Quality Improvement

Abstract Number: Plenary

DECREASING ADMISSIONS, READMISSIONS AND LENGTH OF STAY WHILE IMPROVING PATIENT SAFETY FOR ALCOHOL WITHDRAWAL SYNDROME

Background: There were nearly 33,000 admissions to Department of Veterans Affairs hospitals for alcohol withdrawal syndrome (AWS) in fiscal year 2017. Symptom-triggered management is the standard of care and, when employed effectively, the number of [...]

By | 2019-03-12T15:33:25+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Plenary Presentations, Quality Improvement|Comments Off on DECREASING ADMISSIONS, READMISSIONS AND LENGTH OF STAY WHILE IMPROVING PATIENT SAFETY FOR ALCOHOL WITHDRAWAL SYNDROME

Abstract Number: Oral

THE B-TEAM (BUPRENORPHINE): MEDICATION-ASSISTED TREATMENT FOR PATIENTS WITH OPIOID USE DISORDER IN THE HOSPITAL

Background: Despite a public health crisis - over 500,000 individuals have died from opioid overdoses since 2000 – and the availability of effective therapies, most patients with Opioid Use Disorder (OUD) are not offered treatment. [...]

By | 2019-03-12T15:49:45+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Oral Presentations, Quality Improvement|Comments Off on THE B-TEAM (BUPRENORPHINE): MEDICATION-ASSISTED TREATMENT FOR PATIENTS WITH OPIOID USE DISORDER IN THE HOSPITAL

Abstract Number: 378

HOSPITALISTS IMPROVING PEDIATRIC SEPSIS THROUGH EDUCATION AND RECOGNITION

Background: The Children’s Hospital Association (CHA) Sepsis Collaborative recognizes pediatric sepsis as a significant cause of mortality and nationwide efforts are being developed to improve sepsis recognition. A critical component to decreasing sepsis mortality is [...]

By | 2019-03-11T14:24:57+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on HOSPITALISTS IMPROVING PEDIATRIC SEPSIS THROUGH EDUCATION AND RECOGNITION

Abstract Number: 377

GEOGRAPHIC ROUNDING: A MODEL TO IMPROVE HOSPITALIST- NURSE COMMUNICATION AND UNIT THROUGHPUT

Background: Geographic hospitalist staffing and interdisciplinary rounding has been shown to improve staff communication, patient communication, and reduce length of stay. Communication between hospitalist and nurses also play a crucial role in patient safety and [...]

By | 2019-03-11T14:24:56+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on GEOGRAPHIC ROUNDING: A MODEL TO IMPROVE HOSPITALIST- NURSE COMMUNICATION AND UNIT THROUGHPUT

Abstract Number: 375

BACK TO THE BEDSIDE: UNITING MEDICAL EDUCATION AND INTERPROFESSIONAL ROUNDS

Background: Interprofessional rounding has improved patient safety and provider engagement (1). Our institution implemented interdisciplinary patient rounds (IPR) similarly described in the literature (2). Despite praise for our nursing safety checklist, declining emphasis on bedside [...]

By | 2019-03-11T14:24:53+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on BACK TO THE BEDSIDE: UNITING MEDICAL EDUCATION AND INTERPROFESSIONAL ROUNDS

Abstract Number: 373

PERFORMING SAFE PARACENTESES: VALIDATING THE TWO-PROBE TECHNIQUE

Background: Paracenteses are performed frequently at bedside by hospitalists, intensivists, gastroenterologists and emergency medicine providers. They are considered a core procedure that historically have been performed “blind” with only the use of percussion to determine [...]

By | 2019-03-11T14:24:50+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on PERFORMING SAFE PARACENTESES: VALIDATING THE TWO-PROBE TECHNIQUE

Abstract Number: 371

THE RIGHT RX: A MULTIFACETED APPROACH TO IMPROVING OPIOID PRESCRIBING PRACTICES ON DISCHARGE

Background: Clinician prescribing practices are a contributing factor to and potential mitigator of the opioid epidemic in the United States. Several studies have identified the hospital setting as an important entry point into chronic opioid [...]

