Transitions of Care

3-IN-1: MEETING THE NEEDS OF PATIENTS, RESIDENTS, AND THE INSTITUTION DURING HOSPITAL DISCHARGE

Background: High quality discharges improve patients’ health outcomes and experience and are a vital component of resident education. Our internal medicine residency program has had challenges in sustaining our efforts to improve discharge planning and [...]

By | 2018-03-19T13:10:05+00:00 March 19th, 2018|Hospital Medicine 2018, Innovations, Transitions of Care|Comments Off on 3-IN-1: MEETING THE NEEDS OF PATIENTS, RESIDENTS, AND THE INSTITUTION DURING HOSPITAL DISCHARGE

A MULTI-DISCIPLINARY, MULTI-PRONGED APPROACH TO IMPROVING HANDOFFS FOR MEDICINE PATIENTS ADMITTED FROM THE EMERGENCY DEPARTMENT

Background: The high volume of handoffs between the Emergency Department (ED) team and the inpatient team on a daily basis makes this a ripe area for care improvement. Effective, safe and organized transitions facilitate high [...]

By | 2018-03-19T15:44:22+00:00 March 19th, 2018|Innovations, Transitions of Care, Uncategorized|Comments Off on A MULTI-DISCIPLINARY, MULTI-PRONGED APPROACH TO IMPROVING HANDOFFS FOR MEDICINE PATIENTS ADMITTED FROM THE EMERGENCY DEPARTMENT

ACCURACY AND IMPLICATIONS OF A HOSPITAL MEDICINE , EMERGENCY MEDICINE AND CRITICAL CARE COLLABORATIVE PROCESS TO TRIAGE TO THE MEDICAL INTENSIVE CARE UNIT

Background: Intensive Care Unit (ICU) beds are limited, so effective triage is important for resource utilization. However, inappropriate triage of critically ill patients to non ICU settings can lead to poor patient outcomes, as early [...]

By | 2018-03-19T13:08:57+00:00 March 19th, 2018|Hospital Medicine 2018, Innovations, Transitions of Care|Comments Off on ACCURACY AND IMPLICATIONS OF A HOSPITAL MEDICINE , EMERGENCY MEDICINE AND CRITICAL CARE COLLABORATIVE PROCESS TO TRIAGE TO THE MEDICAL INTENSIVE CARE UNIT

BARRIERS AND FACILITATORS TO IMPLEMENTING AN ELECTRONIC PILLBOX INTERVENTION DURING CARE TRANSITIONS

Background: Adverse drug events are common during transitions of care and often due to patient misunderstanding of the medication regimen or non-adherence. Challenges exist that may influence the ability of new interventions to address this [...]

By | 2018-03-19T12:57:56+00:00 March 19th, 2018|Hospital Medicine 2018, Innovations, Transitions of Care|Comments Off on BARRIERS AND FACILITATORS TO IMPLEMENTING AN ELECTRONIC PILLBOX INTERVENTION DURING CARE TRANSITIONS

Breaking the Cycle: A Successful Inpatient Based Intervention for Hospital High Utilizers

Background: Patients recurrently admitted to the hospital frequently experience fragmentation of care and poor health outcomes, with discontinuity between hospital admissions resulting in unnecessary testing, ineffective or inconsistent treatment plans, patient/provider frustration, and inability to [...]

By | 2018-03-19T12:52:47+00:00 March 19th, 2018|Hospital Medicine 2018, Innovations, Transitions of Care|Comments Off on Breaking the Cycle: A Successful Inpatient Based Intervention for Hospital High Utilizers

DEVELOPMENT OF A MODEL TO CONTEXTUALIZE AND MANAGE THE HOSPITAL ADMISSION PROCESS

Background: Both inappropriate hospital admissions and inappropriate discharges from the ED are associated with adverse patient outcomes. Little is known about the accuracy (sensitivity and specificity) of the hospital admission triage process. Purpose: We sought [...]

