This study demonstrates a system of increasing operating room efficiency by changing patient flow rather than simply working to streamline existing steps. This increase in efficiency is not associated with the expansion of hospital budgets or a decrease in patient safety or satisfaction.

The relatively low sensitivity of PET for identifying locoregional lesions precludes its replacement of conventional CT staging. However, the primary advantage of PET imaging is its superior specificity for tumor detection and improved diagnostic value for distant metastatic sites, features that may substantially affect patient management decisions. In conclusion, PET imaging is useful in the initial staging of esophageal cancer and provides additional and complementary information to that obtained by CT imaging.

A key economic indicator is real output. To get this right, we need to measure accurately both the value of nominal GDP (done by Bureau of Economic Analaysis) and key price indexes (done mostly by Bureau of Labor Statisticcs). All of us have worked on these measurements while at the BLS and the BEA. In this article, we explore some of the thorny statistical and conceptual issues related to measuring a dynamic economy. An often-stated concern is that the national economic accounts miss some of the value of some goods and services arising from the growing digital economy. We agree that measurement problems related to quality changes and new goods have likely caused growth of real output and productivity to be understated. Nevertheless, these measurement issues are far from new, and, based on the magnitude and timing of recent changes, we conclude that it is unlikely that they can account for the pattern of slower growth in recent years. First we discuss how the Bureau of Labor Statistics currently adjusts price indexes to reduce the bias from quality changes and the introduction of new goods, along with some alternative methods that have been proposed. We then present estimates of the extent of remaining bias in real GDP growth that stem from potential biases in growth of consumption and investment. And we take a look at potential biases that could result from challenges in measuring nominal GDP, including those involving the digital economy. Finally, we review ongoing work at BLS and BEA to reduce potential biases and further improve measurement.

Improving team structure and heightening communication will help provide cost-effective and high-quality patient care for general surgery patients. Design: This study surveys teamwork initiatives and their effects on specific variables related to patient care. Patients: The study population comprised all patients admitted to the hospital's general surgery teams during 5 years 3 months. Setting: Tertiary care hospital. Interventions: A complete restructuring of the patient care team for general surgery patients admitted to the hospital. The intervention occurred midway through the study period. Main Outcome Measures: Mean length of stay for general surgery patients as a marker of team efficiency and a standardized patient satisfaction survey. Results: The mean length of stay after initiation of the restructured care team was significantly shorter than before initiation. The significance was present despite a consistent patient acuity measure and was associated with a high patient satisfaction level. Conclusions: Restructuring the patient care team yielded a decreased mean length of stay while maintaining a high level of patient satisfaction. This analysis helps validate a hospitalwide initiative to maintain a high level of patient care while increasing patient volume.

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