Value in Hospital Medicine

HM2017 Abstract Number: 285

EARLY DISCHARGE FROM AN ACADEMIC HOSPITALIST SERVICE – MULTIPLE SUSTAINED INTERVENTIONS ARE NECESSARY FOR SUCCESS

Background: Earlier discharge time is an important satisfaction metric for patients, maximizes the utilization of hospital beds, and reduces waste and capacity issues in EDs /PACUs. Overall, early discharge represents high-value care and responsible stewardship [...]

By | 2018-03-15T20:51:00+00:00 April 20th, 2017|Research Abstracts, Value in Hospital Medicine|Comments Off on EARLY DISCHARGE FROM AN ACADEMIC HOSPITALIST SERVICE – MULTIPLE SUSTAINED INTERVENTIONS ARE NECESSARY FOR SUCCESS

HM2017 Abstract Number: 313

DOES EVERYONE NEED DAILY LABS? CHOOSE WISELY AND REDUCE THE OVERUSE: A HIGH VALUE CARE PROJECT

Background: As part of the ABIM Foundation’s Choosing Wisely campaign the Society of Hospital Medicine recommended providers avoid performing repetitive CBC and chemistry testing in the face of clinical and lab stability. In 2014 as [...]

By | 2018-03-15T20:50:28+00:00 April 20th, 2017|Research Abstracts, Value in Hospital Medicine|Comments Off on DOES EVERYONE NEED DAILY LABS? CHOOSE WISELY AND REDUCE THE OVERUSE: A HIGH VALUE CARE PROJECT

HM2017 Abstract Number: 311

THE DEVELOPMENT AND VALIDATION OF A HIGH VALUE CARE ROUNDING TOOL USING THE DELPHI METHOD

Background: In response to skyrocketing healthcare costs, providing high value care is an increasing priority for health care systems. Physicians are responsible for translating high value care (HVC) to the bedside, however there is a [...]

By | 2018-03-15T20:50:28+00:00 April 20th, 2017|Research Abstracts, Value in Hospital Medicine|Comments Off on THE DEVELOPMENT AND VALIDATION OF A HIGH VALUE CARE ROUNDING TOOL USING THE DELPHI METHOD

HM2017 Abstract Number: 310

PHYSICIAN REIMBURSEMENT MODELS AND VALUE-BASED PAYMENTS: A SURVEY OF FACULTY AND TRAINEE KNOWLEDGE AND INTEREST

Background: Guiding health care delivery towards patient-centered value can be accelerated by reforming physician reimbursement. Recent legislation including the Medicare Access and CHIP Reauthorization Act (MACRA) and the Affordable Care Act have created frameworks for value-based [...]

By | 2018-03-15T20:50:28+00:00 April 20th, 2017|Research Abstracts, Value in Hospital Medicine|Comments Off on PHYSICIAN REIMBURSEMENT MODELS AND VALUE-BASED PAYMENTS: A SURVEY OF FACULTY AND TRAINEE KNOWLEDGE AND INTEREST

HM2017 Abstract Number: 308

WHY ORDER TWO WHEN YOU CAN GET ONE FOR HALF THE PRICE?: EVALUATING THE RELIABILITY OF POINT OF CARE ARTERIAL BLOOD GAS ELECTROLYTE MEASUREMENTS FOR USE IN STANDARD SUPPLEMENTATION PROTOCOLS

Background: Frequent blood draws are implicated in hospital-acquired anemia as well as rising costs. Critically ill patients undergo frequent venous and arterial blood sampling, both providing electrolyte concentrations. In this study, we sought to examine [...]

By | 2018-03-15T20:50:28+00:00 April 20th, 2017|Research Abstracts, Value in Hospital Medicine|Comments Off on WHY ORDER TWO WHEN YOU CAN GET ONE FOR HALF THE PRICE?: EVALUATING THE RELIABILITY OF POINT OF CARE ARTERIAL BLOOD GAS ELECTROLYTE MEASUREMENTS FOR USE IN STANDARD SUPPLEMENTATION PROTOCOLS

HM2017 Abstract Number: 307

THRESHOLDS FOR VENOUS THROMBOEMBOLISM PROPHYLAXIS IN HOSPITALIZED MEDICAL PATIENTS — A COST-EFFECTIVENESS ANALYSIS

Background: Venous thromboembolism (VTE) is a common preventable condition in hospitalized medical patients. Chemoprophylaxis with heparin or fondaparinux has been recommended for all hospitalized patients who are not at low risk, and appropriate thromboprophylaxis is [...]

