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American Journal of Medical Quality

American Journal of Medical Quality

Official Journal of the American College of Medical Quality

eISSN: 1555824X | ISSN: 10628606 | Current volume: 35 | Current issue: 6 Frequency: Bi-monthly

The American Journal of Medical Quality (AJMQ) is focused on keeping readers informed of the resources, processes, and perspectives contributing to quality health care services. This peer-reviewed journal presents a forum for the exchange of ideas, strategies, and methods in improving the delivery and management of health care.

The American Journal of Medical Quality is focused on keeping readers informed of the resources, processes, and perspectives contributing to health care services. This peer-reviewed journal presents a forum for the exchange of ideas, strategies, and methods in the delivery and management of health care.

David B Nash, MD, MBA Jefferson College of Population Health, Philadelphia, PA, USA
Editor Emeritus
David J. Jones, MD, MPH Harrisburg, PA
Associate Editors
Mary Reich Cooper, MD, JD Jefferson College of Population Health, Philadelphia, PA, USA
Samer Ellahham, MD Cleveland Clinic, Cleveland, OH, USA
Mark Keroack, MD, MPH Baystate Health System, Springfield, MA, USA
Vittorio Maio, PharmD, MS Jefferson College of Population Health, Philadelphia, PA, USA
Steven Meurer, PhD, MBA, MHS University HealthSystem Consortium, Chicago, IL, USA
Willie H. Oglesby, PhD, MBA, MSPH, FACHE Jefferson College of Population Health, Philadelphia, PA, USA
Alexis Skoufalos, EdD Jefferson College of Population Health, Philadelphia, PA, USA
James T. Ziegenfuss, Jr, PhD Pennsylvania State University, Middletown, PA
Managing Editor
Deborah C. Meiris Jefferson College of Population Health, Philadelphia, PA, USA
Editorial Board
Susan A. Abookire, MD, MPH, FACP, BSEE, CPHIMS Harvard Medical School, Boston, MA, USA
Daniel Aronzon, MD, FAAP West Park, NY, USA
Richard Bankowitz, MD, MBA, FACP Washington, DC, USA
Paul Barach, MD, MPH Wayne State University School of Medicine, Detroit, Michigan, USA
Anthony Barbato, MD Witt/Kieffer, Oak Brook, IL, USA
Andrea L. Benin, MD Connecticut Children's Medical Center, Hartford, CT, USA
Evan M. Benjamin, MD, FACP Ariadne Labs, Boston, MA, USA
Rohit Bhalla, MD, MPH Stamford Hospital, Stamford, CT, USA
Thomas Biancaniello, MD Columbia University Medical Center, Nesconset, NY, USA
Charles C. Canver, MD, MBA, CPE, FACHE Lake Regional Health System, Osage Beach, FL, USA
Donald E. Casey, Jr., MD, MPH, MBA MEDecision, Inc, Dallas, TX, USA
Karen Chase, MS, BSN, CCDS New York, NY, USA
Carolyn Clancy, MD Health for Quality, Safety, and Value, Veterans Health Administration, Washington DC, USA
Marie Cleary-Fishman, BSN, MS, MBA Health Research and Education Trust, Chicago, IL, USA
Albert Crawford Jefferson College of Population Health, Philadelphia, PA, USA
Nancy Davis, PhD University of Kansas School of Medicine, KS, USA
Thomas W. Diller Blue Cross Blue Shield of Louisiana, Baton Rouge, LA
Joseph Drozda, MD, FACC Mercy Health Research, St. Louis, MO, USA
Adam S. Evans, MD, MBA Icahn School of Medicine at Mount Sinai, USA
Donald E. Fetterolf MiMedx Group, Inc., Oakdale, PA, USA
Peter M. Fleischut, MD New York Presbyterian Hospital, New York, NY, USA
Tejal K. Gandhi, MD, MPH, CPPS Press Ganey, Boston, MA, USA
Terry Ann Glauser, MD, MPH Exton, PA
Jonathan L. Gleason, MD Jefferson College of Population Health, Philadelphia, PA, USA
Neil I. Goldfarb Greater Philadelphia Business Coalition on Health, Philadelphia, PA, USA
Norbert Goldfield, MD Healing Across the Divides, Inc. Northampton, MA, USA
Jenna Goldstein, MA The Center for Quality Improvement, Society of Hospital Medicine, Philadelphia, PA
Rohit Gulati, MD, FACP, MBA, FACHE Einstein Healthcare Network, Philadelphia, PA, USA
