTo assess the frequency of self-perceived medical errors among resident physicians and to determine the association of self-perceived medical errors with resident quality of life, burnout, depression, and empathy using validated metrics.Design, Setting, and ParticipantsProspective longitudinal cohort study of categorical and preliminary internal medicine residents at Mayo Clinic Rochester. Data were provided by 184 (84%) of 219 eligible residents. Participants began training in the 2003-2004, 2004-2005, and 2005-2006 academic years and completed surveys quarterly through May 2006. Surveys included self-assessment of medical errors and linear analog scale assessment of quality of life every 3 months, and the Maslach Burnout Inventory (depersonalization, emotional exhaustion, and personal accomplishment), Interpersonal Reactivity Index, and a validated depression screening tool every 6 months.Main Outcome MeasuresFrequency of self-perceived medical errors was recorded. Associations of an error with quality of life, burnout, empathy, and symptoms of depression were determined using generalized estimating equations for repeated measures.ResultsThirty-four percent of participants reported making at least 1 major medical error during the study period. Making a medical error in the previous 3 months was reported by a mean of 14.7% of participants at each quarter. Self-perceived medical errors were associated with a subsequent decrease in quality of life (P = .02) and worsened measures in all domains of burnout (P = .002 for each). Self-perceived errors were associated with an odds ratio of screening positive for depression at the subsequent time point of 3.29 (95% confidence interval, 1.90-5.64). In addition, increased burnout in all domains and reduced empathy were associated with increased odds of self-perceived error in the following 3 months (P=.001, P<.001, and P=.02 for depersonalization, emotional exhaustion, and lower personal accomplishment, respectively; P=.02 and P=.01 for emotive and cognitive empathy, respectively).ConclusionsSelf-perceived medical errors are common among internal medicine residents and are associated with substantial subsequent personal distress. Personal distress and decreased empathy are also associated with increased odds of future self-perceived errors, suggesting that perceived errors and distress may be related in a reciprocal cycle.

https://jamanetwork.com/journals/jama/articlepdf/203249/joc60109.pdf

Association of perceived medical errors with resident distress and empathy: a prospective longitudinal study.

Background In the 10 years since publication of the Institute of Medicine's report To Err Is Human, extensive efforts have been undertaken to improve patient safety. The success of these efforts remains unclear. Methods We conducted a retrospective study of a stratified random sample of 10 hospitals in North Carolina. A total of 100 admissions per quarter from January 2002 through December 2007 were reviewed in random order by teams of nurse reviewers both within the hospitals (internal reviewers) and outside the hospitals (external reviewers) with the use of the Institute for Healthcare Improvement's Global Trigger Tool for Measuring Adverse Events. Suspected harms that were identified on initial review were evaluated by two independent physician reviewers. We evaluated changes in the rates of harm, using a random-effects Poisson regression model with adjustment for hospital-level clustering, demographic characteristics of patients, hospital service, and high-risk conditions. Results Among 2341 admission...

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Temporal Trends in Rates of Patient Harm Resulting from Medical Care

The American Council of Graduate Medical Education is moving from accrediting residency programs every 5 years to a new system for the annual evaluation of trends in measures of performance.

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The Next GME Accreditation System — Rationale and Benefits

new approach to teaching the practice of medicine. JAMA. 1992;268:24202425. 5. Parkes J, Hyde C, Deeks J, Milne R. Teaching critical appraisal skills in health care settings [database on CD-ROM]. Oxford, England: Cochrane Library, Update Software; 2002;issue 2. 6. Taylor R, Reeves B, Ewings P, et al. A systematic review of the effectiveness of critical appraisal skills training for clinicians. Med Educ. 2000;34:120-125. 7. Norman GR, Shannon SI. Effectiveness of instruction in critical appraisal (evidencebased medicine) skills: a critical appraisal. CMAJ. 1998;158:177-181. 8. Linzer M, Brown JT, Frazier LM, DeLong ER, Siegel WC. Impact of a medical journal club on house-staff reading habits, knowledge, and critical appraisal skills: a randomized controlled trial. JAMA. 1988;260:2537-2541. 9. Stern DT, Linzer M, O’Sullivan PS, Weld L. Evaluating medical residents’ literatureappraisal skills. Acad Med. 1995;70:152-154. 10. Bennett KJ, Sackett DL, Haynes RB, Neufeld VR, Tugwell P, Roberts R. A controlled trial of teaching critical appraisal of the clinical literature to medical students. JAMA. 1987;257:2451-2454. 11. Grimes DA. Introducing evidence-based medicine into a department of obstetrics and gynecology. Obstet Gynecol. 1995;86:451-457. 12. Murray E. Challenges in educational research. Med Educ. 2002;36:110-112. 13. Campbell M, Fitzpatrick R, Haines A, et al. Framework for design and evaluation of complex interventions to improve health. BMJ. 2000;321:694-696. 14. Bogdan R, Biklen SK. Qualitative Research for Education: An Introduction to Theory and Methods. Boston, Mass: Allyn & Bacon; 1982. 15. Green ML, Ellis PJ. Impact of an evidence-based medicine curriculum based on adult learning theory. J Gen Intern Med. 1997;12:742-750. 16. Cabell CH, Schardt C, Sanders L, Corey GR, Keitz SA. Resident utilization of information technology. J Gen Intern Med. 2001;16:838-844. 17. Taylor R, Reeves B, Mears R, et al. Development and validation of a questionnaire to evaluate the effectiveness of evidence-based practice teaching. Med Educ. 2001;35:544-547. 18. Flynn C, Helwig A. Evaluating an evidence-based medicine curriculum. Acad Med. 1997;72:454-455. 19. Dobbie AE, Schneider FD, Anderson AD, Littlefield J. What evidence supports teaching evidence-based medicine? Acad Med. 2000;75:1184-1185.