By | 2018-03-19T13:09:17+00:00 March 19th, 2018|Hospital Medicine 2018, Innovations, Transitions of Care|Comments Off on DEVELOPMENT OF A MODEL TO CONTEXTUALIZE AND MANAGE THE HOSPITAL ADMISSION PROCESS

EMR based sign-out: A tool that improves efficiency and satisfaction

Background: Transitions of care are critical to maintaining patient safety and decreasing adverse events, but they remain a complex process with many pitfalls. Electronic Medical Record (EMR) based handoffs can enhance communication by centralizing content [...]

By | 2018-03-19T15:44:20+00:00 March 19th, 2018|Innovations, Transitions of Care, Uncategorized|Comments Off on EMR based sign-out: A tool that improves efficiency and satisfaction

GETTING DISCHARGES OFF THE BACK BURNER: THE ROLE OF THE ATTENDING NURSE

Background: Throughput is a challenge for many hospitals. Discharging patients impacts throughput, but is time-consuming and competes with other physician and nurse tasks, often being left on the “back burner” while attending to sicker patients. [...]

By | 2018-03-19T13:07:41+00:00 March 19th, 2018|Hospital Medicine 2018, Innovations, Transitions of Care|Comments Off on GETTING DISCHARGES OFF THE BACK BURNER: THE ROLE OF THE ATTENDING NURSE

IMPROVING TRANSITIONS IN CARE SURROUNDING DOCUMENTATION OF TESTS PENDING AT DISCHARGE FROM THE HOSPITALIST SERVICE

Background: Effective communication and care coordination between inpatient and outpatient teams are essential for safe care transitions. Currently there is infrequent communication between PCPs and Hospitalists around the time of discharge. Often, the PCPs are [...]

By | 2018-03-19T12:58:00+00:00 March 19th, 2018|Hospital Medicine 2018, Innovations, Transitions of Care|Comments Off on IMPROVING TRANSITIONS IN CARE SURROUNDING DOCUMENTATION OF TESTS PENDING AT DISCHARGE FROM THE HOSPITALIST SERVICE

Long Stay Committee finds Innovative Discharge Plans for Difficult Discharges

Background: Hospital length of stay has been an important measure of hospital efficiency and resource utilization. Increase length of stay results in higher cost and increased morbidity to patients. Length of stay outliers or “long [...]

By | 2018-03-19T15:44:07+00:00 March 19th, 2018|Innovations, Transitions of Care, Uncategorized|Comments Off on Long Stay Committee finds Innovative Discharge Plans for Difficult Discharges

NURSING TELEPHONIC TRIAGE OF AFTER-HOUR PATIENT CALLS BY CLINICAL ADVICE SERVICE

Background: It is challenging for patients to navigate through complex healthcare systems after-hours. This leads to delays in patient care, patient/provider dissatisfaction, inappropriate resource utilization, readmissions, and higher healthcare costs. Prior to August 2015, non-medical [...]

By | 2018-03-19T13:04:06+00:00 March 19th, 2018|Hospital Medicine 2018, Innovations, Transitions of Care|Comments Off on NURSING TELEPHONIC TRIAGE OF AFTER-HOUR PATIENT CALLS BY CLINICAL ADVICE SERVICE

OPTIMIZING COMPLEX PATIENT TRANSITIONS THROUGH COLLABORATIVE CARE

Background: Due to the complexity of patient discharge needs leading to increased length of stay within a large academic medical center, a specialized inpatient unit became a priority. Purpose: The University of Kentucky Healthcare created [...]

By | 2018-03-19T15:43:53+00:00 March 19th, 2018|Innovations, Transitions of Care, Uncategorized|Comments Off on OPTIMIZING COMPLEX PATIENT TRANSITIONS THROUGH COLLABORATIVE CARE

Post-discharge phone call program initiated by hospitalists

Background: Centers for Medicare & Medicaid Services (CMS) reimbursement increasingly depends on patient satisfaction scores and readmission rates to incentivize high-quality inpatient hospital care. Providers are continuously implementing complementary interventions to improve patient satisfaction and [...]

By | 2018-03-19T13:12:38+00:00 March 19th, 2018|Hospital Medicine 2018, Innovations, Transitions of Care|Comments Off on Post-discharge phone call program initiated by hospitalists