"Why Did She Talk to Him Again?" The Effects of the Justice Motive, Relationship Type, and Degree of Postassault Contact on Perceptions of Sexual Assault.

Victim blaming attitudes are prevalent within the criminal justice system where survivor behavior before, during, and following an assault is heavily scrutinized. Although dispositional characteristics (e.g., strength of one's justice motive) and characteristics of the assault (e.g., the type of relationship between a survivor and an offender) have been found to predict the degree of victim blaming, the effects of these variables on sexual assault myth endorsement are unclear. In addition, a variable that has not been examined in past literature is the degree of contact maintained between a survivor and offender after the assault. The purpose of the current study was to examine the extent to which the justice motive (strong vs. weak), the relationship between a fictional survivor and an offender (strangers vs. intimate partners), and contact between a survivor and offender postassault (contact vs. no contact) influenced endorsement of sexual assault myths. Undergraduate students read a vignette depicting a fictional sexual assault that varied with respect to the relationship and the amount of postassault contact between the survivor and offender and completed measures of the strength of their justice motive and their endorsement of sexual assault myths. Results indicated that participants (N = 419) who held a strong justice motive showed higher endorsement of sexual assault myths. Participants were also more likely to endorse sexual assault myths when there was postoffense contact between the survivor and offender. The implications of these findings and their relevance to the criminal justice system are discussed, including the need for further research into the creation of survivor-oriented education and training capable of counteracting bias toward survivors of sexual violence and producing sustained attitudinal changes.

Lean Process Improvement in the Emergency Department.

Lean engineering is based on a process improvement strategy originally developed at Toyota and has been used in many different industries to maximize efficiency by minimizing waste. Lean improvement projects are frequently instituted in emergency departments in an effort to improve processes and thereby improve patient care. Such projects have been undertaken with success in many emergency departments in order to improve metrics such as door-to-provider time, left without being seen rate, and patient length of stay. By reducing waste in the system, Lean processes aim to maximize efficiency and minimize delay and redundancy to the extent possible.

An Updated Healthcare System-Wide Clinical Pathway for Managing Patients With Chest Pain and Acute Coronary Syndromes.

Clinical pathways reinforce best practices and help healthcare institutions standardize care delivery. The NewYork-Presbyterian/Columbia University Irving Medical Center has used such a pathway for the management of patients with chest pain and acute coronary syndromes for almost 2 decades. A multidisciplinary panel of stakeholders serially updates the algorithm according to new data and recently published guidelines. Herein, we present the 2019 version of the clinical pathway. We explain the rationale for changes to the algorithm and describe our experience expanding the pathway to all the 8 affiliated institutions within the NewYork Presbyterian healthcare system.