By | 2019-03-11T14:24:47+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on THE RIGHT RX: A MULTIFACETED APPROACH TO IMPROVING OPIOID PRESCRIBING PRACTICES ON DISCHARGE

Abstract Number: 370

UNIT BASED INTERDISCIPLINARY TEAM APPROACH TO IMPLEMENTING A NALOXONE PRESCRIPTION UPON HOSPITAL DISCHARGE

Background: An estimated 68,000 Americans died of opioid-related overdoses between March 2017-2018. In Monroe County NY heroin/fentanyl deaths are up 200% from 2015- 2017. Guidelines recommending naloxone co-prescription for high-risk patients on opioid pain medications [...]

By | 2019-03-11T14:24:46+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on UNIT BASED INTERDISCIPLINARY TEAM APPROACH TO IMPLEMENTING A NALOXONE PRESCRIPTION UPON HOSPITAL DISCHARGE

Abstract Number: 368

STREAMLINING THE IDENTIFICATION OF HIGH RISK PATIENTS IN NEED OF GOALS OF CARE DISCUSSIONS- A PILOT STUDY

Background: Multiple studies show that patients with serious illness often do not discuss their goals and preferences with their clinicians leading to low patient and family satisfaction, and costly care that is often unwanted and [...]

By | 2019-03-11T14:24:43+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on STREAMLINING THE IDENTIFICATION OF HIGH RISK PATIENTS IN NEED OF GOALS OF CARE DISCUSSIONS- A PILOT STUDY

Abstract Number: 367

DISCHARGES BEFORE NOON – A COLLABORATIVE APPROACH TO BUILD A SUSTAINABLE GOAL

Background: Patient flow and throughput are challenges that hospitals throughout the country face daily. Delays in throughput lead to prolonged ER times, delays in patient care, increased length of stay, patient dissatisfaction and frustrations for [...]

By | 2019-03-11T14:24:42+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on DISCHARGES BEFORE NOON – A COLLABORATIVE APPROACH TO BUILD A SUSTAINABLE GOAL

Abstract Number: 357

ZERO IS NO LONGER AN UNREASONABLE TARGET IN CAUTI

Background: Catheter Associated Urinary Tract Infection (CAUTI) is the most common hospital acquired infection and constitutes upto 40% of all Healthcare Associated infections. Urinary catheter is used in 15% to 25% of hospitalized patients and [...]

By | 2019-03-11T14:24:28+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on ZERO IS NO LONGER AN UNREASONABLE TARGET IN CAUTI

Abstract Number: 355

IMPROVING DISCHARGE TIME AND DECREASING LENGTHS OF STAY: PILOT STUDY OF AN EMR-EMBEDDED, PHYSICIAN-DESIGNED SOLUTION FOR CROSS-DISCIPLINARY CLINICAL COMMUNICATION

Background: The EMR does not provide readily available information that conveys an at-a-glance understanding of discharge progress for a given patient. Healthcare workers have different workflows and need to manage the information in different ways, [...]

By | 2019-03-11T14:24:25+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on IMPROVING DISCHARGE TIME AND DECREASING LENGTHS OF STAY: PILOT STUDY OF AN EMR-EMBEDDED, PHYSICIAN-DESIGNED SOLUTION FOR CROSS-DISCIPLINARY CLINICAL COMMUNICATION

Abstract Number: 350

AN INTERDISCIPLINARY APPROACH TO IMPROVING ADVANCE CARE PLANNING IN INTERNAL MEDICINE

Background: While Medicare data demonstrates that healthcare spending is up to four times higher in yearly decedents than survivors, studies demonstrate that early advance care planning (ACP) leads to improved clinical outcomes and reduces cost [...]

By | 2019-03-11T14:24:18+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on AN INTERDISCIPLINARY APPROACH TO IMPROVING ADVANCE CARE PLANNING IN INTERNAL MEDICINE

Abstract Number: 349

CHANGING HOSPITALISTS’ PRACTICE HABITS; THE EFFECT OF REAL-TIME INDIVIDUALIZED FEEDBACK ON OPIOID PRESCRIBING

Background: Prescribing of opioid medications has been a hot button issue for at least a decade now. Hospitalists play a unique role as we are on the front lines of patient care and have to [...]

