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The COWABUNGA Cart: Intervention to Optimize Patient Safety, Quality of Care, and Work Efficiency in a Dermatology Hospital Practice

Julia S. Lehman, MD; Lawrence E. Gibson, MD
Arch Dermatol. 2008;144(10):1308. doi:10.1001/archderm.144.10.1308.
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As embodied by Hippocrates' primary charge to physicians, First, do no harm, patient safety is of paramount importance in the delivery of excellent health care. In 2000, the Institute of Medicine's landmark report, “To Err is Human: Building a Safer Health System,” highlighted the impact of medical mistakes on health care outcomes and prioritized patient safety on the national scale.1 Patient safety is interwoven inextricably with quality of care, a concept that has been emphasized recently by health care professionals, researchers, and payers as a means to assess health outcomes. While patient safety and delivery of quality care are critical in the practice of medicine, work efficiency also is a legitimate concern of physicians,2 especially in today's practice climate, which rewards productivity.

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The COWABUNGA (Computer On Wheels, with Availability of Biopsy supplies, Utensils for potassium hydroxide preparation and cutaneous culture, computerized Notes, and other General Applications) cart, involving a laptop computer to facilitate bedside access to the electronic medical record, point-of-care literature searches, and electronic postprocedural documentation. Also included on the cart are biopsy, culture, and potassium hydroxide assay supplies (arrow), specimen label printer (asterisk), and hand sanitizer.

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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