By | 2018-03-15T20:50:29+00:00 April 20th, 2017|Research Abstracts, Value in Hospital Medicine|Comments Off on THRESHOLDS FOR VENOUS THROMBOEMBOLISM PROPHYLAXIS IN HOSPITALIZED MEDICAL PATIENTS — A COST-EFFECTIVENESS ANALYSIS

HM2017 Abstract Number: 305

DRAWING WISELY BEYOND EDUCATIONAL SESSIONS: THE IMPACT OF ADMISSION ORDER SET ADJUSTMENT ON INPATIENT LABORATORY ORDERING PRACTICES

Background: In an era where the cost of healthcare in the United States is rising at an unsustainable rate, promoting high value care has never been more important. As highlighted by the Society of Hospital [...]

By | 2018-03-15T20:50:29+00:00 April 20th, 2017|Research Abstracts, Value in Hospital Medicine|Comments Off on DRAWING WISELY BEYOND EDUCATIONAL SESSIONS: THE IMPACT OF ADMISSION ORDER SET ADJUSTMENT ON INPATIENT LABORATORY ORDERING PRACTICES

HM2017 Abstract Number: 304

CONTINUOUS BLOOD COLLECTION: A REVIEW OF CURRENT CBC UTILIZATION, PROVIDER SURVEY, AND PILOT INTERVENTION AT A LARGE ACADEMIC MEDICAL CENTER

Background: Inappropriate laboratory utilization in hospitalized patients is a significant contributing factor to health care expenditures, iatrogenic anemia, downstream testing, and poor patient satisfaction. For these reasons, the Society of Hospital Medicine has recommended through [...]

By | 2018-03-15T20:50:29+00:00 April 20th, 2017|Research Abstracts, Value in Hospital Medicine|Comments Off on CONTINUOUS BLOOD COLLECTION: A REVIEW OF CURRENT CBC UTILIZATION, PROVIDER SURVEY, AND PILOT INTERVENTION AT A LARGE ACADEMIC MEDICAL CENTER

HM2017 Abstract Number: 303

REPETITIVE CBC TESTING IN PATIENTS WITH COMMUNITY-ACQUIRED PNEUMONIA: A MULTICENTER STUDY

Background: Avoiding repeated complete blood count (CBC) testing in the face of clinical and laboratory stability is a Choosing Wisely initiative recommendation endorsed by the Society of Hospital Medicine. We investigated the prevalence and clinical [...]

By | 2018-03-15T20:50:29+00:00 April 20th, 2017|Research Abstracts, Value in Hospital Medicine|Comments Off on REPETITIVE CBC TESTING IN PATIENTS WITH COMMUNITY-ACQUIRED PNEUMONIA: A MULTICENTER STUDY

HM2017 Abstract Number: 301

EVALUATION OF TELEMETRY USE IN THE PATIENT AT RISK FOR ALCOHOL WITHDRAWAL

Background: Cardiac telemetry is frequently overused in the hospital. Our institution requires telemetry while patients are on the Clinical Institute Withdrawal Assessment (CIWA) protocol, regardless of the presence or severity of alcohol withdrawal (AW).  Telemetry use [...]

By | 2018-03-15T20:50:29+00:00 April 20th, 2017|Research Abstracts, Value in Hospital Medicine|Comments Off on EVALUATION OF TELEMETRY USE IN THE PATIENT AT RISK FOR ALCOHOL WITHDRAWAL

HM2017 Abstract Number: 300

IF YOU BUILD IT, THEY WILL ORDER IT…APPROPRIATELY: USE OF A TELEMETRY ORDER SET IMPROVES ADHERENCE TO EVIDENCE-BASED PRACTICE

Background: Inappropriate telemetry use has been associated with increased health care cost and unnecessary diagnostic procedures. For these reasons, the Society of Hospital Medicine’s Choosing Wisely campaign promoted use of both American Heart Association (AHA) [...]

