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Background Interdisciplinary plans of care (IPOCs) guide care standardization and satisfy accreditation requirements. Yet patient outcomes associated with IPOC usage through an electronic medical record (EMR) are not present in the literature. EMR systems facilitate the documentation of IPOC use and produce data to evaluate patient outcomes. Objectives This article aimed to evaluate whether IPOC-guided care as documented in an EMR is associated with inpatient mortality. Methods We contrasted whether IPOC-guided care was associated with a patient being discharged alive. We further tested whether the association differed across strata of acuity levels and overall frequency of IPOC usage within a hospital. Results Our sample included 165,334 adult medical/surgical discharges for a 12-month period for 17 hospitals. All hospitals had 1 full year of EMR use antedating the study period. IPOCs guided care in 85% (140,187/165,334) of discharges. When IPOCs guided care, 2.1% (3,009/140,187) of admissions ended with the patient dying while in the hospital. Without IPOC-guided care, 4.3% (1,087/25,147) of admissions ended with the patient dying in the hospital. The relative likelihood of dying while in the hospital was lower when IPOCs guided care (odds ratio: 0.45; 99% confidence interval: 0.41–0.50). Conclusion In this observational study within a quasi-experimental setting of 17 community hospitals and voluntary usage, IPOC-guided care is associated with a decreased likelihood of patients dying while in the hospital.

This study compares the attitudes toward breastfeeding of high-school students in Japan and the United States. The study was conducted as a cross-sectional survey with a convenience sample (N=329). Data were collected in 1989 and 1990 at two private, girls-only high schools (Tokyo, Japan and Farmington, Michigan). Retrieval rates were 100 percent (Tokyo) and 78 percent (Michigan) respectively. Responses were compared by the chi-square (x2) test with Yate's correction and factor analyses.Tokyo students perceived that their mothers talked positively about breastfeeding (54 percent), while only 17 percent of Michigan students reported that their mothers did so (Overall, this study indicates that high school students in Japan have more positive attitudes toward breastfeeding than students in the United States; however, teenagers in the United States are more interested than their Japanese age-mates in gaining information about breastfeeding.