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Indexed in MEDLINE, PubMed, and PubMed Central PRSRT STD US POSTAGE National Library of Medicine PAID 500 NE Multnomah St, Suite 100 PORTLAND OR PERMIT NO 1452 Portland, Oregon 97232 Volume Change Service Requested Summer 2012 Volume 16 No. 3 16 No. 3 — Summer A peer-reviewed journal of medical science, 2012 social science in medicine, and medical humanities Original Research & Contributions 4 Prostate Cancer Screening Trends in a Large, Integrated Health Care System 10 A Colorectal “Care Bundle” to Reduce Surgical Site Infections in Colorectal Surgeries: A Single-Center Experience 18 Reductions in Pain Medication Use THE Associated with Traditional Chinese Medicine for Chronic Pain PERMANENTE 25 Ultrasound Measurements in Hypertrophic Pyloric Stenosis: Don’t Let the Numbers Fool You 28 Living With Advanced Illness: Longitudinal JOURNAL Study of Patient, Family, and Caregiver Needs 37 Sociodemographic Characteristics of Members of a Large, Integrated Health Care System: Comparison with US Census Bureau Data 42 Engaging Patients in Managing Their Health Care: Patient Perceptions of the Effect of a Total Joint Replacement Presurgical Class Special Report 49 A Framework for Making Patient-Centered Care Front and Center Review Article 54 Women in Surgery: Bright, Sharp, Brave, and Temperate Case Studies 60 Lymphoepithelial Carcinoma: A Case of a Rare Parotid Gland Tumor 63 Neurothekeoma in the Posterior Fossa: Case Report and Literature Review Commentary 71 Solving the Emergency Care Crisis in Printed on acid free paper. America: The Power of the Law and Storytelling The Permanente Journal Summer 2012 Volume 16 No. 3 ISSN 1552-5767 www.thepermanentejournal.org Summer 2012/ Volume 16 No. 3 The ORIGINAL RESEARCH users, there was a short-term reduction Books published by PermanenteJournal & CONTRIBUTIONS in NSAID use—sustained as visits became less frequent. There was no indication Permanente authors: 4 Prostate Cancer Screening Trends in a that pain reduction during TCM treat- Large, Integrated Health Care System. Mission: The Permanente Journal advances ment was influenced by drug use. Lauren Wallner, PhD, MPH; Stanley knowledge in scientific research, clinical Pfenninger & Fowler’s Procedures Frencher, MD; Jin-Wen Hsu, PhD; 25 Ultrasound Measurements in Hyper- medicine, and innovative health care for Primary Care; Third Edition Ronald Loo, MD; Joice Huang, PharmD, trophic Pyloric Stenosis: Don’t Let the John L Pfenninger, Gran C Fowler; delivery. MBA; Michael Nichol, PhD; Steven Numbers Fool You. Meena Said, MD; Special Editors: Haneef Alibhai, Jacobsen, MD, PhD Donald B Shaul, MD; Michele Fuji- Jamie Broomfield, Joe Esherick, moto, MD; Gary Radner, MD; Roman In a retrospective cohort study (1998- Grant C Fowler, Theodore O’Connell, Circulation: 25,000 print readers per M Sydorak, MD; Harry Applebaum, MD 2007) of 2,061,047 men (older than 35 Dale Patterson, Mike Petrizzi quarter, and 1 million Internet hits in years) within a large integrated health In a retrospective analysis of 189 ISBN-10: 0323052673 2011 from 150 countries. care system, 572,306 (28%) had pros- patients with hypertrophic pyloric ISBN-13: 978-0323052672 tate-specific antigen (PSA) screening. stenosis (means of: 4.6 weeks, 3.9 kg, Patterns of screenings varied modestly 0.42 cm muscle thickness, and 1.89 cm Philadelphia, PA: Elsevier Mosby; by age, race, and physician. The low- muscle length) that were treated at a 2011 est frequencies were in men younger single institution over a 5-year period Hardcover: 1776 pages than 45 years (19%) and older than 85 (2005-2010), analysis showed a signifi- $162.95 years (13%). PSA screening was most cant relationship between both age and common in white men (33.5%) and weight and the muscle thickness. No in men seen by physicians of the same significant relationship existed between race/ethnicity (32%), compared with pyloric length and age or weight. men with physicians of disparate race/ ethnicity (26%, p < 0.001). 28 Living With Advanced Illness: Longi- The Power of Prana: Breathe tudinal Study of Patient, Family, and Your Way to Health and Vitality 10 A Colorectal “Care Bundle” to Reduce Caregiver Needs. Karen Tallman, PhD; Master Stephen Co; Eric B Surgical Site Infections in Colorectal Ruth Greenwald, MS, MA; Alice Reide- Robins, MD; John Merryman Surgeries: A Single-Center Experience. nouer, SM; Laurel Pantel ON THE COVER Waleed Lutfiyya, MD, FASCRS; David ISBN-10: 160407440X Little is known about how the needs of “Lower Falls” a Parsons, MD, FASCRS; Juliann Breen, ISBN-13: 978-1604074406 patients with advanced illness and the photograph by Gary RN, CPHQ Boulder, CO: Sounds True, Inc; Larsen, MS, was taken needs of their families and caregivers In a retrospective analysis of infection 2011 at Artist Point in the evolve, or how effectively those needs rates at Kaiser Sunnyside Medical Cen- Paperback: 189 pages Grand Canyon of are addressed. A video-ethnographic ap- ter, from the National Surgical Quality $15.95 the Yellowstone in proach was conducted to observe