By | 2018-03-15T20:50:29+00:00 April 20th, 2017|Research Abstracts, Value in Hospital Medicine|Comments Off on IF YOU BUILD IT, THEY WILL ORDER IT…APPROPRIATELY: USE OF A TELEMETRY ORDER SET IMPROVES ADHERENCE TO EVIDENCE-BASED PRACTICE

HM2017 Abstract Number: 298

OPTIMIZING LABORATORY TEST UTILIZATION IN LONG-TERM ACUTE CARE HOSPITALS

Background: Misuse of laboratory tests can be difficult to determine unless tests are clearly overused or repeated routinely. However, excessive testing of chronically critically ill patients treated in long-term acute care hospitals (LTACHs) can be [...]

By | 2018-03-15T20:50:08+00:00 April 20th, 2017|Research Abstracts, Value in Hospital Medicine|Comments Off on OPTIMIZING LABORATORY TEST UTILIZATION IN LONG-TERM ACUTE CARE HOSPITALS

HM2017 Abstract Number: 297

DRIVERS OF OVERUSE OF PANCREATIC ENZYME LAB TESTING AT AN ACADEMIC MEDICAL CENTER

Background: Decades-old clinical data and practice guidelines support the use of lipase over amylase in the workup and management of acute pancreatitis. Yet, laboratory testing for amylase continues to cost the Center for Medicare and [...]

By | 2018-03-15T20:50:08+00:00 April 20th, 2017|Research Abstracts, Value in Hospital Medicine|Comments Off on DRIVERS OF OVERUSE OF PANCREATIC ENZYME LAB TESTING AT AN ACADEMIC MEDICAL CENTER

HM2017 Abstract Number: 296

DERIVATION OF A CLINICAL PREDICTION MODEL TO PREDICT UNCHANGED INPATIENT ECHOCARDIOGRAMS

Background:  Transthoracic echocardiography (TTE) is one of the most popular tests in healthcare. Studies of Medicare beneficiaries for example have shown that each year approximately 20% undergo at least one TTE. Repeat TTE defined as [...]

By | 2018-03-15T20:50:09+00:00 April 20th, 2017|Research Abstracts, Value in Hospital Medicine|Comments Off on DERIVATION OF A CLINICAL PREDICTION MODEL TO PREDICT UNCHANGED INPATIENT ECHOCARDIOGRAMS

HM2017 Abstract Number: 295

UTILIZATION AND COST EFFECTIVENESS OF A RISK STRATIFIED DIAGNOSTIC APPROACH TO PATIENTS WITH SUSPECTED THROMBOTIC THROMBOCYTOPENIC PURPURA

Background: Thrombotic thrombocytopenic purpura (TTP) is a rare but deadly thrombotic microangiopathy (TMA) that is caused by ADAMTS13 deficiency. The PLASMIC clinical scoring system was developed and validated to determine the pretest probability of severe [...]

By | 2018-03-15T20:50:09+00:00 April 20th, 2017|Research Abstracts, Value in Hospital Medicine|Comments Off on UTILIZATION AND COST EFFECTIVENESS OF A RISK STRATIFIED DIAGNOSTIC APPROACH TO PATIENTS WITH SUSPECTED THROMBOTIC THROMBOCYTOPENIC PURPURA

HM2017 Abstract Number: 294

AN INNOVATIVE HOSPITAL MEDICINE ELECTIVE: NOT JUST ANOTHER FLOOR MONTH

Background: Hospital Medicine is a rapidly growing specialty and a higher percentage of patients are under the care of hospitalists across the country.  Like other internal medicine subspecialties, an increasing number of residents have expressed [...]

By | 2018-03-15T20:50:09+00:00 April 20th, 2017|Research Abstracts, Value in Hospital Medicine|Comments Off on AN INNOVATIVE HOSPITAL MEDICINE ELECTIVE: NOT JUST ANOTHER FLOOR MONTH

HM2017 Abstract Number: 292

THE INCIDENCE RATE AND CAUSE OF NON-COMPLIANCE OF THE DNR ORDERS

Background: End of life discussion is very important for preventing undesired cardiopulmonary resuscitation (CPR). It is reportedly associated with less aggressive medical care near death and better quality of life. Its importance has been gradually [...]

By | 2018-03-15T20:50:09+00:00 April 20th, 2017|Research Abstracts, Value in Hospital Medicine|Comments Off on THE INCIDENCE RATE AND CAUSE OF NON-COMPLIANCE OF THE DNR ORDERS

HM2017 Abstract Number: 291

A QUANTITATIVE ASSESSMENT OF REDUNDANT LAB ORDERS AT AN ACADEMIC MEDICAL CENTER

Background: The Choosing Wisely Campaign encourages physicians to avoid over-utilizing routine labs in hospitalized patients with clinical and laboratory stability.  A number of studies have shown adverse effects on hospitalized patients from lab overutilization.  In [...]

