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    Performance Improvement

    Explore this JAMA series that discusses best ways to reduce medical errors and improve the safety and quality of health care.

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    • Caring for Emergency Department Patients With Complex Medical, Behavioral Health, and Social Needs
      JAMA
      Case Report
      December 22, 2020

      This JAMA Performance Improvement article describes experience at Zuckerberg San Francisco General Hospital with an emergency department social medicine (EDSM) team to facilitate care of ED patients with low-acuity medical illnesses and complex psychosocial comorbidities (homelessness, mental illness, substance use, poverty).

      Psychiatry Emergency Medicine Substance Use and Addiction
      Full Text | pdf link PDF has multimedia
    • Outpatient Management of Liver Function Test Abnormalities in Patients With a Liver Transplant
      JAMA
      Case Report
      November 10, 2020

      This JAMA Performance Improvement article describes development of a protocol for workup and management of elevated liver function tests in liver transplant patients without readmission to their transplant referral center, and findings and outcomes for a case series of 80 patients managed with the new protocol from 2017 to 2019.

      Hepatobiliary Disease Gastroenterology and Hepatology Pathology and Laboratory Medicine Surgery Transplantation
      Full Text | pdf link PDF has multimedia
    • Video-Based Feedback for the Improvement of Surgical Technique: A Platform for Remote Review and Improvement of Surgical Technique
      JAMA Surgery
      Review
      November 1, 2020

      This article describes Video-Based Feedback for the Improvement of Surgical Technique, a video-centered approach to coaching practicing surgeons.

      Surgery Surgical Innovation
      Full Text | pdf link PDF
    • Best Practices in Assessing Aging Physicians for Professional Competency
      JAMA
      Opinion
      January 14, 2020
      Dementia and Cognitive Impairment Geriatrics Neurology Health Care Safety Health Care Policy
      Full Text | pdf link PDF
    • Cognitive Testing of Older Clinicians Prior to Recredentialing
      JAMA
      Case Report
      January 14, 2020

      This JAMA Performance Improvement article reports the methods and outcomes of a cognitive screening program implemented at a US hospital to assess medical staff aged 70 years or older for clinical competency every 2 years as a requirement for reappointment.

      Dementia and Cognitive Impairment Neurology Health Care Quality Professional Well-being
      Full Text | pdf link PDF has multimedia with quiz
    • Processes of Care Associated With Risk of Mortality and Recurrent Stroke Among Patients With Transient Ischemic Attack and Nonsevere Ischemic Stroke
      JAMA Network Open
      Research
      July 3, 2019

      This cohort study identifies processes of care that are associated with reduced risk of death or recurrent stroke among patients with transient ischemic attack or nonsevere ischemic stroke.

      Cerebrovascular Disease Hypertension Dyslipidemia Neurology Stroke
      Full Text | pdf link PDF open access
    • Reducing Emergency Department Length of Stay
      JAMA
      Case Report
      April 9, 2019

      This JAMA Performance Improvement article uses the case of a patient who presented to the emergency department but left after waiting 4 hours without being seen to discuss interdisciplinary improvement efforts for reducing system inefficiencies and improving access to care in emergency departments.

      Emergency Medicine Health Care Quality
      Full Text | pdf link PDF has multimedia with quiz
    • Performing an Inadvertent Procedure
      JAMA
      Case Report
      February 5, 2019

      This JAMA Performance Improvement article uses the case of a patient with end-stage renal disease admitted for septic shock, peritonitis, and calciphylaxis who erroneously underwent tunneled central catheter placement after he elected to pursue only hospice care to discuss unintended errors introduced by computerized order entry and opportunities for health information technology system improvements.

      Critical Care Medicine Nephrology End of Life Health Care Safety Health Care Quality
      Full Text | pdf link PDF has multimedia with quiz
    • Assessment of Incorrect Surgical Procedures Within and Outside the Operating Room: A Follow-up Study From US Veterans Health Administration Medical Centers
      JAMA Network Open
      Research
      November 21, 2018

      This quality improvement study examines the rate of surgical adverse events in US Veterans Health Administration medical centers from 2010 to 2017 and compares it with rates from previous studies.

