Quality Improvement

HM2017 Abstract Number: 157

MALNUTRITION CARE: “LOW HANGING FRUIT” FOR HOSPITALIST CLINICAL PERFORMANCE IMPROVEMENT

Background: As public and private stakeholders demand higher quality of care in the hospital setting, hospitalists play a critical role in leading performance improvement. As hospitalists seek ways to improve quality and lower costs, malnutrition [...]

By | 2018-03-15T20:51:00-04:00 May 10th, 2017|Innovations Abstracts, Quality Improvement|Comments Off on MALNUTRITION CARE: “LOW HANGING FRUIT” FOR HOSPITALIST CLINICAL PERFORMANCE IMPROVEMENT

HM2017 Abstract Number: 185

ELECTRONIC MEDICAL RECORD SIGN OUT TOOL IMPROVEMENT PROJECT: A NARRATIVE DESCRIPTION OF THE EFFECTIVENESS OF THE UNIVERSITY OF MICHIGAN’S HOUSE OFFICER QUALITY AND SAFETY COUNCIL.  

Background: The American College of Graduate Medical Education requires resident involvement in patient safety and quality improvement (PS/QI) but it remains difficult to engage house officers (HOs) in meaningful and sustainable projects. In 2011, the [...]

By | 2018-03-15T20:50:28-04:00 April 20th, 2017|Innovations Abstracts, Quality Improvement|Comments Off on ELECTRONIC MEDICAL RECORD SIGN OUT TOOL IMPROVEMENT PROJECT: A NARRATIVE DESCRIPTION OF THE EFFECTIVENESS OF THE UNIVERSITY OF MICHIGAN’S HOUSE OFFICER QUALITY AND SAFETY COUNCIL.  

HM2017 Abstract Number: 226

EDUCATION AS A QUALITY INTERVENTION IN THROMBOPHILIA TESTING

Background: As hospitals continue to see increasing costs, quality improvement interventions are essential to maintaining a high level of quality care in the inpatient setting. Multiple studies have shown that a systems based approach offers [...]

By | 2017-04-20T17:34:35-04:00 April 20th, 2017|Innovations Abstracts, Quality Improvement|Comments Off on EDUCATION AS A QUALITY INTERVENTION IN THROMBOPHILIA TESTING

HM2017 Abstract Number: 222

BEDSIDE ASSESSMENT OF THE NECESSITY OF DAILY LAB TESTING FOR PATIENTS NEARING DISCHARGE

Background : As part of the Choosing Wisely campaign, the Society of Hospital Medicine recommends against performing "repetitive complete blood count [CBC] and chemistry testing in the face of clinical and lab stability.” This recommendation [...]

By | 2017-04-20T17:34:38-04:00 April 20th, 2017|Innovations Abstracts, Quality Improvement|Comments Off on BEDSIDE ASSESSMENT OF THE NECESSITY OF DAILY LAB TESTING FOR PATIENTS NEARING DISCHARGE

HM2017 Abstract Number: 218

ENGAGING RESIDENTS IN BLOOD TRANSFUSION PROTOCOLS THROUGH QI

Background: In the past 20 years, the "10/30" rule for blood transfusions has been replaced with conservative guidelines which have demonstrated improved patient outcomes and reduced overall healthcare costs. Hospitals across the country have enlisted [...]

By | 2017-04-20T17:34:40-04:00 April 20th, 2017|Innovations Abstracts, Quality Improvement|Comments Off on ENGAGING RESIDENTS IN BLOOD TRANSFUSION PROTOCOLS THROUGH QI

HM2017 Abstract Number: 212

A FULL HOUSE: RE-SHUFFLING PATIENTS TO MANAGE CAPACITY ACROSS A HEALTH SYSTEM

Background: Capacity constraints are a common problem at many academic institutions.  At Duke University Hospital (DUH) , capacity constraints continue to result in critical bed shortages.  Our affiliated hospital, Duke Regional Hospital (DRH) which is [...]