Nathan R. Handley, MD, MBA Sidney Kimmel Cancer Center at Thomas Jefferson University, Philadelphia, PA, USA
Christopher S. Hollenbeak, PhD Penn State College of Medicine, USA
Keith Horvath, MD American Association of Medical Colleges, Washington, DC
Mark Hurwitz, MD Thomas Jefferson University and Hospitals, Philadelphia, PA, USA
Eric V. Jackson, Jr, MD Masimo, Inc., Irvine, CA
Ted A. James, MD, MS, FACS Beth Israel Deaconess Medical Center, Boston, MA, USA
John Kimberly, PhD University of Pennsylvania, Philadelphia, PA, USA
Stephen Lawless Wilmington, DE, USA
David G. Lindquist, MD Rhode Island Hospital, Providence, RI, USA
Mary Lou Manning, PhD, CRNP, CIC Jefferson College of Nursing, Philadelphia, PA
Andrew Masica, MD, MSc Texas Health Resources, Arlington, TX, USA
David E. McNamara, MD Meadville, PA, USA
James Merlino, MD, FACS, FASCRS Press Ganey, USA
Michael Millenson Northwestern University, Highland Park, IL, USA
Ira S. Nash, MD Northwell Health, Manhasset, NY, USA
James E. Orlikoff, MA Orlikoff & Associates, Inc., Chicago, IL, USA
Arthur Pelberg, MD, MPA Phoenix, AZ, USA
Robert F. Pendrak, MD, MS, ARM, DFASHRM Harrisburg, PA
Monika Pogorzelska-Maziarz, PhD, MPH Jefferson College of Nursing, Philadelphia, PA
Rhea E. Powell, MD, MPH Thomas Jefferson University, Philadelphia, PA, USA
Scott Ransom, DO, MBA, MPH McKinsey & Company, Inc., Dallas, TX, USA
Jeffrey Rice, MD, JD The Healthcare Blue Book, Brentwood, TN, USA
Lee Ann Riesenberg, PhD, RN The University of Alabama at Birmingham, Birmingham, AL, USA
Jeffrey Riggio, MD Thomas Jefferson University Hospital, Philadelphia, PA, USA
Alex Rodriguez, MD Bay Pines VA Hospital, Seminole, FL, USA
Bernard M. Rosof, MD, MACP Hofstra Northwell School of Medicine, Hempstead, NY, USA
Marc B. Royo, MD, MBA Hospital of the University of Pennsylvania, Philadelphia, PA, USA
Vivek A. Saoji, MD, MS KLE University, JNMC Campus, Karnataka, India
Harm Scherpbier, MD Jefferson College of Population Health, PA, USA
Stephen C. Schoenbaum, MD, MPH Josiah Macy Jr. Foundation, New York, NY, USA
Sharon B. Schweikhart, PhD The Ohio State University, School of Public Health, Columbus, OH, USA
Margrit M. Shoemaker, MD, FACP Geisinger Commonwealth School of Medicine, Pennsylvania, USA
Stanton N. Smullens, MD Pennsylvania Patient Safety Authority, Philadelphia, PA, USA
Nelson Teich, MD, MBA MedInsight - Decisions in Health Care, Rio de Janiero, Brazil
Anjala Tess, MD Beth Israel Deaconess Medical Center, Boston, MA, USA
George Valko Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA, USA
Prathibha Varkey, MBBS, MPH, MHPE Stratford, CT
Lawrence Ward, MD, MPH, FACP Thomas Jefferson University Hospital, Philadelphia, PA, USA
Mark B. Wenneker, MD, MPH The Chartis Group, Newtonville, MA, USA
Dan M. Westphal, MD, MBA, CHQ Memorial Hospital Pembroke, Pembroke Pines, FL, USA
Flossie Wolf, MS PA Health Care Cost Containment Council, Harrisburg, PA, USA
Sang Hoon Woo, MD Thomas Jefferson University, Philadelphia, PA, USA
Gary R. Yates, MD Healthcare Performance Improvement, LLC, Virginia Beach, VA, USA
Eyal Zimlichman, MD, MSc Chaim Sheba Medical Center, Tel Hshomer, Israel
Officers of the American College of Medical Quality
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  • Instructions for Authors

    The American Journal of Medical Quality is the official Journal of the American College of Medical Quality. The journal publishes original work in the entire field of quality measurement and improvement. Manuscripts submitted to AJMQ should meet the following criteria: the material is original, the writing is clear, the study methods are appropriate, the data are valid, the conclusions are reasonable and supported by the data, the information is important, and the topic has general medical quality interest. We will assess a paper’s eligibility for publication based on these basic criteria.