      Health Care Safety Surgery Health Care Quality Veterans Health
      Full Text | pdf link PDF open access
    • β-Blockers in Myocardial Infarction: Issues With Standard Admission Order Sets
      JAMA
      Case Report
      March 27, 2018

      This JAMA Performance Improvement article uses the case of a patient with acute myocardial infarction and heart failure who developed cardiogenic shock after being given carvedilol as part of a standard STEMI admission order set to discuss the limits of orders sets and of guideline-based care and the need to optimize each for individual patient circumstances.

      Acute Coronary Syndromes Cardiology Critical Care Medicine Emergency Medicine Health Care Safety
      Full Text | pdf link PDF has multimedia with quiz
    • Oversedation of a Patient With Obstructive Sleep Apnea Prior to Imaging
      JAMA
      Case Report
      February 6, 2018

      This JAMA Performance Improvement article uses the case of a patient with obstructive sleep apnea who experienced cardiac arrest after sedation for magnetic resonance imaging to discuss proper handling and avoidance of oversedation in high-risk patients.

      Anesthesiology Neurology Pulmonary Medicine Sleep Medicine Obstructive Sleep Apnea
      Full Text | pdf link PDF has multimedia with quiz
    • Interdisciplinary Disease-Based Peer Review: Moving Quality Assurance Into the Future
      JAMA Surgery
      Opinion
      January 1, 2018

      This Viewpoint argues that moribidity and mortality conferences and peer reviews for diseases that cross multiple specialities should be more interdisciplinary.

      Shared Decision Making and Communication Surgery Health Care Quality Professionalism
      Full Text | pdf link PDF
    • Insulin Dosing Error in a Patient With Severe Hyperkalemia
      JAMA
      Case Report
      December 26, 2017

      This JAMA Performance Improvement article uses the case of a patient who received an overdose of insulin to discuss proper protocol and follow-up after a medication dosing error.

      Health Care Safety Health Care Quality Diabetes and Endocrinology
      Full Text | pdf link PDF has multimedia with quiz
    • Wrong-Site Surgery
      JAMA
      Case Report
      November 28, 2017

      This JAMA Performance Improvement article uses the case of a patient with both a cancerous mass and a benign mass in the same breast in whom the wrong mass was excised to discuss proper handling of wrong-site surgery.

      Health Care Safety Surgery Health Care Quality
      Full Text | pdf link PDF has multimedia with quiz
    • Phenytoin Toxicity
      JAMA
      Case Report
      June 20, 2017

      This JAMA Performance Improvement article uses the case of a patient with iatrogenic phenytoin toxicity due to an excess prescribed dosage to discuss proper handling and reporting of significant adverse drug events.

      Clinical Pharmacy and Pharmacology Epilepsy and Seizures Neurology Adverse Drug Events
      Full Text | pdf link PDF is expired quiz has multimedia
    • Retained Lumbar Catheter Tip
      JAMA
      Case Report
      March 28, 2017

      This JAMA Performance Improvement article uses the case of a patient with a retained lumbar catheter tip to discuss strategies for patient communication, clinician education, and reporting of procedure-related adverse events.

      Anesthesiology Health Care Safety Surgery Health Care Quality
      Full Text | pdf link PDF free is expired quiz has multimedia with quiz
    • Management of a Patient With a Latex Allergy
      JAMA
      Case Report
      January 17, 2017

      This JAMA Performance Improvement article explores the case of a patient with latex allergy who had a latex catheter placed and how the health care team should handle the situation both during surgery and postoperatively.

      Allergy and Clinical Immunology Health Care Safety Urology Health Care Quality
      Full Text | pdf link PDF is expired quiz has multimedia
    • Ensuring Staff Safety When Treating Potentially Violent Patients
      JAMA
      Case Report
      December 27, 2016

      This JAMA Performance Improvement article uses the case of an on-duty nurse attacked by a patient to discuss how to treat potentially violent patients while ensuring the safety of health care personnel.

      Emergency Medicine Nursing Occupational Health Health Care Safety
      Full Text | pdf link PDF is expired quiz has multimedia with quiz
    • Performing the Wrong Procedure
      JAMA
      Case Report
      September 20, 2016

      This JAMA Performance Improvement uses the case of a patient given the wrong catheter to discuss appropriate clinician and health system responses to procedure errors.

      Health Care Safety Ethics
      Full Text | pdf link PDF is expired quiz
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