s quality improvement (QI) has become an integral part of clinical practice, residency training programs have continued to evolve in how best to teach QI.The Accreditation Council for Graduate Medical Education (ACGME) Common Program requirements mandate that core competencies in residency programs include practice-based learning and improvement and systems-based practice. 1Residents should receive education in QI, receive data on quality metrics and benchmarks related to their patient population, and participate in QI activities.The Clinical Learning Environment Review (CLER) program was established to provide feedback to institutions on 6 focused areas, including patient safety and health care quality.In visits to institutions across the United States, the CLER committees found that many residents had limited knowledge of QI concepts and limited access to data on quality metrics and benchmarks. 2 There are many barriers to implementing a QI curriculum in residency programs, and creating and maintaining successful strategies has proven challenging.

Objective: The purpose of this quality improvement project was to abstract and analyze previously collected data from veterans with high-impact chronic pain who attended the Empower Veterans Program (EVP) offered by a Veterans Administration facility in the northeastern United States.

atients receive interdisciplinary inpatient rehabilitation treatment after they have sustained a lower limb fracture, a lower limb joint replacement, or have generalized deconditioning (muscle wasting and disuse atrophy) following hospitalization for surgery or illness.The degree of a patient's impairment or loss of functional capacity, as well as their ability to manage at home safely, is assessed using standardized outcome measures during their recovery and rehabilitation. 1,2hysiotherapists routinely use validated outcome measures to assess patient progress and to measure goal attainment through assessment of functional independence, dynamic balance performance, and ambulatory ability.These objective assessments provide clinicians with information about the effectiveness of the rehabilitation program, as well as the patient's ability to manage in their home environment, to determine the need for assistive devices, level of caregiver support, future level of autonomy, and strategies for falls prevention. [3]][5][6][7] There is a view among service providers that rehabilitation decisions can be based on a singular measure of function known as the Functional Independence Measure (FIM).This is an understandable position because not only is the FIM an internationally recognized, valid, and reliable tool, but, as a singular measure, it also means

Objective.To assess the efficacy and safety of olaparib as an adjuvant treatment in patients with BRCA1 or BRCA2 germline mutations who are at a high-risk for relapse.Design.A randomized, double-blind, placebo-controlled, multicenter phase III study.The published results are from the prespecified interim analysis.Intervention.Patients were randomized in 1:1 ratio to either receive 300 mg of olaparib orally twice daily or to receive a matching placebo.Randomization was stratified by hormone receptor status (estrogen receptor and/or progesterone receptor positive/HER2-negative vs triple negative), prior neoadjuvant vs adjuvant chemotherapy, and prior platinum use for breast cancer.Treatment was continued for 52 weeks.Setting and participants.A total of 1836 patients were randomized in a 1:1 fashion to receive olaparib or a placebo.Eligible patients had a germline BRCA1 or BRCA1 pathogenic or likely pathogenic variant.Patients had highrisk, HER2-negative primary breast cancers and all had received definitive local therapy and neoadjuvant or adjuvant chemotherapy.Patients were enrolled between 2 to 12 weeks after completion of all local therapy.Platinum chemotherapy was allowed.Patients received adjuvant endocrine therapy for hormone receptor positive disease as well as adjuvant bisphosphonates per institutional guidelines.Patients with triple negative disease who received adjuvant chemotherapy were required to be lymph node positive or have at least 2 cm invasive disease.Patients who received neoadjuvant chemotherapy were required to have residual invasive disease to be eligible.For hormone receptor positive patients receiving adjuvant chemotherapy to be eligible they had to have at least 4 pathologically confirmed lymph nodes involved.Hormone receptor positive patients who had neoadjuvant chemotherapy were required to have had residual invasive disease.Main outcome measures.The primary endpoint for the study was invasive disease-free survival which was defined as time from randomization to date of recurrence or death from any cause.The secondary endpoints included overall survival (OS), distant disease-free survival, safety, and tolerability of olaparib.

Objective: To develop a process through which Mobile Integrated Health (MIH) can treat patients with chronic obstructive pulmonary disease (COPD) at high risk for readmission in an outpatient setting. In turn, South Shore Hospital (SSH) looks to leverage MIH to improve hospital flow, decrease costs, and improve patient quality of life.

Objective: The pandemic has forced closures of primary schools, resulting in loss of learning time on a global scale. In addition to face coverings, social distancing, and hand hygiene, an efficient testing method is important to mitigate the spread of COVID-19 in schools. We evaluated the feasibility of a saliva-based SARS-CoV-2 polymerase chain reaction testing program among 18 primary schools in the Emirate of Abu Dhabi, United Arab Emirates. Qualitative results show that children 4 to 5 years old had difficulty producing an adequate saliva specimen compared to those 6 to 12 years old.