By | 2019-03-11T14:24:17+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on CHANGING HOSPITALISTS’ PRACTICE HABITS; THE EFFECT OF REAL-TIME INDIVIDUALIZED FEEDBACK ON OPIOID PRESCRIBING

Abstract Number: 348

WHERE’S MY DATA? USING APP-SPECIFIC DATA TO DRIVE HIGH IMPACT RESULTS

Background: Prior to this project, inpatient Advanced Practice Providers (APPs) at UW Health lacked organizational data including volumes, patient experience, hospital acquired conditions, and operational efficiency metrics. In 2016, inpatient APPs collaborated with UW Health’s [...]

By | 2019-03-11T14:24:15+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on WHERE’S MY DATA? USING APP-SPECIFIC DATA TO DRIVE HIGH IMPACT RESULTS

Abstract Number: 347

THE TRICKLE DOWN EFFECT: NON-COVERED HOSPITALIST TEAMS LAB ORDERING CULTURAL SHIFT

Background: A previous project targeting Medicine residents’ high-value care practices prompted evaluation of the non-resident hospitalist teams ordering practices. Would exposure to residents (receiving education on high-value care) translate to changes in attending physician ordering [...]

By | 2019-03-11T14:24:14+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on THE TRICKLE DOWN EFFECT: NON-COVERED HOSPITALIST TEAMS LAB ORDERING CULTURAL SHIFT

Abstract Number: 346

SUSTAINING MINDFUL LABORATORY ORDERING PRACTICES: A CULTURE CHANGE

Background: The United States is in the midst of a health quality crisis; for this to resolve, we must transform to a high-value, low-cost healthcare culture. To achieve such a culture, trainees must learn high-value [...]

By | 2019-03-11T14:24:12+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on SUSTAINING MINDFUL LABORATORY ORDERING PRACTICES: A CULTURE CHANGE

Abstract Number: 345

DISMANTLING A BARRIER TO MINDFUL LAB ORDERING: THE ATTENDING PHYSICIAN

Background: Unnecessary laboratory orders are a well-known contributor to healthcare cost. Our residents identified “fear of attending” as a barrier to more mindful lab ordering. This project focused on educating attending physicians on high-value care [...]

By | 2019-03-11T14:24:11+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on DISMANTLING A BARRIER TO MINDFUL LAB ORDERING: THE ATTENDING PHYSICIAN

Abstract Number: 339

RESTRUCTURING A HOSPITAL MEDICINE ONBOARDING PROGRAM TO PRIORITIZE PATIENT SAFETY AND PHYSICIAN WELLNESS

Background: First year hospitalists have higher inpatient and 30 day post discharge mortality than hospitalists with at least a year of experience. The Joint Commission found that improper orientation and training is the second leading [...]

By | 2019-03-11T14:24:02+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on RESTRUCTURING A HOSPITAL MEDICINE ONBOARDING PROGRAM TO PRIORITIZE PATIENT SAFETY AND PHYSICIAN WELLNESS

Abstract Number: 337

ENGAGING HOSPITALISTS IN QUALITY IMPROVEMENT STRATEGIES FOR PRESSURE INJURY PREVENTION TO AVOID PATIENT HARM AND COSTLY PENALTIES

Background: Pressure injuries are tissue damage caused by pressure and shear. Susceptible patients are the elderly, acute, critically ill and malnourished. Pressure injuries severely deplete hospital performance measures in the U.S. Currently, over 2.5 million [...]

By | 2019-03-11T14:23:58+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on ENGAGING HOSPITALISTS IN QUALITY IMPROVEMENT STRATEGIES FOR PRESSURE INJURY PREVENTION TO AVOID PATIENT HARM AND COSTLY PENALTIES

Abstract Number: 335

STILL EFFECTIVE WELL AFTER KINDERGARTEN: HOW A LOW TECH (STICKER CHART!) INTERVENTION HELPED DOUBLE RATES OF HOSPITAL DISCHARGE BEFORE NOON

Background: Hospital discharges before noon have become a common institutional goal in order to improve hospital throughput, reduce emergency department boarding time, and enhance patient satisfaction. Evaluation of baseline rates at Brigham and Women's Faulkner [...]

By | 2019-03-11T14:23:55+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on STILL EFFECTIVE WELL AFTER KINDERGARTEN: HOW A LOW TECH (STICKER CHART!) INTERVENTION HELPED DOUBLE RATES OF HOSPITAL DISCHARGE BEFORE NOON

Abstract Number: 334

REDUCING INAPPROPRIATE TELEMETRY UTILIZATION

Background: Telemetry utilization for a long time has been dependent on individual physician experiences, preference as there were no good randomized controlled trails or guidelines from any scientific organization. American Heart Association has released the [...]