and Improvement Program (NSQIP) database, Yellowstone National interview 12 patients and their families the authors reviewed overall, superficial, Park. The mist rainbow before, during, and after an inpatient deep, and organ/space surgical site infec- can be seen every day palliative care consult at 3 urban Medi- tions (SSIs). As a baseline there were 430 around 9:50 am and is cal Centers. This longitudinal approach colorectal cases from January 2006 to just one of the stunning highlighted areas for improvement, December 2009. After a colorectal care sights to see in this which include clear, integrated com- bundle of interventions was implemented A Soldier’s Story: World War II magnificent place. munications in the hospital and coor- January 2010 through June 2011, there dinated, comprehensive postdischarge and the Battle at Sessenheim, Mr Larsen is a Clinical Microbiologist in the were 13 infections in 195 cases, a 6.67% support for patients not under hospice France Bacteriology Department of the Northern California overall rate. The overall decrease of care and for their caregivers. John T “Jack” Scannell; Kate Regional Laboratory in Berkeley, CA. He uses 14.49% from baseline, and the decrease Scannell, MD, editor photography as a refreshing excuse to get away of superficial SSI from 15.12% to 3.59%, 37 Sociodemographic Characteristics of from the busy laboratory to peaceful locations and were both significant (p <0.0001). The Members of a Large, Integrated Health ISBN-10: 1467990116 to indulge in his re-energizing hobby. rates for deep and organ/space SSIs Care System: Comparison with US ISBN-13: 978-1467990110 showed a nonsignificant decrease. The Census Bureau Data. Corinna Koebnick, Scotts Valley, CA: CreateSpace; NSQIP observed-to-expected ratio for PhD, MS; Annette M Langer-Gould, MD, 2011 colorectal SSI decreased from a range of PhD, MS; Michael K Gould, MD, MS; Chun R Chao, PhD, MS; Rajan L Iyer, Paperback: 104 pages 1.27 to 1.83 before implementation to $8.99 0.54 after implementation. MPH; Ning Smith, PhD; Wansu Chen, MS; Steven J Jacobsen, MD, PhD 18 Reductions in Pain Medication Use On review of sociodemographic char- Associated with Traditional Chinese acteristics of 3,328,579 members of Medicine for Chronic Pain. Kaiser Permanente Southern California Charles Elder, MD, MPH, FACP; Cheryl (KPSC) in 2000 and 3,357,959 members 78 BOOK REVIEW Ritenbaugh, PhD, MPH; Mikel Aickin, in 2010, compared with those of the PhD; Richard Hammerschlag, PhD; Silicone 80 CME EVALUATION FORM underlying population in the coverage Samuel Dworkin, DDS, PhD; Scott Mist, Carlos Meza area based on US Census Bureau data; PhD, MAcOM; Richard E Harris, PhD similarities included: neighborhood edu- ISBN: 978-0-61533-859-0 Participants (168) in a randomized trial cational levels, household incomes, sex, ISBN: 978-0-98260-510-3 of traditional Chinese medicine (TCM) age, and the proportion of Hispanics/La- Tamarac, FL: Roatan Press; 2010 for temporomandibular joint dysfunction tinos; however, KPSC members included Paperback: 270 pages had a linear decline in pain over 16 TCM more blacks. These findings suggest that $14.95 The Permanente Journal visits. This article reports an observational this setting may provide valid inference analysis of the average pain outcomes 500 NE Multnomah St, Suite 100 for clinical, epidemiologic, and health and medication use reported at every services research. Portland, Oregon 97232 TCM visit. Among the heaviest non- www.thepermanentejournal.org steroidal anti-inflammatory drug (NSAID) ISSN 1552-5767 The Permanente Journal/ Summer 2012/ Volume 16 No. 3 CME credits are available online at www.thepermanentejournal.org. The mail-in CME form can be found on page 80. 42 Engaging Patients in Managing CASE STUDIES 67 Development of a Computerized Their Health Care: Patient Perceptions 60 Lymphoepithelial Carcinoma: Intravenous Insulin Application of the Effect of a Total Joint A Case of a Rare Parotid Gland Tumor. (AutoCal) at Kaiser Permanente Replacement Presurgical Class. Christopher G Tang, MD; Thomas M Northwest, Integrated into Kaiser Mary-Louise Lane-Carlson, EdD, MPH, Schmidtknecht, MD; Grace Y Tang; Luke J Permanente HealthConnect: Impact RD, CDE; John Kumar, MD Schloegel, MD; Barry Rasgon, MD on Safety and Nursing Workload. Most research studies on presurgical Christine Olinghouse, MPH/MSN, A 29-year-old woman presented with a FNP-BC, BC-ADM, CDE education are quantitative in nature, 10-month history of an enlarging left- preventing patients’ voices from being sided facial mass. The patient received a A review of 35 patient charts using heard. Using a success-case, narrative total left parotidectomy and a selective a computerized insulin infusion design, 24 patients (from the Kaiser neck dissection. A lymphoepithelial tool indicated 100% accuracy in Permanente Downey Medical Center) carcinoma of the parotid is a rare salivary computations with a reduction of were interviewed regarding their pre- gland tumor accounting for less than 1% nursing workload from 2 minutes to 30 and postsurgical experiences.