OR distractions linked to more errors; Med students hesitate to call out senior staff on hand hygiene;

> Surgical residents are more likely to make errors in the operating room when exposed to distractions and interruptions, according to a study published online in Archives of Surgery, Med Page Today reported. In simulated procedures, surgical residents made eight times as many errors with disruptions than during procedures without distractions. The primary cause of interruption was the unexpected movement, speaking or cell phone use. Article

> Expediting primary healthcare for chronically ill inmates soon after release from prison leads to fewer hospital emergency department visits, according to a Yale study published in the American Journal of Public Health, researchers said Thursday. The study found that patients who used transition clinics and management programs that focus on the healthcare of former inmates had a 51 percent lower rate of ED visits in the 12 months following their release. Statement

> President and CEO of St. John's Health Center in Santa Monica, Cali., addressed how hospitals should respond to a crisis like the Aurora (Colo.) theater shooting in an interview Friday with The Los Angeles Times. Lou Lazatin stressed the importance of ensuring readiness for large-scale emergencies by preparing the ED, alerting the entire facility to the emergency and running regular drills with the staff to prepare for crisis. Article

> After four years of negotiations, three New Hampshire facilities have launched a collaborative effort to streamline costs and meet demands for quality local healthcare, the Union Leader reported yesterday. Upper Connecticut Valley Hospital, Weeks Medical Center and Androscoggin Valley Hospital all voted to form the Northern New Hampshire Healthcare Collaborative, which aims to provide services for the state's local uninsured and underinsured Medicaid and Medicare patients. Article

> Eighty-three percent of medical students said they are unwilling to speak up to senior staff about subpar hand hygiene practices, according to a survey conducted by researchers at the Monash University in Melbourne (AU), Infection Control Today reported. A key factor that prevents students from speaking up is the fear of questioning senior staff. Disrupting the hierarchal culture in healthcare should not affect the quality of patient care, researchers said. Article

And Finally… NYC's water-only café. Article