By | 2019-03-11T14:23:54+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on REDUCING INAPPROPRIATE TELEMETRY UTILIZATION

Abstract Number: 332

A SEPSIS ALERT SYSTEM WITH EARLY INTERVENTION BY A HOSPITALIST RAPID RESPONSE PROVIDER REDUCES MORTALITY AND LENGTH OF STAY IN THE SEPSIS POPULATION

Background: Sepsis is a leading cause of death in US hospitals, and is a major contributor to hospital mortality and length of stay. Much has been done in hospitals nationwide to identify and treat sepsis [...]

By | 2019-03-11T14:23:51+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on A SEPSIS ALERT SYSTEM WITH EARLY INTERVENTION BY A HOSPITALIST RAPID RESPONSE PROVIDER REDUCES MORTALITY AND LENGTH OF STAY IN THE SEPSIS POPULATION

Abstract Number: 330

ACTIVE LEARNING QUALITY IMPROVEMENT TRAINING CURRICULUM FOR FACULTY IN HOSPITAL MEDICINE

Background: There is a growing emphasis on teaching Quality Improvement (QI) to resident physicians and medical students. Successful QI training for residents and students requires faculty role models, teachers and mentors. However, faculty with QI [...]

By | 2019-03-11T14:23:48+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on ACTIVE LEARNING QUALITY IMPROVEMENT TRAINING CURRICULUM FOR FACULTY IN HOSPITAL MEDICINE

Abstract Number: 329

COMBINING LEAN SIX-SIGMA QUALITY IMPROVEMENT METHODS WITH SAFETY BARRIER ANALYSIS TO DEVELOP INTERVENTIONS THAT REDUCE HOSPITAL-ACQUIRED VENOUS THROMBOEMBOLISM (HA-VTE)

Background: The U.S. healthcare system has a poor safety record when compared to other major industries. For example, at 250,000 per year, medical errors are the 3rd leading cause of death according to the CDC. [...]

By | 2019-03-11T14:23:46+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on COMBINING LEAN SIX-SIGMA QUALITY IMPROVEMENT METHODS WITH SAFETY BARRIER ANALYSIS TO DEVELOP INTERVENTIONS THAT REDUCE HOSPITAL-ACQUIRED VENOUS THROMBOEMBOLISM (HA-VTE)

Abstract Number: 325

INPATIENT DIABETES MANAGEMENT SERVICE, LENGTH OF STAY AND 30-DAY READMISSION RATE OF PATIENTS WITH DIABETES AT A COMMUNITY HOSPITAL.

Background: Diabetes mellitus is common among hospitalized patients. An inpatient diabetes management service (IDMS) was implemented at a community hospital in suburban Maryland to provide better glycemic control for inpatients.Purpose: To analyze the length of [...]

By | 2019-03-11T14:23:40+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on INPATIENT DIABETES MANAGEMENT SERVICE, LENGTH OF STAY AND 30-DAY READMISSION RATE OF PATIENTS WITH DIABETES AT A COMMUNITY HOSPITAL.

Abstract Number: 324

‘TAKE 5’ TO IMPROVE RESIDENT SATISFACTION WITH CDI

Background: The Accreditation Council for Graduate Medical Education (ACGME) includes “Systems Based Practice” as part of its six core competencies for resident education. Clinical documentation is a primary resource of patient safety and quality metrics [...]

By | 2019-03-11T14:23:39+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on ‘TAKE 5’ TO IMPROVE RESIDENT SATISFACTION WITH CDI

Abstract Number: 321

ORAL NUTRITIONAL SUPPLEMENTATION REDUCES READMISSION OF MALNOURISHED PATIENTS

Background: According to a report of the Healthcare Cost and Utilization Project (HCUP) that looked at hospital admissions in 2013, the care of hospitalized malnourished patients costs twice as much as those without malnourishment due [...]