By | 2017-04-25T23:01:13-04:00 April 20th, 2017|Innovations Abstracts, Quality Improvement|Comments Off on A FULL HOUSE: RE-SHUFFLING PATIENTS TO MANAGE CAPACITY ACROSS A HEALTH SYSTEM

HM2017 Abstract Number: 210

RADY’S HOMECARE ORDER SET: NO MORE GUESSES, NO MORE ERRORS! LET EMR WORK FOR YOU!

Background:  Children and Young Adults with Special Healthcare Needs (CSCHN), especially those with multiple organ systems involvement, experience frequent and often lengthy hospitalizations. Hospital discharges for these children can be a complicated process that requires [...]

By | 2017-04-20T17:34:45-04:00 April 20th, 2017|Innovations Abstracts, Quality Improvement|Comments Off on RADY’S HOMECARE ORDER SET: NO MORE GUESSES, NO MORE ERRORS! LET EMR WORK FOR YOU!

HM2017 Abstract Number: 208

UTILIZING UNIT SPECIFIC PATIENT COMPLAINT DATA TO IMPROVE PERFORMANCE AND INCREASE PATIENT SATISFACTION: THE EXPERIENCE ON AN INPATIENT MEDICINE UNIT AT A LARGE URBAN ACADEMIC CENTER

Background: Patient complaints reflect their unmet expectations and are a valuable resource to understand key drivers of patient experience. It is unclear, however, how patient complaints can be used to improve service quality and guide [...]

By | 2017-04-20T17:34:49-04:00 April 20th, 2017|Innovations Abstracts, Quality Improvement|Comments Off on UTILIZING UNIT SPECIFIC PATIENT COMPLAINT DATA TO IMPROVE PERFORMANCE AND INCREASE PATIENT SATISFACTION: THE EXPERIENCE ON AN INPATIENT MEDICINE UNIT AT A LARGE URBAN ACADEMIC CENTER

HM2017 Abstract Number: 206

IMPROVING ACCURACY IN MEASURING FLUID BALANCE ON A GENERAL MEDICINE WARD

Background: The measurement of fluid balance (FB) for hospitalized patients has been a standard of nursing practice for many years, but its utility and accuracy is questioned in the literature. There is no gold standard [...]

By | 2017-04-20T17:34:51-04:00 April 20th, 2017|Innovations Abstracts, Quality Improvement|Comments Off on IMPROVING ACCURACY IN MEASURING FLUID BALANCE ON A GENERAL MEDICINE WARD

HM2017 Abstract Number: 201

IMPROVING HOSPITALIST SATISFACTION THROUGH CLINICAL SCHEDULE REDESIGN

Background: Control over work hours and schedule flexibility are important predictors of clinicians’ career satisfaction, work-life balance, and burnout, which are in turn linked to quality of patient care, recruitment, and retention.  In our rapidly [...]

By | 2017-04-20T17:34:54-04:00 April 20th, 2017|Innovations Abstracts, Quality Improvement|Comments Off on IMPROVING HOSPITALIST SATISFACTION THROUGH CLINICAL SCHEDULE REDESIGN

HM2017 Abstract Number: 200

TEAM-BASED STRUCTURE OF DISCHARGE MULTIDISCIPLINARY ROUNDS LEADS TO EARLIER DISCHARGE

Background: Collaboration between multidisciplinary teams during the discharge process can optimize the safety of discharge planning. At our tertiary academic medical center, case managers (CM) and pharmacists have historically been assigned to patients by unit [...]

By | 2017-04-20T17:34:55-04:00 April 20th, 2017|Innovations Abstracts, Quality Improvement|Comments Off on TEAM-BASED STRUCTURE OF DISCHARGE MULTIDISCIPLINARY ROUNDS LEADS TO EARLIER DISCHARGE

HM2017 Abstract Number: 197

DEVELOPMENT AND IMPLEMENTATION OF AN ALCOHOL WITHDRAWAL PROTOCOL USING A 5-ITEM BRIEF ALCOHOL WITHDRAWAL SCALE (BAWS)

Background: The standard of care for the treatment of alcohol withdrawal is symptom triggered treatment using the Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar) scale. However, this 10-item scale is cumbersome to use.   Purpose: [...]

