Journal of general internal medicine
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Comparative Study
Use of an appreciative inquiry approach to improve resident sign-out in an era of multiple shift changes.
Resident duty hour restrictions have resulted in more frequent patient care handoffs, increasing the need for improved quality of residents' sign-out process. ⋯ Resident views toward sign-out are diverse, and accuracy of written records may be limited. Consecutive sign-outs are associated with degradation of information. An appreciative-inquiry approach capitalizing on exemplar residents was effective at creating standards for sign-out.
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Comparative Study
Traditional expectations versus US realities: first- and second-generation Asian Indian perspectives on end-of-life care.
Although end-of-life care preferences vary across racial/ethnic groups, little is known about how cultural values affect end-of-life care preferences among South Asian immigrants and their offspring in the US. ⋯ Traditional cultural values, such as duty to family, greatly influenced end-of-life care preferences and retained importance across generations. Clinicians caring for Asian Indian patients at the end of life may be better able to assess care preferences after exploring the complex interplay between traditional expectations and specific social realities for each patient. Particular attention should be given to attitudes toward death and suffering, family duty, and preferences for information disclosure and decision making.
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Multicenter Study Comparative Study
Governance around quality of care at hospitals that disproportionately care for black patients.
Hospital boards of directors can play a pivotal role in improving care, yet we know little about how the boards of hospitals that disproportionately serve minority patients engage in this issue. ⋯ Board chairpersons of black-serving hospitals report less expertise with quality of care issues and are less likely to give high priority to these issues than board chairpersons of non-black-serving hospitals. Interventions to engage and educate board members in issues of quality and racial disparities may be needed to improve quality and reduce disparities in care.