    AJMQ operates a conventional single-blind reviewing policy in which the reviewer’s name is always unknown to the submitting author.


    Manuscripts must be submitted electronically at, where authors will be required to set up an online account in the SAGETRACK system powered by ScholarOne. Average time from submission to first decision: 28 days.
    Questions about manuscript submission can be addressed to Deborah Meiris, Managing Editor, American Journal of Medical Quality, Tel: (215) 955-0745; Fax: (215) 923-7583; E-mail:
    Manuscripts are considered with the understanding that they have not been published previously in print or electronic format, and are not under consideration by another publication or electronic medium, except in the form of an abstract of not more than 400 words. Prior abstract presentations should be described in a footnote to the title. Submissions should be accompanied by a letter requesting evaluation for publication.



    Medical research involving human subjects must be conducted according to the World Medical Association Declaration of Helsinki.

    Submitted manuscripts should conform to the ICMJE Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals, and all papers reporting animal and/or human studies must state in the methods section that the relevant Ethics Committee or Institutional Review Board provided (or waived) approval. Please ensure that you have provided the full name and institution of the review committee, in addition to the approval number.

    For research articles, authors are also required to state in the methods section whether participants provided informed consent and whether the consent was written or verbal.



    Papers should only be submitted for consideration once consent is given by all contributing authors. Those submitting papers should carefully check that all those whose work contributed to the paper are acknowledged as contributing authors. 

    The list of authors should include all those who can legitimately claim authorship. This is all those who:

    (i) Made a substantial contribution to the concept and design, acquisition of data or analysis and interpretation of data,

    (ii) Drafted the article or revised it critically for important intellectual content,

    (iii) Approved the version to be published.

    Authors should meet the conditions of all of the points above. Each author should have participated sufficiently in the work to take public responsibility for appropriate portions of the content. Each author’s contribution must be delineated in the submission after the acknowledgements (i.e. planning, execution, analysis of the study, etc.)

    When a large, multicentre group has conducted the work, the group should identify the individuals who accept direct responsibility for the manuscript. These individuals should fully meet the criteria for authorship. 

    Acquisition of funding, collection of data, or general supervision of the research group alone does not constitute authorship, although all contributors who do not meet the criteria for authorship should be listed in the Acknowledgments section.

    Please refer to the International Committee of Medical Journal Editors (ICMJE) authorship guidelines for more information on authorship.



    As part of our commitment to ensuring an ethical, transparent and fair peer review process SAGE is a supporting member of ORCID, the Open Researcher and Contributor ID. ORCID provides a unique and persistent digital identifier that distinguishes researchers from every other researcher, even those who share the same name, and, through integration in key research workflows such as manuscript and grant submission, supports automated linkages between researchers and their professional activities, ensuring that their work is recognized.

    The collection of ORCID iDs from corresponding authors is now part of the submission process of this journal. If you already have an ORCID iD you will be asked to associate that to your submission during the online submission process. We also strongly encourage all co-authors to link their ORCID ID to their accounts in our online peer review platforms. It takes seconds to do: click the link when prompted, sign into your ORCID account and our systems are automatically updated. Your ORCID iD will become part of your accepted publication’s metadata, making your work attributable to you and only you. Your ORCID iD is published with your article so that fellow researchers reading your work can link to your ORCID profile and from there link to your other publications.

    If you do not already have an ORCID iD please follow this link to create one or visit our ORCID homepage to learn more.



    Manuscripts should be submitted Word format (in AMA style); double spaced with ample margins on all sides.