By | 2017-04-20T17:34:58-04:00 April 20th, 2017|Innovations Abstracts, Quality Improvement|Comments Off on DEVELOPMENT AND IMPLEMENTATION OF AN ALCOHOL WITHDRAWAL PROTOCOL USING A 5-ITEM BRIEF ALCOHOL WITHDRAWAL SCALE (BAWS)

HM2017 Abstract Number: 191

DIAGNOSING OUR DOCUMENTATION: A NOVEL ELECTRONIC PEER-FEEDBACK PROGRAM TO IMPROVE THE QUALITY OF HOSPITALISTS’ NOTES AT A LARGE TERTIARY CARE MEDICAL CENTER

Background: The advent of the Electronic Health Record (EHR) has changed the face of medical documentation. Illegibility and absence of data have all but disappeared, and EHRs can foster thoughtful assessments by providing a platform [...]

By | 2017-04-20T17:35:42-04:00 April 20th, 2017|Innovations Abstracts, Quality Improvement|Comments Off on DIAGNOSING OUR DOCUMENTATION: A NOVEL ELECTRONIC PEER-FEEDBACK PROGRAM TO IMPROVE THE QUALITY OF HOSPITALISTS’ NOTES AT A LARGE TERTIARY CARE MEDICAL CENTER

HM2017 Abstract Number: 190

CAN WE DO BETTER? IMPLEMENTATION OF A HOSPITALIST-PSYCHIATRY COLLABORATIVE FOR THE IMPROVEMENT OF CARE FOR BEHAVIORALLY AND MEDICALLY COMPLEX PATIENTS

Background: Medical patients with comorbid psychiatric illness comprise 20-40% of general medicine inpatient admissions. These patients often have multiple providers involved in their care which can lead to poor communication, longer lengths of stay, and [...]

By | 2017-04-20T17:35:44-04:00 April 20th, 2017|Innovations Abstracts, Quality Improvement|Comments Off on CAN WE DO BETTER? IMPLEMENTATION OF A HOSPITALIST-PSYCHIATRY COLLABORATIVE FOR THE IMPROVEMENT OF CARE FOR BEHAVIORALLY AND MEDICALLY COMPLEX PATIENTS

HM2017 Abstract Number: 186

THE DOCTOR IS IN: OVERHAULING AN ED ADMISSION PROCESS TO EMPHASIZE THE INITIAL PHYSICIAN-PATIENT ENCOUNTER

Background: Patients often must wait several hours before being seen by an admitting attending physician. Protracted admit wait times are undeniably associated with delays in care, patient and family dissatisfaction, and very likely increased lengths of [...]

By | 2017-04-20T17:35:47-04:00 April 20th, 2017|Innovations Abstracts, Quality Improvement|Comments Off on THE DOCTOR IS IN: OVERHAULING AN ED ADMISSION PROCESS TO EMPHASIZE THE INITIAL PHYSICIAN-PATIENT ENCOUNTER

HM2017 Abstract Number: 178

A SIMPLE TOOL TO INCREASE FREQUENCY OF CODE STATUS DISCUSSIONS UPON HOSPITAL ADMISSION

Background: Hospitalization of the patient with advanced cancer can be a pivotal moment and opportunity to explore patient goals of care in order to deliver high value, patient-centered care that emphasizes quality of life. Part [...]

By | 2017-04-20T17:35:49-04:00 April 20th, 2017|Innovations Abstracts, Quality Improvement|Comments Off on A SIMPLE TOOL TO INCREASE FREQUENCY OF CODE STATUS DISCUSSIONS UPON HOSPITAL ADMISSION

HM2017 Abstract Number: 176

APPLYING A USER-CENTERED DESIGN PROCESS TO CO-CREATE INPATIENT EXPERIENCE IMPROVEMENT STRATEGIES

Background: Practical and financial pressures have placed a renewed focus on improving the human experience of healthcare from both the patient and provider perspective. Despite this, aligning patients and interdisciplinary providers around meaningful experience improvement [...]