By | 2019-03-11T14:23:35+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on ORAL NUTRITIONAL SUPPLEMENTATION REDUCES READMISSION OF MALNOURISHED PATIENTS

Abstract Number: 319

TREATING THE HARDEST TO TREAT: THE INPATIENT ADMISSION AS AN OPPORTUNITY TO INITIATE HEPATITIS C TREATMENT

Background: Veterans in care at Veterans Affairs (VA) medical centers have a higher prevalence of Hepatitis C (HCV) antibody positivity than the general population1,2. Despite high tolerability and cure rates approaching 95% with new direct-acting [...]

By | 2019-03-11T14:23:32+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on TREATING THE HARDEST TO TREAT: THE INPATIENT ADMISSION AS AN OPPORTUNITY TO INITIATE HEPATITIS C TREATMENT

Abstract Number: 318

REDESIGNING YOUR INTERDISCIPLINARY ROUNDS TO GET YOUR ACCOUNTABLE CARE UNIT BACK ON TRACK

Background: Geographic Accountable Care Units (ACUs) have been in existence for years at our institution. The ACUs have demonstrated improved throughput, quality and patient experience metrics. Our hospitalists have embraced the ACU philosophy due to [...]

By | 2019-03-11T14:23:30+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on REDESIGNING YOUR INTERDISCIPLINARY ROUNDS TO GET YOUR ACCOUNTABLE CARE UNIT BACK ON TRACK

Abstract Number: 317

IMPLEMENTATION OF A HOSPITALIST LED MULTIDISCIPLINARY SWAT TEAM TO PREVENT AVOIDABLE READMISSIONS ON REPEAT PRESENTATION TO THE EMERGENCY DEPARTMENT

Background: Avoidable readmissions result in unnecessary hospital stays for patients, over utilization of beds, and increased waiting time for other patients. Multiple interventions have examined reducing readmissions, mostly focusing on pre-discharge and out of hospital [...]

By | 2019-03-11T14:23:29+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on IMPLEMENTATION OF A HOSPITALIST LED MULTIDISCIPLINARY SWAT TEAM TO PREVENT AVOIDABLE READMISSIONS ON REPEAT PRESENTATION TO THE EMERGENCY DEPARTMENT

Abstract Number: 316

HEALING HANDS: PILOTING THE USE OF MASSAGE FOR SYMPTOM MANAGEMENT IN PATIENTS HOSPITALIZED FOR HEMATOLOGIC MALIGNANCIES

Background: Despite advances in pharmacologic care for side effects of Hematopoietic stem cell transplant, patients often suffer from long hospitalizations, multiple side effects including fatigue, insomnia, nausea, anxiety, and poor sleep. Non-pharmacologic treatments for side [...]

By | 2019-03-11T14:23:28+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on HEALING HANDS: PILOTING THE USE OF MASSAGE FOR SYMPTOM MANAGEMENT IN PATIENTS HOSPITALIZED FOR HEMATOLOGIC MALIGNANCIES

Abstract Number: 315

PROJECT TOPS: TOTAL OVERSIGHT OF PATIENT SATISFACTION

Background: Patient experience is one of the key foundations of quality care. The Hospital Consumer Assessment of Healthcare Providers and Systems Survey (HCAHPS) is the standard measurement of patient experience, and higher scores have been [...]

By | 2019-03-11T14:23:26+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on PROJECT TOPS: TOTAL OVERSIGHT OF PATIENT SATISFACTION

Abstract Number: 313

A MULTIFACETED HOSPITALIST LED QUALITY ASSURANCE COMMITTEE TO CREATE A CULTURE OF CONTINOUS IMPROVEMENT

Background: In an attempt to enhance the quality of the care we deliver as a Group in the hospital, we undertook the formation of a Quality Assurance Committee. It is composed of 3 MD’s, one [...]

By | 2019-03-11T14:23:23+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on A MULTIFACETED HOSPITALIST LED QUALITY ASSURANCE COMMITTEE TO CREATE A CULTURE OF CONTINOUS IMPROVEMENT

Abstract Number: 310

A STANDARDIZED HOSPITALIST APPROACH TO ACUTE PAIN CRISES IN SICKLE CELL DISEASE PATIENTS

Background: Vaso-occlusive acute pain crises are the leading cause for hospitalization in adult sickle cell patients. For our academic hospitalist group at a quaternary care center in New York, acute pain crises in 2017 accounted [...]

