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We Measure Satisfaction Published by the North Carolina Institute of Medicine and The Duke Endowment www.ncmedicaljournal.com July/August 2005, 66:4 We Measure Satisfaction Southeast Anesthesiology Consultants and Southeast Pain Care Are Dedicated To Patient and Surgeon Satisfaction. One patient at a time. Everyone talks about exceeding expectations, but Southeast Anesthesiology Consultants and Southeast Pain Care do more than talk. Through ongoing patient surveys, we measure the satisfaction levels of our 70,000 anesthesia and 30,000 chronic pain patients each year. In addition, we survey our surgical colleagues every other year for their assessment of our performance. Patient Satisfaction Surgeon Satisfaction Surgical anesthesia was excellent or good Quality of anesthesia care 100 99.7% 99.6% 99.7% 97.6% 100% 99% 99% 50 2003- 2001 2002 2003 2004 1999 2001 2004 0 Patient and surgeon satisfaction results are audited by a third party and are statistically significant. Patient and surgeon satisfaction surveys are crucial elements in our comprehensive Continuous Quality Improvement program, which also includes 50-point quality checklists on every patient we treat. It’s all part of our dedication to Assuring Safety and Administering Comfort, one patient at a time. Southeast Southeast Anesthesiology Charlotte Huntersville Kings Mountain Lincolnton Pain Care Monroe Pineville Rock Hill University Area Consultants P.O. Box 36351, Charlotte NC 28236 www.seanesthesiology.com 800 354 3568 -ANAGING#HRONIC(EALTH #ONDITIONS4HROUGH-EMBER (EALTH0ARTNERSHIPS >LiÌiÃ] >ÃÌ >] `iÞ `Ãi>Ãi] wLÀÞ>}>] }À>i À i>ÀÌ `Ãi>Ãi° 7 i > «>ÌiÌ ÀiViÛiÃ Ì i iÜÃ Ì >Ì Ì iÞ >Ûi >Þ i v Ì iÃi V ÀV V`ÌÃ] V >Vià >Ài Ì >Ì Ì iÞ Ü Ü>Ì Ì i>À iÛiÀÞÌ } Ì iÞ V> >LÕÌ Ì° Ì Õi ÀÃà >` Õi - i` v ÀÌ >À>] Üi Ü>Ì ÕÀ iLiÀÃ Ì i>À Ü Ì LiÌÌiÀ >>}i Ì iÀ V ÀV V`ÌÃ] >à Üi >à }iÌ Ì i v>VÌÃ Ü Ì iÞ V> Ûi > i>Ì iÀ viÃÌÞi° 7i Ü>Ì Ì i« Ì i ÃÀÌ Ì ÀÕ} Ì i vÀ>Ì ÛiÀ>` Ì >Ì Ì iÞ Ü iÞ iVÕÌiÀ] >` }iÌ Ì i Õ«Ì`>Ìi vÀ>Ì >LÕÌ Ì iÀ ëiVwV V`Ì Ü i Ì iÞ ii` Ì° / >Ì½Ã Ü Þ Üi vviÀ iLiÀ i>Ì *>ÀÌiÀà «Ã-° iÃ}i` Ì i`ÕV>Ìi ÕÀ iLiÀà >LÕÌ Ì iÀ `Û`Õ> i>Ì VViÀÃ] Ì iÃi VÕÃÌâi` «À}À>à >à i« Ài`ÕVi Ì i i>Ì ÀÃÃ Ì >Ì >Þ `iÛi« ÜÌ > V ÀV V`Ì° 7Ì i`ÕV>Ì> ÀiÃÕÀViÃ] Ãiv>>}iiÌ ÌÃ] V`ÌëiVwV µÕ>ÀÌiÀÞ iÜÃiÌÌiÀà >` iÛi w>V> ViÌÛiÃ] iLiÀÃ Ü LiiwÌ vÀ Ì i Üi`}i Ì iÞ V> }> vÀ Ì iÃi vÀii] Vw`iÌ> «À}À>ð / iÞ V> >à ëi> ÜÌ Ã«iV>Þ ÌÀ>i` ÕÀÃiÃ] Ü V> >ÃÃÃÌ Ì i Õ`iÀÃÌ>`} Ì iÀ ÌÀi>ÌiÌ «Ìà >` i« Ì i }iÌ Ì i ÃÌ ÕÌ v Ì iÀ vwVi ÛÃÌà ÜÌ ÞÕ° >``Ì Ì V`Ìà ÃÕV >à >ÃÌ >] `>LiÌià À i>ÀÌ `Ãi>Ãi] Üi >à vviÀ > iLiÀ i>Ì *>ÀÌiÀà «Ã «À}À> vÀ iÝ«iVÌ>Ì Ì iÀà ÜÌ «Ài>Ì> V>Ài ÃÃÕið v ÞÕ >Ûi Õi ÀÃà >` Õi - i` v ÀÌ >À> «>ÌiÌÃ Ü ÜÕ` LiiwÌ vÀ >Þ v ÕÀ iLiÀ i>Ì *>ÀÌiÀà «Ã «À}À>Ã] iVÕÀ>}i Ì i Ì V> Õà >Ì £nääÓ£nxÓx À ÛÃÌ Õà i >Ì BCBSNCCOM vÀ Ài vÀ>Ì° À Ài Ì > Ç£ Þi>ÀÃ] ÕÀ iLiÀà >` «>ÀÌV«>Ì} `VÌÀà >Ûi Vi Ì iÝ«iVÌ Û>Ì vÀ Õi ÀÃà >` Õi - i` v ÀÌ >À>] ÕÀ ÃÌ>Ìi½Ã ÃÌ>Li] Ài>Li >` >À}iÃÌ i>Ì ÃÕÀiÀ° Ê`i«i`iÌÊViÃiiÊvÊÌ iÊ ÕiÊ ÀÃÃÊ>`Ê ÕiÊ- i`ÊÃÃV>Ì°ÊÁÊ>ÀÊvÊÌ iÊ ÕiÊ ÀÃÃÊ>`Ê ÕiÊ- i`ÊÃÃV>Ì°Ê-Ê-iÀÛViÊ>ÀÊvÊ ÕiÊ ÀÃÃÊ>`Ê ÕiÊ- i`ÊvÊ ÀÌ Ê >À>°Ê1ÓÇÈL]ÊxÉäx Publisher Pam C. Silberman, JD, DrPH / NC Institute of Medicine, Durham Publisher