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Quality and safety in the literature: April 2023
  1. Jordan Maxey1,2,
  2. Ashwin Gupta1,2,
  3. Nathan Houchens1,2
  1. 1 Medicine Service, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
  2. 2 Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
  1. Correspondence to Dr Jordan Maxey, VA Ann Arbor Healthcare System, Ann Arbor, MI 48105, USA; maxeyj{at}

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Healthcare quality and safety span multiple topics across the spectrum of academic and clinical disciplines. Keeping abreast of the rapidly growing body of work can be challenging. In this series, we provide succinct summaries of selected relevant studies published in the last several months. Some articles will focus on a particular theme, whereas others will highlight unique publications from high-impact medical journals.

Key points

  • In older patients with diabetes mellitus and risk of cardiovascular events, the addition of a clinical decision support system to team-based care compared with team-based care alone resulted in modest reductions in glycosylated haemoglobin, low-density lipoprotein cholesterol levels and systolic blood pressure after 18 months of follow-up, although there was no difference in all-cause mortality at 36 months. Ann Intern Med. 6 December 2022.

  • The use of a validated point-of-care risk stratification tool to assist emergency department providers in disposition planning (ie, admission vs discharge) for patients with heart failure in combination with standardised transitional care is associated with lower risk of death from any cause or hospitalisation for cardiovascular causes within 30 days and at 20 months when compared with usual care. N Engl J Med. 5 November 2022.

  • Increasing physician–nurse familiarity using geographic localisation of physicians on an inpatient medical floor was associated with improved performance in a standardised patient scenario, but without any correlation with changes in patient outcomes. JAMA Intern Med. 10 October 2022.

Comparative effectiveness of team-based care with and without a clinical decision support system for diabetes management: a cluster randomized trial

Ann Intern Med, 6 December 2022

The prevalence of diabetes mellitus (DM) is increasing worldwide.1 Although the mere presence of DM alone increases risk of major cardiovascular events such as myocardial infarction, comorbid conditions commonly found in patients with DM including hypertension and hyperlipidaemia are also independent risk factors for cardiovascular disease.2–4 Despite high global prevalence and their association with cardiovascular disease, simultaneous …

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  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests JM, AG and NH are employed by the US Department of Veterans Affairs.

  • Provenance and peer review Not commissioned; internally peer reviewed.