By | 2019-03-11T14:23:19+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on A STANDARDIZED HOSPITALIST APPROACH TO ACUTE PAIN CRISES IN SICKLE CELL DISEASE PATIENTS

Abstract Number: 309

A BUNDLED INTERVENTION TO REDUCE INAPPROPRIATE PRESCRIBING OF PROTON PUMP INHIBITORS IN AN ACADEMIC URBAN HOSPITAL MEDICINE GROUP

Background: Proton pump inhibitors (PPIs) are one of the most prescribed medications in the United States. Long-term PPI use is increasingly being associated with many adverse health consequences such as Clostridium difficile infections, osteoporosis, impaired [...]

By | 2019-03-11T14:23:17+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on A BUNDLED INTERVENTION TO REDUCE INAPPROPRIATE PRESCRIBING OF PROTON PUMP INHIBITORS IN AN ACADEMIC URBAN HOSPITAL MEDICINE GROUP

Abstract Number: 308

UTILIZING IDEA BOARD WEEKLY MEETINGS TO REDUCE READMISSIONS

Background: Readmission rate at UMASS Memorial Hospital medicine division is high at 15.5%. Majority of patients are admitted to Hospitalist service. Given the challenges in obtaining real time readmission data, physician engagement is poor. Etiology [...]

By | 2019-03-11T14:23:16+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on UTILIZING IDEA BOARD WEEKLY MEETINGS TO REDUCE READMISSIONS

Abstract Number: 306

PRECISION ‘MEDICINE’: AN INDIVIDUALIZED APPROACH TO THE HIGHEST UTILIZERS OF HOSPITAL-BASED CARE

Background: Nationally, a minority of patients with complex medical and psychosocial needs consume a disproportionate amount of healthcare. In the U.S. in 2015, the top 1% of the population accounted for 23% of all healthcare [...]

By | 2019-03-11T14:23:13+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on PRECISION ‘MEDICINE’: AN INDIVIDUALIZED APPROACH TO THE HIGHEST UTILIZERS OF HOSPITAL-BASED CARE

Abstract Number: 304

DEVELOPMENT OF A HEALTHCARE IMPROVEMENT PORTFOLIO FOR PROMOTION ACROSS HEALTH PROFESSIONS

Background: Healthcare systems need formal processes for recognizing achievements in healthcare improvement to support promotion. To aid in the recognition of faculty members’ contributions to healthcare improvement, institutions have begun to use portfolios to document [...]

By | 2019-03-11T14:23:10+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on DEVELOPMENT OF A HEALTHCARE IMPROVEMENT PORTFOLIO FOR PROMOTION ACROSS HEALTH PROFESSIONS

Abstract Number: 303

SLEEP OPPORTUNITY: A NEW MEASURE OF INPATIENT SLEEP

Background: Hospitalized patients are often disrupted at night for routine medical care, some of which is unnecessary. These sleep disruptions have implications for patient satisfaction, delirium, mobility, immune status, as well as hospital outcomes such [...]

By | 2019-03-11T14:23:08+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on SLEEP OPPORTUNITY: A NEW MEASURE OF INPATIENT SLEEP

Abstract Number: 302

ONE STEP AT A TIME: IMPROVING MOBILITY THROUGH ENHANCED PATIENT-PROVIDER COMMUNICATION AND GOAL-SETTING

Background: Immobility in the hospital setting is associated with persistent inability to perform activities of daily living, increased length of stay, and decreased return to independent living; this loss of function is identified by patients [...]

By | 2019-03-11T14:23:07+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on ONE STEP AT A TIME: IMPROVING MOBILITY THROUGH ENHANCED PATIENT-PROVIDER COMMUNICATION AND GOAL-SETTING

Abstract Number: 301

‘REACH-IN’: A HOSPITAL-BASED INITIATIVE TO CONFRONT THE OPIOID EPIDEMIC

Background: Persons with opioid use disorder (OUD) represent an estimated 4-11% of hospitalized patients and are increasingly admitted for opioid-related complications. In response to the opioid epidemic, national organizations have recommended hospitals develop protocols to [...]