    These are the word count limitations for manuscripts, effective October 1, 2009: Original manuscript—3500 words, excluding abstract, tables/figures, and references. It may include up to 5 tables or figures (total), and up to 40 references. Commentary, Perspective, or Editorial—1300 words or 1000 words with 1 small table or figure, excluding references. A maximum of 10 references.

    The title page should include the authors’ names and affiliations, the source of a work or study (if any), and a running title of approximately 45 characters. We require the full mailing address and contact information (telephone, fax, e-mail address, and alternate address) for the corresponding author listed on your article. This information should appear on the title page or on a separate sheet. Include full names and e-mail addresses for all co-authors. 

    AJMQ requires all authors to acknowledge their funding in a consistent fashion under a separate heading. Please visit the Funding Acknowledgements page on the SAGE Journal Author Gateway to confirm the format of the acknowledgment text in the event of funding, or state that: This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. It is the policy of AJMQ to require a declaration of conflicting interests from all authors enabling a statement to be carried within the paginated pages of all published articles.

    Please ensure that a ‘Declaration of Conflicting Interests’ statement is included at the end of your manuscript, after any acknowledgements and prior to the references. If no conflict exists, please state that ‘The Author(s) declare(s) that there is no conflict of interest’.

    For guidance on conflict of interest statements, please see the ICMJE recommendations here.

    Failure to include this information will delay the review process. Each author's disclosure will be published. Additionally, a Conflict of Interest and Financial Disclosure Form, completed by all authors, must be submitted along with the manuscript. The form is available from the managing editor at

    The third page should consist of an abstract of not more than 150 words, which should be self-explanatory without reference to the text. Reference citations are not permitted in the abstract of a paper. Number pages consecutively. At the end of the paper, give the name and address of the individual to whom reprint requests should be directed.

    How to get help with the quality of the English in your submission:

    Authors seeking assistance with English language editing, translation, or figure and manuscript formatting to fit the journal’s specifications should consider using SAGE Language Services. Visit SAGE Language Services on our Journal Author Gateway for further information.


    Each table or figure should appear on a separate page and be placed at the end of the document, following the text and references. Use Arabic numerals to number tables. Each table must stand alone (ie, contain all necessary information in the caption), and the table itself must be understood independently of the text. Details of experimental conditions should be included in table footnotes. Information that appears in the text should not be repeated in tables, and tables should not contain data that can be given in the text in one or two sentences. The text of the tables should be editable; that is, the tables should not be saved as images that cannot be altered or edited. 

    Position of figures and tables in the text should be indicated in the manuscript and cited in order in the text. 

    Contact the managing editor for artwork submission guidelines or visit resources for journal editors/authors at for additional help.


    References must be double spaced, in AMA style, and numbered consecutively as they are cited in the text (using superscript numbers). References appearing for the first time in tables and figures must be numbered in sequence with those cited in the text where the table or figure is mentioned. Use journal abbreviations as provided by the IndexMedicus, National Library of Medicine. List all authors when there are six or less. When there are more than six authors, list the first three, followed by et al. If references to personal communications or unpublished data are used, they are not to be included in the list of references. Refer to them in the text in parentheses (C.O. Tucker, personal communication). Among the references, include papers accepted but not yet published; designate the journal, and add “In Press.”


    Journal article:

    Sahai AV, Pineault R. An assessment of the use of costs and quality of life as outcomes in endoscopic research. Gastrointest Endosc. 1997;46:113-118.


    Pritchard JA, MacDonald PC, Grant NF. Williams obstetrics, 17th edition. Norwalk, CT: Appleton-Century-Crofts, 1985:457.


    Acknowledgements should appear on a separate page following the manuscript.


    The author must obtain permission to reproduce figures, tables, and text from previously published material. Please see resources for journal editors/authors at for more details. Written permission must be obtained from the original copyright holder (generally the publisher, not the author or editor) of the journal or book concerned. An appropriate credit line should be included in the reference list. Written permission must be obtained from the author of any unpublished material cited from other laboratories, and should accompany the manuscript.


    Authors submitting a manuscript do so on the understanding that if it is accepted for publication, copyright of the article, including the right to reproduce the article in all forms and media, shall be assigned exclusively to the American College of Medical Quality.


    Letters discussing a recent AJMQ article are welcome and must be received within 6 weeks of the article’s publication. All letters are to be typewritten and not exceed 500 words, excluding references.


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