Eugene W. Cochrane, Jr. / The Duke Endowment, Charlotte Editor-In-Chief Gordon H. DeFriese, PhD / NC Institute of Medicine, Durham Scientific Editor John W.Williams, Jr., MD, MHS / Duke University Medical Center, Durham Editor Emeritus Francis A. Neelon, MD / Duke University, Durham Associate Editor Mary L. Piepenbring / The Duke Endowment, Charlotte Associate Editor Thomas C. Ricketts, III, PhD / University of North Carolina at Chapel Hill Contributing Editor Donald L. Madison, MD / University of North Carolina at Chapel Hill Section Editor, Running the Numbers Paul A. Buescher, PhD / NC DHHS, Raleigh Managing Editor Kristie Weisner Thompson, MA / NC Institute of Medicine, Durham Editorial Fellow C. Annette DuBard, MD / University of North Carolina at Chapel Hill Editorial Fellow Sharon K. Hull, MD, MPH / University of North Carolina at Chapel Hill Business Manager Adrienne R. Parker / NC Institute of Medicine, Durham Founded by the North Carolina Medical Society in 1849 Published by The North Carolina Institute of Medicine and The Duke Endowment (ISSN 0029-2559) Editorial Board Gail B. Agrawal, JD / University of North Carolina at Chapel Hill William B. Applegate, MD, MPH / Wake Forest University,Winston-Salem Cynthia B. Archie, RN, EdD / Wayne Community College, Goldsboro There Are William K. Atkinson, II, PhD / WakeMed, Raleigh James A. Bryan, II, MD / University of North Carolina at Chapel Hill J. Steven Cline, DDS, MPH / Division of Public Health / NC DHHS, Raleigh More Than Fred M. Eckel, MS / NC Association of Pharmacists at Chapel Hill E. Harvey Estes, Jr., MD / Duke University, Durham Herbert G. Garrison, MD, MPH / East Carolina University, Greenville Beth A. Griffin, MHP,PA-C / Stella Margaret N. Harker, MD / Morehead City Robert T. Harris, MD / BlueCross BlueShield of North Carolina, Chapel Hill 25,000 Olson Huff, MD / NC Child Advocacy Institute, Asheville Thomas G. Irons, MD / East Carolina University, Greenville Richard D. Jordan, DDS / Arden Ricky L. Langley, MD / Burlington Reasons Julienne K. Kirk, PharmD / Wake Forest University,Winston-Salem Mark Massing, MD, PhD / Medical Review of NC, Cary Jane B. Neese, RN, PhD / University of North Carolina at Charlotte to Advertise M. Alec Parker, DMD / Fletcher Blaine Paxton Hall, PA-C / Duke University Medical Center, Durham in the North Deborah Porterfield, MD, MPH / Division of Public Health / NC DHHS, Raleigh Senator William R. Purcell, MD / NC General Assembly, Laurinburg Phillip A. Sellers, MD / Hendersonville Carolina Dennis R. Sherrod, RN, EdD / Winston-Salem State University,Winston-Salem J. Luckey Welsh, Jr., FACHE / Southeast Regional Medical Center, Lumberton W.T.Williams, Jr., MD / Davidson Medical David R.Work, JD / NC Board of Pharmacy, Chapel Hill Joyce M.Young, MD, MPH / IBM Corporation, Research Triangle Park Journal The North Carolina Medical Journal (ISSN 0029-2559) is published by The North Carolina Institute of Medicine under the direction of its Editorial Board. Copyright © 2005 The North Carolina Institute of Medicine. Address manuscripts and communications regarding editorial matters, subscription rates, etc., to the Managing