By | 2019-03-11T14:23:05+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on ‘REACH-IN’: A HOSPITAL-BASED INITIATIVE TO CONFRONT THE OPIOID EPIDEMIC

Abstract Number: 297

RAPIDLY ENGAGING THE FRONTLINE: IMPLEMENTING A HOSPITALIST-LED, REAL-TIME, ELECTRONIC MORTALITY REVIEW PROCESS

Background: Traditional review approaches to inpatient mortality remain flawed. M&M conferences, administrative data analysis, and chart review do not effectively leverage the frontline perspective, are frequently delayed, and may be perceived as punitive if not [...]

By | 2019-03-11T14:23:00+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on RAPIDLY ENGAGING THE FRONTLINE: IMPLEMENTING A HOSPITALIST-LED, REAL-TIME, ELECTRONIC MORTALITY REVIEW PROCESS

Abstract Number: 295

UTILIZING CUSP TO DRIVE QUALITY ON A MEDICAL OBSERVATION UNIT

Background: The Comprehensive Unit-based Safety Program (CUSP) promoted by AHRQ is typically a staff nurse led quality improvement team focused on improving elements of unit-level patient safety. Physician engagement in projects is encouraged, but at [...]

By | 2019-03-11T14:22:57+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on UTILIZING CUSP TO DRIVE QUALITY ON A MEDICAL OBSERVATION UNIT

Abstract Number: 292

REDESIGNING THE RAPID RESPONSE TEAM: ADDITION OF A HOSPITALIST PROVIDER AND THE USE OF SURVEILLANCE TOOLS SIGNIFICANTLY DECREASES RAPID RESPONSE DURATION AND NUMBER OF CALLS.

Background: As the concept of a rapid response team continues to evolve nationwide, it is becoming increasingly apparent that the proactive monitoring of patients through surveillance tools is important to prevent adverse events. However, it [...]

By | 2019-03-11T14:22:53+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on REDESIGNING THE RAPID RESPONSE TEAM: ADDITION OF A HOSPITALIST PROVIDER AND THE USE OF SURVEILLANCE TOOLS SIGNIFICANTLY DECREASES RAPID RESPONSE DURATION AND NUMBER OF CALLS.

Abstract Number: 289

EFFECTIVENESS OF AN INTERDISCIPLINARY, NURSE DRIVEN IN-HOSPITAL CODE STROKE PROTOCOL ON RECOGNITION AND DIAGNOSIS OF IN-HOSPITAL STROKE

Background: Up to 17% of all strokes occur in patients hospitalized for another diagnosis or procedure, and in-hospital strokes complicate up to 0.06% of all admissions. In-hospital strokes carry higher mortality, longer length of stay [...]

By | 2019-03-11T14:22:48+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on EFFECTIVENESS OF AN INTERDISCIPLINARY, NURSE DRIVEN IN-HOSPITAL CODE STROKE PROTOCOL ON RECOGNITION AND DIAGNOSIS OF IN-HOSPITAL STROKE

Abstract Number: 287

COLLABORATIVE APPROACH TO IMPROVING MEDICATION RECONCILIATION

Background: Medication errors harm 1.5 million patients yearly, designating medication reconciliation a National Patient Safety Goal. The average hospitalized patient is subject to at least 1 medication error per day (IOM,2007), with 70% of patients [...]

By | 2019-03-11T14:22:46+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on COLLABORATIVE APPROACH TO IMPROVING MEDICATION RECONCILIATION

Abstract Number: 285

REDUCING ANTIBIOTIC USE IN PATIENTS WITH CONTAMINATED BLOOD CULTURES THROUGH A CLINICAL PATHWAY

Background: Using evidence-based clinical pathways has been shown to improve mortality in patients with staphylococcus aureus bacteremia. However, little is known if these pathways can decrease antibiotic use as a means of antibiotic stewardship in [...]

By | 2019-03-11T14:22:43+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on REDUCING ANTIBIOTIC USE IN PATIENTS WITH CONTAMINATED BLOOD CULTURES THROUGH A CLINICAL PATHWAY

Abstract Number: 284

EFFECTS OF IMPLEMENTATION OF ACCOUNTABLE CARE UNIT WITH EMPHASIS ON STRUCTURED INTERDISCIPLINARY BEDSIDE ROUNDING: OUR EXPERIENCES IN AN ACADEMIC STEP DOWN, NON-DISCHARGING INTERMEDIATE CARE UNIT

Background: Traditionally, models of healthcare delivery to hospitalized patients have been indirect and inefficient. The typical hospital system has providers spread between multiple units and nurses interacting with multiple provider teams. Several studies focusing on [...]