By | 2018-03-15T20:50:09+00:00 April 20th, 2017|Research Abstracts, Value in Hospital Medicine|Comments Off on A QUANTITATIVE ASSESSMENT OF REDUNDANT LAB ORDERS AT AN ACADEMIC MEDICAL CENTER

HM2017 Abstract Number: 290

EFFECT OF ADMISSION LOCATION ON COST AND CLINICAL AND SAFETY OUTCOMES IN PATIENTS WITH DIABETIC KETOACIDOSIS

Background: Diabetic ketoacidosis (DKA) is a serious, acute complication of diabetes mellitus caused by a state of insulin deficiency requiring exogenous insulin administration.  Significant variation in intensive care unit (ICU) admission rates for DKA exists [...]

By | 2017-04-25T22:21:25+00:00 April 20th, 2017|Research Abstracts, Value in Hospital Medicine|Comments Off on EFFECT OF ADMISSION LOCATION ON COST AND CLINICAL AND SAFETY OUTCOMES IN PATIENTS WITH DIABETIC KETOACIDOSIS

HM2017 Abstract Number: 288

CONSULTATION TO A CARDIOLOGIST PRIOR TO LOW RISK PROCEDURES SIGNIFICANTLY INCREASES INPATIENT LENGTH OF STAY WITHOUT AFFECTING OUTCOMES

Background: The healthcare system in the United States is often times costly and inefficient. Some estimates suggest that 20-34% of healthcare dollars are spent ineffectively. Despite efforts such as the Choosing Wisely Campaign to limit [...]

By | 2017-04-25T22:22:44+00:00 April 20th, 2017|Research Abstracts, Value in Hospital Medicine|Comments Off on CONSULTATION TO A CARDIOLOGIST PRIOR TO LOW RISK PROCEDURES SIGNIFICANTLY INCREASES INPATIENT LENGTH OF STAY WITHOUT AFFECTING OUTCOMES

HM2017 Abstract Number: 284

RESIDENT PERSPECTIVES ON LABORATORY OVER-UTILIZATION: DIFFERENCES BETWEEN RESIDENCY PROGRAM SITES

Background: Unnecessary diagnostic testing contributes to the escalating cost of health care in the US and can cause harm to patients. Daily blood work has become a routine part of care for hospitalized adults though [...]

By | 2017-04-25T22:23:24+00:00 April 20th, 2017|Research Abstracts, Value in Hospital Medicine|Comments Off on RESIDENT PERSPECTIVES ON LABORATORY OVER-UTILIZATION: DIFFERENCES BETWEEN RESIDENCY PROGRAM SITES

HM2017 Abstract Number: 283

TEST, PATIENT, AND PHYSICIAN CHARACTERISTICS ASSOCIATED WITH ACTIONABLE TESTS PENDING AT DISCHARGE: CAN WE ORDER TESTS MORE WISELY?

Background: Previous studies have determined that a small subset (~10%) of the results of tests pending at discharge (TPADs) require action. Challenges for hospitalists in dealing with actionable TPADs include identifying TPADs that are truly [...]

By | 2017-04-26T01:06:24+00:00 April 20th, 2017|Research Abstracts, Value in Hospital Medicine|Comments Off on TEST, PATIENT, AND PHYSICIAN CHARACTERISTICS ASSOCIATED WITH ACTIONABLE TESTS PENDING AT DISCHARGE: CAN WE ORDER TESTS MORE WISELY?

HM2017 Abstract Number: H

HOSPITALISTS BREAK WITH CONVENTION TO DRIVE DISCHARGE THROUGHPUT AND MAKING HUGE IMPACT

Background: We identified a number of quality, patient satisfaction, and staff satisfaction issues that all seemed to be linked to throughput challenges. We had trouble getting patients out of the hospital on discharge day, which [...]

By | 2017-04-26T01:07:21+00:00 April 20th, 2017|Research Abstracts, Value in Hospital Medicine|Comments Off on HOSPITALISTS BREAK WITH CONVENTION TO DRIVE DISCHARGE THROUGHPUT AND MAKING HUGE IMPACT