By | 2017-04-20T17:35:52-04:00 April 20th, 2017|Innovations Abstracts, Quality Improvement|Comments Off on APPLYING A USER-CENTERED DESIGN PROCESS TO CO-CREATE INPATIENT EXPERIENCE IMPROVEMENT STRATEGIES

HM2017 Abstract Number: 174

SLEEP IS VITAL: IMPROVING SLEEP BY REDUCING UNNECESSARY NOCTURNAL VITAL SIGNS

Background: Hospitalized patients get fewer than five hours of sleep a night. Poor sleep leads to increased rates of delirium, falls, and hypertension, and decreased patient satisfaction. Purpose: To improve sleep among hospitalized patients through [...]

By | 2017-04-20T17:35:55-04:00 April 20th, 2017|Innovations Abstracts, Quality Improvement|Comments Off on SLEEP IS VITAL: IMPROVING SLEEP BY REDUCING UNNECESSARY NOCTURNAL VITAL SIGNS

HM2017 Abstract Number: 173

INCREASING MOBILITY AND REDUCING FALLS AND FALL-RELATED INJURIES IN HOSPITALIZED MEDICINE PATIENTS

Background: Hospitalized patients have significantly reduced ambulation, which leads to decreased muscle strength, coordination, and balance, all which increase the risk of falls. According to the Joint Commission, hundreds of thousands of patients fall in [...]

By | 2017-04-20T17:35:57-04:00 April 20th, 2017|Innovations Abstracts, Quality Improvement|Comments Off on INCREASING MOBILITY AND REDUCING FALLS AND FALL-RELATED INJURIES IN HOSPITALIZED MEDICINE PATIENTS

HM2017 Abstract Number: 164

USE OF ELECTRONIC TOOL TO REDUCE ERRORS IN INPATIENT MEDICATION RECONCILIATION

Background: Inpatient medication reconciliation errors are common and can lead to serious adverse drug events. Most medication discrepancies are due to errors in taking an accurate medication history. Tools imbedded in the electronic medical record [...]

By | 2017-04-20T17:35:59-04:00 April 20th, 2017|Innovations Abstracts, Quality Improvement|Comments Off on USE OF ELECTRONIC TOOL TO REDUCE ERRORS IN INPATIENT MEDICATION RECONCILIATION

HM2017 Abstract Number: 163

BUILDING A DASHBOARD TO IDENTIFY PATIENTS AT HIGH RISK FOR ADVERSE DRUG EVENTS RELATED TO OPIOIDS

Background: In the inpatient setting, opioids are the most commonly prescribed medication and the 2nd most frequent cause of adverse drug events (ADE).  Identifying patients at high risk for ADEs related to narcotics is essential. [...]

By | 2017-04-20T17:36:01-04:00 April 20th, 2017|Innovations Abstracts, Quality Improvement|Comments Off on BUILDING A DASHBOARD TO IDENTIFY PATIENTS AT HIGH RISK FOR ADVERSE DRUG EVENTS RELATED TO OPIOIDS

HM2017 Abstract Number: 160

PATIENT REGIONALIZATION TO IMPROVE CARE EFFICIENCY (PRICE). IMPLEMENTATION OF A MODEL AT UIHC

Background: Unit-based medical teams improve cohesiveness and communication among team members and increase time spent with patients. At the University of Iowa Hospitals and Clinics, physician teams had patients in 5-6 different units on an [...]

By | 2017-04-20T17:36:04-04:00 April 20th, 2017|Innovations Abstracts, Quality Improvement|Comments Off on PATIENT REGIONALIZATION TO IMPROVE CARE EFFICIENCY (PRICE). IMPLEMENTATION OF A MODEL AT UIHC

HM2017 Abstract Number: 158

SICKLE CELL CARE- CLINICAL REDESIGN PROJECT: A MULTIDISCIPLINARY AND STANDARDIZED APPROACH TO PAIN MANAGEMENT IMPROVES QUALITY OF CARE, DECREASES LENGTH OF STAY AND COST PER CASE

Background: Sickle cell disease (SCD) causes frequent painful episodes from vaso-occlusion. As hospitalists, we identified that SCD patients occupied a large number of hospital days. Undertreatment and lack of standardization of pain management was a [...]

