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A 58-Year-Old Woman Dissatisfied With Her Care
Jennifer Daley, MD, Discussant
JAMA. 2001;285:2629-2635.
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INTRODUCTION
DR AUDET: Ms G is a 58-year-old woman dissatisfied with the care she received during ambulatory, same-day knee surgery. She is widowed and the mother of 3 children. She has managed care insurance.
After surgery, Ms G related several concerns about her care to her primary care physician (Dr B), her orthopedist, and the hospital administrator, including disregard for her values and decisions about her preferred anesthetic agent, failure of clinicians to heed comments about the frailties of her veins resulting in unnecessary pain, and lack of attention by staff in the recovery room area.
During preadmission testing, Ms G met with an anesthesiologist and discussed various options for anesthesia. She agreed to a short-acting (lidocaine) nerve block because she wanted to observe the surgery and recover promptly. The day of surgery, another anesthesiologist selected and administered a longer-acting anesthetic agent, bupivacaine, which had not been . . . [Full Text of this Article]
MS G: HER VIEW
DR B: HIS VIEW
AT THE CROSSROADS: QUESTIONS FOR DR DALEY
What Is Quality in Health Care? Did Ms G Receive Good Quality of Care? How Good Is Service Quality in Health Care and Why Should We Care? Improving Ms G's Care Experience Restoring Ms G's Trust and Confidence What Can Clinicians Do to Promote Improvement?
QUESTIONS AND DISCUSSION
Author Affiliation: Dr Daley is Director, Center for Health Systems Design and Evaluation, Institute for Health Policy, Department of Medicine, Massachusetts General Hospital/Partners HealthCare System, and Associate Professor of Medicine, Harvard Medical School, Boston, Mass (e-mail: jdaley1@partners.org).
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