This Article  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

Bernard Lo, MD
University of California, San Francisco

JAMA. 1996;275(16):1231.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

In Reply.

—These letters illustrate the range of responses that the SUPPORT project has evoked and suggest the tasks that lie ahead if we are to improve the care of seriously ill patients. The groups led by Dr Frank and Dr Solomon argue that interventions that affect the entire health care organization can change physician behavior and institutional culture and practices. I agree with their analysis. The challenge is to demonstrate that organizational interventions in fact improve important clinical outcomes. SUPPORT has set a new standard for evaluating interventions that are intended to improve the care of dying patients. Factors other than the institution-wide intervention may influence outcomes. For instance, hospital lengths of stay may decrease for many reasons, such as financial incentives under managed care. End points must be selected carefully. In addition to improving hospital policies, institutions need to show that their interventions improve pain control, increase discussions . . . [Full Text PDF of this Article]

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?