Benneyan JC. Number between g-type statistical quality control charts for monitoring adverse events. Health Care Management Science. 2001;4:305-318.

Many organizations involved in health care improvement are faced with the good problem of increasingly rare events, whether they are surgical site infections, ventilator-associated pneumonias, or other adverse events. In such cases, the standard approach of monitoring weekly or monthly rates on a time series chart is not very useful visually nor statistically (essentially because these charts tend to plot long sequences of zeros when there are no cases each week or month, with no visible trends or variation patterns).

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Williams SC, Schmaltz SP, Morton DJ, Koss RG, Loeb JM. Quality of care in US hospitals as reflected by standardized measures, 2002-2004. New England Journal of Medicine. Jul 2005;353(3):255-264.

In July 2002, the Joint Commission on Accreditation of Healthcare Organizations implemented standardized performance measures that were designed to track the performance of accredited hospitals and encourage improvement in the quality of health care. The authors examined hospitals' performance on 18 standardized indicators of the quality of care for acute myocardial infarction, heart failure, and pneumonia.

Besserman E, Teres, D, Logan A, Brennan P, Cleaves S, Bayly R, et al. Use of flexible intermediate and intensive care to reduce multiple transfers of patients. American Journal of Critical Care. 1999;8(3):170-179.

Described here is a method for small-cycle quality improvement: Plan-Do-Study-Act. Mostly concentrates on Adult Intensive Care Unit and the IHI Breakthrough Series.

Bellomo R, Goldsmith D, Uchino S, et al. A prospective before-and-after trial of a medical emergency team. Medical Journal of Australia. 2003;179(6):283-287.

This article describes a study whose purpose was to determine the effect on cardiac arrests and overall hospital mortality of an intensive care-based medical emergency team. The incidence of in-hospital cardiac arrest and death following cardiac arrest decreased after introduction of an intensive-care-based medical emergency team, as did overall hospital mortality.

Fox E, Tulsky JA. Recommendations for the ethical conduct of quality improvement. Journal of Clinical Ethics. 2005;16(1):61-71.

Quality improvement activity is essential and has brought tremendous benefits for patients. Yet, while widely accepted ethical standards exist for other activities in the clinical arena, including medical treatment and research, no analogous ethical standards currently exist for QI. This article is a preliminary attempt to fill this gap by providing practical recommendations for the responsible conduct of QI, designed to balance the ethical imperative to adequately protect patients and the ethical imperative to continuously improve patient care.

Stone D, Patton B, Heen S, Fisher R
New York, New York, USA: Penguin Publishing; 1999

In this book, the authors offer a guide for how to handle difficult conversations.  Breaking down these types of conversations into three components, they offer concrete tips through anecdotes, examples, and scripted conversations to help build up confidence when faced with a difficult conversation.

Audet AM, Doty MM, Shamasdin J, Schoenbaum SC. Measure, learn, and improve: Physicians' involvement in quality improvement. Health Affairs. 2005;24(3):843-853.

This article describes a 2003 national physician survey which found that most physicians do not use quality improvement (QI) principles in their work.  The authors contend that QI is institutionalized, but not yet professionalized.  They suggest building infrastructure to support quality.

Lappe JM, Muhlestein JB, Lappe DL, et al. Improvements in 1-year cardiovascular clinical outcomes associated with a hospital-based discharge medication program. Annals of Internal Medicine. 2004;141(6):446-453.

The authors describe a nonrandomized before-after study comparing patients hospitalized before (1996-1998) and after (1999-2002) implementation of a discharge medication program (DMP) by the 10 largest hospitals in the Utah-based Intermountain Health Care system.  The goal of the program was to ensure appropriate prescription of aspirin, statins, beta-blockers, ACE inhibitors, and warfarin at hospital discharge.

Jencks SF, Huff ED, Cuerdon T. Change in the quality of care delivered to Medicare beneficiaries, 1998-1999 to 2000-2001. Journal of the American Medical Association. 2003;289(3):305-312.

In an effort to assess the impact of the Medicare Quality Improvement Organization (QIO) program on the quality and safety of health care in the United States, the authors tracked national- and state-level changes in performance on 22 quality indicators for care of Medicare beneficiaries using observational cross-sectional studies of national- and state-level fee-for-service data for Medicare beneficiaries during 1998-1999 (baseline) and 2000-2001 (follow-up).

Hennekens CH, Albert CM, Godfried SL, Gaziano JM, Buring JE. Adjunctive drug therapy of acute myocardial infarction – evidence from clinical trials. New England Journal of Medicine. 1996;335(22):1660-1667.

The authors review current evidence from randomized trials and meta-analyses regarding the effectiveness of several categories of drugs in the treatment of patients with AMI, including beta-adrenergic antagonists, angiotnesin-converting-enzyme (ACE) inhibitors, nitrates, calcium-channel blockers, antiarrhythmic drugs, and magnesium.  They conclude that beta-adrenergic antagonists are effective in reducing mortality during and after AMI (relative risk 0.87 and 0.77) and that ACE inhibitors are effective in reducing mortality after AMI in patients with left ventricular dysfunction (relative risk 0.78).