PHYSICIAN ADVISERS ADD UP FOR SOME HOSPITALS.

A team of health care experts crunches the numbers sand reaches the conclusion that creating - or expanding - a physician adviser program is a good return on investment for any organization that's considering it.

Self-reflection as a Tool to Increase Hospitalist Participation in Readmission Quality Improvement.

BACKGROUND: Reducing 30-day readmissions is a national priority. Although multipronged programs have been shown to reduce readmissions, the role of the individual hospitalist physician in reducing readmissions is not clear. OBJECTIVES: We evaluated the effect of physicians' self-review of their own readmission cases on the 30-day readmission rate. METHODS: Over a 1-year period, hospitalists were sent their individual readmission rates and cases on a weekly basis. They reviewed their cases and completed a data abstraction tool. In addition, a facilitator led small group discussion about common causes of readmission and ways to prevent such readmissions. RESULTS: Our preintervention readmission rate was 16.16% and postintervention was 14.99% (P = .76). Among hospitalists on duty, nearly all participated in scheduled facilitated discussions. Self-review was completed in 67% of the cases. CONCLUSIONS: A facilitated reflective practice intervention increased hospitalist participation and awareness in the mission to reduce readmissions and this intervention resulted in a nonsignificant trend in readmission reduction.

Novel biologically potent diorganosilicon(IV) complexes of indole-2,3-dione derivatives.

The aim of the present study is to synthesize some novel ecofriendly fungicides and bactericides of indole-2,3-dione derivatives, having important pharmacodynamic significance. The ligands used in the present account are derived by the condensation of 1,3-dihydro-3-[2-(phenyl)-2-oxoethylidene]-2H-indol-2- one, 1,3-dihydro-3-[2-(4-nitrophenyl)-2-oxoethylidene]-2H-indol-2-one and 1,3-dihydro-3-[2-(4-nitro-3-methylphenyl)- 2-oxoethylidene]-2H-indol-2-one with hydrazinecarboxamide and hydrazinecarbothioamide. These imines, on interaction with diorganosilicon(IV) chlorides, yield complexes having Si-O or Si-S and Si<--N bonds. The structure of these compounds have been elucidated by elemental microanalyses and spectral [(UV), (IR), (1)H, (13)C and (29)Si NMR)] studies which unerringly point to a trigonal bipyramidal and octahedral geometries for unimolar and bimolar reactions, respectively. The potency of the synthesized compounds have been assessed by growth inhibiting potential of the complexes against variety of fungal and bacterial strains and male albino rats. The results of these biological studies have been compared with the standard fungicide, Bavistin. The studies demonstrate that, 1,3-dihydro-3-[2-(4-nitrophenyl)-2-oxoethylidene]-2H-indol-2-onehydrazincarbothioamide and its diphenylsilicon(IV) complexes have comparable antimicrobial activity and are less toxic to male albino rats than Bavistin.