Editor Six times a year, the at the address below. All advertisements are accepted subject to the approval of the Journal’s Editorial Board. The appearance of an advertisement in this publication does not constitute any endorsement of the subject North Carolina Medical or claims of the advertisement.This publication is listed in Index Medicus. Managing Editor: Kristie Weisner Thompson, 919/401-6599, ext. 21, [email protected]. Business Manager: Adrienne R. Parker, 919/401-6599, ext. 28, [email protected]. Graphic Design: Angie Journal reaches more than Dickinson, [email protected]. Printing: The Ovid Bell Press, Inc., 1201-05 Bluff St., Fulton, MO 65251, 800/835-8919. Annual subscription (6 issues): $40 (plus 7% NC tax = $42.80). Institutional subscriptions: $60 (plus tax = $64.20). Single copies: $5.00 (plus tax = $5.35). Periodicals postage paid at Durham NC 25,000 healthcare 27713 and at additional mailing offices. Postmaster: send address changes to The North Carolina Medical Journal, 5501 Fortunes Ridge Drive, Suite E, Durham, NC 27713. professionals and policy Co-Sponsors of the Journal are: Medical Review of North Carolina / North Carolina Academy of Physician Assistants / North Carolina Association of Pharmacists / North Carolina College of Internal Medicine / North Carolina Dental Society / North Carolina Health Care Facilities shapers—making it the Association / North Carolina Hospital Association / North Carolina Medical Society / North Carolina Nurses Association Members of these organizations receive the Journal free of charge. Additional major funding support most widely distributed comes from The Duke Endowment. North Carolina-based, health-focused journal Woodcroft Professional Center • 5501 Fortunes Ridge Drive, Suite E • Durham, NC 27713 phone: 919/401-6599 • fax: 919/401-6899 • e-mail: [email protected] in the state. Internet address: http://www.ncmedicaljournal.com NC Med J July/August 2005, Volume 66, Number 4 263 July/August 2005,Volume 66, Number 4 Published by the North Carolina Institute of Medicine and The Duke Endowment ARTICLES 296 Fluid Intake and Hydration: Critical Indicators of Nursing Home Quality 267 Perceived Racial/Ethnic Bias in Healthcare in Durham County, North Carolina: Robert J. Sullivan, Jr., MD, MPH A Comparison of Community and National 298 Creative Hydration Programs Samples Lanaya Cunningham, RD Joëlle Y.Friedman, MPA, Kevin J. Anstrom, PhD, Kevin P.Weinfurt, PhD, Mary McIntosh, PhD, Hayden B. 300 Regulating Food Service in North Carolina’s Bosworth, PhD, Eugene Z. Oddone, MD, MHS, Cedric Long-Term Care Facilities M. Bright, MD, and Kevin A. Schulman, MD Cindy H. DePorter, MSSW 304 A Physicians’ Perspective on the Dining POLICY FORUM Experience in Long-Term Care Quality of Long-Term Care: Christopher M. Herman, MD, CMD Nutrition as a Critical Dimension 307 Nutrition in Advanced Alzheimer’s Disease 277 Introduction Heidi K.White, MD, MHS Gordon H. DeFriese, PhD, and Kristie Weisner Thompson, MA 313 Use of Feeding Tubes in the Care of Long- Term Care Residents 278 Issue Brief: Nutrition and the Dining Timothy S.
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