Computer-aided diabetes education: a synthesis of randomized controlled trials.

Computer-aided diabetes education is the application of technology to provide information on diabetes self-management as well as test the users' knowledge and provide feedback. The objective of this paper was to evaluate the impact of computer-aided diabetes education in improving health outcomes. We identified reports of randomized controlled trials through systematic electronic database searches. Three eligibility criteria were applied: randomized controlled trial; evaluation of a computerized diabetes education program; and assessment measured on the outcome of patient care. We abstracted data by using a standardized form. Of 19 eligible trials, 16 trials (84.2%) reported significant positive outcomes. A total of 112 outcomes were identified. Forty-two percent (42.0%) of the outcomes demonstrated significant improvements (47 of 112 outcomes). Considering the importance of patient self-management behaviors in chronic disease management, initial evidence suggests computer-aided diabetes education can play a more significant role in the future.

Assessing patient safety awareness and needs in rural hospitals in one US state.

Several initiatives have addressed patient safety by enabling electronic voluntary reporting of adverse events within academic medical centres in urban settings. Such initiatives are lacking in the rural context, and it remains unknown whether the same challenges and solutions apply to rural hospitals. The purpose of this study is to provide insight into the organisational culture and level of readiness to adopt patient safety strategies in a rural setting, as well as to identify critical issues pertaining to the rural context that need to inform the design of such strategies. We conducted telephone interviews with administrators and healthcare providers of rural hospitals in one US state. Questions referred to the respondents' current reporting mechanism, its advantages and disadvantages, and organisational patient safety culture. A total of 16 administrators and 14 providers of eight rural hospitals in the state of Missouri were interviewed. Findings indicate that very few administrators felt that there was a timely response to adverse event reports. Half of the administrators stated that the current mechanism is an appropriate and adequate outlet to ensure patient safety. None of the healthcare providers found errors and adverse events to be over-reported; the majority believe that they are being under-reported. Only 36% of the care providers interviewed have themselves reported an error or adverse drug event during their tenure with their organisation. The study findings demonstrate a definite need for improvement of the current infrastructure of rural hospitals in order to enable an effective outlet for ensuring patient safety.