"Manufacturing vs repair" in health care.
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Biomedical subjects
Publications and source records attributed to Seth Powsner.
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Efforts to improve quality of medical care often involve large data sets. Reviewing laboratory results over time for a cohort of patients is particularly problematic: traditional statistics conflate case to case variations with day to day variations (within a case). To help solve this problem, we propose using sparklines for case by case review and a modified box-plot for overall data review. We demonstrate these data presentations using fingerstick glucose values.
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OBJECTIVE: To review key issues in the preoperative assessment of patients with psychiatric disorders: assessment of cognitive capacity, psychiatric history, capacity to give informed consent, and the impact of psychotropic medications or substances of abuse. We also outline a general approach to the psychiatric patient. Our review focuses on those psychiatric conditions and medications most likely to complicate perioperative care. DATA SOURCE: Critical studies and expert reviews in the field, as well as the authors' clinical experience in general hospital psychiatry. CONCLUSIONS: Psychiatric disorders need not unduly complicate perioperative care, but they present certain challenges; a systematic approach as described here will simplify perioperative care of these patients.
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