By | 2017-04-20T17:36:51-04:00 April 20th, 2017|Innovations Abstracts, Quality Improvement|Comments Off on SICKLE CELL CARE- CLINICAL REDESIGN PROJECT: A MULTIDISCIPLINARY AND STANDARDIZED APPROACH TO PAIN MANAGEMENT IMPROVES QUALITY OF CARE, DECREASES LENGTH OF STAY AND COST PER CASE

HM2017 Abstract Number: 151

THE IMPACT OF A TRANSITION OF CARE TEAM IN DECOMPENSATED HEART FAILURE READMISSION RATES

Background:   Congestive heart failure is a leading cause of hospitalization in adults greater than 65 years old. It is estimated that over 1 million people are hospitalized annually with a primary diagnosis of heart [...]

By | 2017-04-20T17:36:53-04:00 April 20th, 2017|Innovations Abstracts, Quality Improvement|Comments Off on THE IMPACT OF A TRANSITION OF CARE TEAM IN DECOMPENSATED HEART FAILURE READMISSION RATES

HM2017 Abstract Number: 148

INCREASING DISCHARGE BEFORE NOON RATES THROUGH IMPROVED INTERDISCIPLINARY COMMUNICATION

Background: Late-day hospital discharges are associated with emergency room overcrowding, longer length of stay (LOS), worsened quality of care and lower patient satisfaction scores. Early discharge, or discharge before noon (DBN) is an achievable and [...]

By | 2017-04-20T17:36:55-04:00 April 20th, 2017|Innovations Abstracts, Quality Improvement|Comments Off on INCREASING DISCHARGE BEFORE NOON RATES THROUGH IMPROVED INTERDISCIPLINARY COMMUNICATION

HM2017 Abstract Number: 147

HIGH-RELIABILITY ACADEMIC HOSPITALIST PROGRAMS: A LIFECYCLE OF ASSESSMENT AND FEEDBACK INTEGRATING NEW AND VETERAN FACULTY

Background: Hospital medicine programs have a responsibility to maintain high standards of clinical excellence, patient safety, and efficiency for all hospitalists within their program.  Organizational change, program growth, and faculty turnover make this endeavor challenging.  [...]

By | 2017-04-20T17:36:57-04:00 April 20th, 2017|Innovations Abstracts, Quality Improvement|Comments Off on HIGH-RELIABILITY ACADEMIC HOSPITALIST PROGRAMS: A LIFECYCLE OF ASSESSMENT AND FEEDBACK INTEGRATING NEW AND VETERAN FACULTY

HM2017 Abstract Number: 146

SAVING MONEY – ONE STICK AT A TIME

Background: The American Board of Internal Medicine Choosing Wisely initiative advocates avoiding automatic daily labs as a way to lower hospital costs. The Legacy Health Inpatient Medicine Service (LIMS) aimed to reduce unnecessary and inappropriate [...]

By | 2017-04-20T17:36:59-04:00 April 20th, 2017|Innovations Abstracts, Quality Improvement|Comments Off on SAVING MONEY – ONE STICK AT A TIME

HM2017 Abstract Number: 143

LESS LUMENS = LESS RISK

Background: Multi-lumen (ML) peripherally inserted central catheters (PICCs) are associated with increased risk of central line associated blood stream infection (CLABSI), venous thromboembolism (VTE) and increased cost compared to single lumen (SL) PICCs. Current guidelines [...]

By | 2017-04-20T17:37:01-04:00 April 20th, 2017|Innovations Abstracts, Quality Improvement|Comments Off on LESS LUMENS = LESS RISK

HM2017 Abstract Number: 141

CELLULITIS: MEDICAL RESPONSIBILITY IN SELECTING ANTIBIOTICS

Background: Despite detailed Infectious Disease Society of America (IDSA) skin and soft tissue infection guidelines, patients with cellulitis at our institution consistently receive antibiotics with high local resistance or that are inappropriate based on IDSA [...]

By | 2017-04-20T17:37:04-04:00 April 20th, 2017|Innovations Abstracts, Quality Improvement|Comments Off on CELLULITIS: MEDICAL RESPONSIBILITY IN SELECTING ANTIBIOTICS