New requirements for resident duty hours.

Study Objectives: To explore the effect of sleep loss on cognitive function, memory, and vigilance in resident physicians and nonphysicians and on residents' clinical performance. Design: Meta-analysis of 60 studies on the effect of sleep deprivation, with a total sample of 959 physicians and 1,028 nonphysicians and 5,295 individual effect indexes. Outcome Measures: Cognitive performance and performance on clinical tasks under acute and partial chronic sleep deprivation. Additional analyses stratified the data by physician/nonphysician, type of performance, and length and type of sleep loss and assessed the combined effect of several of these factors. Results: Sleep loss of less than 30 hours reduced physicians' overall performance by nearly 1 standard deviation and clinical performance by more than 1.5 standard deviations. The effect of sleep deprivation was larger in nonphysicians than in physicians (corrected d value -.995 vs -.880), with these smaller effects likely resulting from study factors, primarily variation in the hours without sleep prior and chronically reduced sleep in the rested controls in physician studies. Conclusions: The weekly hours and continuous wakefulness permitted under the current national minimum standards for residents may not completely guard against the negative effect of sleep loss on cognitive and clinical performance. Research is needed to explore the effect of continuous duty periods and chronic partial sleep loss in residents and to assess the clinical and educational consequences of sleep loss. The goal should be to combine scientifically based duty-hour limits with broader efforts to enhance patient safety and resident learning.

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Sleep loss and performance in residents and nonphysicians: a meta-analytic examination.

Context Sleep deprivation is associated with increased risk of serious medical errors and motor vehicle crashes among interns. The Accreditation Council for Graduate Medical Education (ACGME) introduced duty-hour standards in 2003 to reduce work hours. Objective To estimate compliance with the ACGME duty-hour standards among interns. Design, Setting, and Participants National prospective cohort study with monthly Web-based survey assessment of intern work and sleep hours using a validated instrument, conducted preimplementation (July 2002 through May 2003) and postimplementation (July 2003 through May 2004) of ACGME standards. Participants were 4015 of the approximately 37 253 interns in US residency programs in all specialties during this time; they completed 29477 reports of their work and sleep hours. Main Outcome Measure Overall and monthly rates of compliance with the ACGME standards. Results Postimplementation, 1068 (83.6%; 95% confidence interval [Cl], 81.4%-85.5%) of 1278 of interns reported work hours in violation of the standards during 1 or more months. Working shifts greater than 30 consecutive hours was reported by 67.4% (95% CI, 64.8%-70.0%). Averaged over 4 weeks, 43.0% (95% CI, 40.3%-45.7%) reported working more than 80 hours weekly, and 43.7% (95% CI, 41.0%-46.5%) reported not having 1 day in 7 off work duties. Violations were reported during 3765 (44.0%; 95% CI, 43.0%-45.1%) of the 8553 intern-months assessed postimplementation (including vacation and ambulatory rotations), and during 2660 (61.5%; 95% CI, 60.0%-62.9%) of 4327 intern-months during which interns worked exclusively in inpatient settings. Postimplementation, 29.0% (95% CI, 28.7%-29.7%) of reported work weeks were more than 80 hours per week, 12.1% (95% CI, 11.8%-12.6%) were 90 or more hours per week, and 3.9% (95% CI, 3.7%-4.2%) were 100 or more hours per week. Comparing preimplementation to postimplementation responses, reported mean work duration decreased 5.8% from 70.7 (95% CI, 70.5-70.9) hours to 66.6 (95% CI, 66.3-66.9) hours per week (P<.001), and reported mean sleep duration increased 6.1 % (22 minutes) from 5.91 (95% CI, 5.88-5.94) hours to 6.27 (95% CI, 6.23-6.31) hours per night (P<.001). However, reported mean sleep during extended shifts decreased 4.5%, from 2.69 (95% CI, 2.66-2.73) hours to 2.57 (95% CI, 2.52-2.62) hours (P<.001). Conclusion In the first year following implementation of the ACGME duty-hour standards, interns commonly reported noncompliance with these requirements.

Interns' compliance with accreditation council for graduate medical education work-hour limits. Commentary

PurposeTo systematically study the number of US resident deaths from all causes, including suicideMethodThe more than 9,900 programs accredited by the Accreditation Council for Graduate Medical Education (ACGME) annually report the status of residents The authors aggregated ACGME data on 381,614

Ingrid Philibert

Papers

The Next GME Accreditation System — Rationale and Benefits

New requirements for resident duty hours.

Sleep loss and performance in residents and nonphysicians: a meta-analytic examination.

Interns' compliance with accreditation council for graduate medical education work-hour limits. Commentary

Causes of Death of Residents in ACGME-Accredited Programs 2000 Through 2014: Implications for the Learning Environment.