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Quality and Accountability: A New Era in American Hospitals
terpretation. Concise, easy to understand explanations are found on the reverse side of each strip. Because this is designed as a workbook, no instructional text is presented. Other ECG texts must be consulted for more in-depth explanations of interpretations. The rhythm strips in this workbook are challenging and must be systematically analyzed to arrive at the correct interpretation. This workbook would be an excellent practice tool for any nurse, medical student, or physician interested in further developing his ECG interpretation skills. Elizabeth A Rimm, RN Washington, DC
Quality and Accountability: A New Era in American Hospitals. Stanley A Skillicorn. Editorial Consultants, Inc, 655 Sutter St, San Francisco, Calif 94102, 1980, 144 pp, $14. This is a fascinating book for all concerned with the quality of patient care. It was written by the director of medical education at San Jose (Calif) Hospital. As at most hospitals, the administration of this 543-bed acute care facility was concerned about the quality of its care. When inadequacies of its quality control systems were recognized, a quality control committee was formed. The committee set out to end such problems as patient falls, preventable postoperative complications, medication errors, unnecessary x-rays, incompetence, and inefficiency.The new program, which was instituted in 1977, corresponds closely to the Joint Commission on Accreditation of Hospitals’ (JCAH) 1980 quality assurance standard. In telling the story of how the committee instituted its new program, the author necessarily had to tell us how things were before changes were made. It took courage to be so honest, and the reader will appreciate the administration’s frankness in permitting its story to be told. Although incidents of neglect, error, incompetence, and carelessness are described, it must be remembered that they represent only a small amount of the patient care given. The approach the hospital took was “to search out deficiencies in patient care, wherever they occur and whoever might be responsible for them, and then through a system of peer review to adopt measures necessary to
eliminate the problems.” The author clearly outlines how the committee and hospital staff did this and what they did with the information that was found. Among the conclusions are that few errors are caused by a lack of knowledge by professionals and that deficiencies in performance usually arise from adeficiency in some internal hospital system. The examples and forms that are included would be helpful for those at other hospitals in developing quality assurance guidelines. The appendices contain the JCAH quality assurance standard,the San Jose Hospital’s quality assurance program, and its patient relations program. There is also a bibliography. Sister Kane, RHSJ, RN Cornwall, Ontario
Allergies to paper may cause skin rash Are you buried in paperwork? It may be more aggravating than you think. That puzzling skin rash that won’t go away just might be caused by the paper you work with every day. Skin specialists have known for years that some individuals are allergic to the ingredients in typing paper, carbon paper, paper used in duplicating machines, and just paper in general. One person has been found to be allergic to newspapers. The newest problem to be discovered is allergy to carbonless copy paper. James G Marks, Jr, MD, dermatologist with the Milton S Hershey Medical Center of PennsylvaniaState University College of Medicine, Hershey, reports in the June 12 Journal of the American Medical Association on a 21-year-old clerk in a college registrar’s office who suffered skin rashes for more than a year before the cause was traced to the carbonless copy paper used for student registration. Avoiding the paper cured the rash. Dr Marks also cites earlier reports of allergy to paper. A female office worker developed a rash on her hands from the typing paper she used. Papers used in photocopying machines cause problems for some workers.
AORN Journal, September 1981, Vo l 3 4 , No 3
515
Quality and Accountability: A New Era in American Hospitals. Stanley A Skillicorn. Editorial Consultants, Inc, 655 Sutter St, San Francisco, Calif 94102, 1980, 144 pp, $14. This is a fascinating book for all concerned with the quality of patient care. It was written by the director of medical education at San Jose (Calif) Hospital. As at most hospitals, the administration of this 543-bed acute care facility was concerned about the quality of its care. When inadequacies of its quality control systems were recognized, a quality control committee was formed. The committee set out to end such problems as patient falls, preventable postoperative complications, medication errors, unnecessary x-rays, incompetence, and inefficiency.The new program, which was instituted in 1977, corresponds closely to the Joint Commission on Accreditation of Hospitals’ (JCAH) 1980 quality assurance standard. In telling the story of how the committee instituted its new program, the author necessarily had to tell us how things were before changes were made. It took courage to be so honest, and the reader will appreciate the administration’s frankness in permitting its story to be told. Although incidents of neglect, error, incompetence, and carelessness are described, it must be remembered that they represent only a small amount of the patient care given. The approach the hospital took was “to search out deficiencies in patient care, wherever they occur and whoever might be responsible for them, and then through a system of peer review to adopt measures necessary to
eliminate the problems.” The author clearly outlines how the committee and hospital staff did this and what they did with the information that was found. Among the conclusions are that few errors are caused by a lack of knowledge by professionals and that deficiencies in performance usually arise from adeficiency in some internal hospital system. The examples and forms that are included would be helpful for those at other hospitals in developing quality assurance guidelines. The appendices contain the JCAH quality assurance standard,the San Jose Hospital’s quality assurance program, and its patient relations program. There is also a bibliography. Sister Kane, RHSJ, RN Cornwall, Ontario
Allergies to paper may cause skin rash Are you buried in paperwork? It may be more aggravating than you think. That puzzling skin rash that won’t go away just might be caused by the paper you work with every day. Skin specialists have known for years that some individuals are allergic to the ingredients in typing paper, carbon paper, paper used in duplicating machines, and just paper in general. One person has been found to be allergic to newspapers. The newest problem to be discovered is allergy to carbonless copy paper. James G Marks, Jr, MD, dermatologist with the Milton S Hershey Medical Center of PennsylvaniaState University College of Medicine, Hershey, reports in the June 12 Journal of the American Medical Association on a 21-year-old clerk in a college registrar’s office who suffered skin rashes for more than a year before the cause was traced to the carbonless copy paper used for student registration. Avoiding the paper cured the rash. Dr Marks also cites earlier reports of allergy to paper. A female office worker developed a rash on her hands from the typing paper she used. Papers used in photocopying machines cause problems for some workers.
AORN Journal, September 1981, Vo l 3 4 , No 3
515