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Dr. Joseph S. Alpert

Sloppy, Greedy, or Overworked?

In early 2010, my administrative assistant, Barbara Raney, came into my office with a worried expression on her face. She told me that a lawyer from the Department of Justice (DOJ) in Washington, DC was on the phone and wanted to speak with me. My immediate thought was “What have I done that would raise […]

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Inpatient Housestaff Discontinuity of Care and Patient Adverse Events

  For more than a decade, the medical community has been concerned about continuity of care. Concern began when the Accreditation Council for Graduate Medical Education implemented national duty hour limitations in 2003. These rules became more restrictive in 2010. The current rules include an 80-hour-per-week limit, no more than 16 hours consecutively (for interns) or 28 […]

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William H. Frishman, MD

Critique of Duty Hour Requirements

A Bridge too Far: A Critique of the New ACGME Duty Hour Requirements The issue of resident work hours has been discussed extensively for more than 25 years.(1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11) Errors and signs of sleep deprivation in residents have been catalogued in a few single institution studies […]

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Anticoagulation-associated Adverse Drug Events

Most anticoagulant-associated adverse drug events (70%) are potentially preventable. Transcription errors comprise the most frequent root cause of anticoagulant-associated medication errors. In turn, medication errors are a common root cause of anticoagulant-associated adverse drug reactions. Abstract Purpose Anticoagulant drugs are among the most common medications that cause adverse drug events (ADEs) in hospitalized patients. We […]

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Copy and Paste: A Remediable Hazard of Electronic Health Records

The electronic health record offers numerous advantages over its paper counterpart: the ability to access a chart from any location; the opportunity for multiple viewers to read or contribute to a chart simultaneously; legibility; and the ease of incorporation of data into the note, without transcription error. Electronic charting is not without its pitfalls, however. […]

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