By | 2019-03-11T14:22:41+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on EFFECTS OF IMPLEMENTATION OF ACCOUNTABLE CARE UNIT WITH EMPHASIS ON STRUCTURED INTERDISCIPLINARY BEDSIDE ROUNDING: OUR EXPERIENCES IN AN ACADEMIC STEP DOWN, NON-DISCHARGING INTERMEDIATE CARE UNIT

Abstract Number: 282

ACCOUNTABLE CARE UNIT: AN INPATIENT STRUCTURE FOR SUSTAINED IMPROVEMENT

Background: Financial incentives motivate hospitals to focus on improving patient experience, quality indicators, and efficiency metrics. Efforts to geographically staff hospitalists have renewed the focus on quality improvement efforts at the inpatient unit level. However, [...]

By | 2019-03-11T14:22:37+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on ACCOUNTABLE CARE UNIT: AN INPATIENT STRUCTURE FOR SUSTAINED IMPROVEMENT

Abstract Number: 280

STUCK IN TRAFFIC: USING A QUEUING THEORY MODEL TO PREDICT PATIENT DELAYS TO A UNIT

Background: Delays in care can lead to patient harm. At our large urban academic medical center, we have been struggling with increasing inpatient volumes and delays, particularly to enter our medicine, observation, and cardiology units. [...]

By | 2019-03-11T14:22:35+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on STUCK IN TRAFFIC: USING A QUEUING THEORY MODEL TO PREDICT PATIENT DELAYS TO A UNIT

Abstract Number: 274

UTILIZING A KEY PERFORMANCE INDICATOR BOARD FOR TRACKING HOSPTIALIST QUALITY IMPROVEMENT INITIATIVES

Background: Understanding current practice patterns is essential to identifying opportunities for improvement and acknowledging good practice behaviors. However, often this information is not easily accessible or provided in a timely fashion, especially to front line [...]

By | 2019-03-11T14:22:26+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on UTILIZING A KEY PERFORMANCE INDICATOR BOARD FOR TRACKING HOSPTIALIST QUALITY IMPROVEMENT INITIATIVES

Abstract Number: 271

GMS ESCALATE: THE “EASY” BUTTON FOR TEAMS ENCOUNTERING BARRIERS TO PATIENT CARE PROGRESSION

Background: Many efforts to improve bed availability in hospitals with high occupancy focus on encouraging providers to discharge patients earlier in the day without making substantial changes to workflows or to address barriers to patient [...]

By | 2019-03-11T14:22:22+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on GMS ESCALATE: THE “EASY” BUTTON FOR TEAMS ENCOUNTERING BARRIERS TO PATIENT CARE PROGRESSION

Abstract Number: 270

IMPROVEMENT IN DISCHARGE DELAYS THROUGH PHARMACIST COLLABORATION AND RESIDENT EDUCATION

Background: Discharging patients in an efficient manner improves patient satisfaction and hospital throughput. In this project, we sought to improve patient throughput as well as benefit resident education. Prior to our project, 75% of patient [...]

By | 2019-03-11T14:22:21+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on IMPROVEMENT IN DISCHARGE DELAYS THROUGH PHARMACIST COLLABORATION AND RESIDENT EDUCATION

Abstract Number: 268

A PATIENT-CENTRIC APPROACH TO IMPROVING COMMUNICATION ABOUT MEDICATIONS IN THE IN-PATIENT ENVIRONMENT

Background: Discharge from an in-patient hospital stay is a critical opportunity to teach patients about their medications. Communication about medications and appropriate transition of care are two domains of the Hospital Consumer Assessment of Healthcare [...]

By | 2019-03-11T14:22:18+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on A PATIENT-CENTRIC APPROACH TO IMPROVING COMMUNICATION ABOUT MEDICATIONS IN THE IN-PATIENT ENVIRONMENT

Abstract Number: 261

CRUSH THE RESISTANCE: A MULTIDISCIPLINARY PILOT PROJECT TO IMPROVE ANTIBIOTIC UTILIZATION

Background: Growing antimicrobial resistance, C. difficile infection and cost have triggered a greater reliance on antimicrobial stewardship. Most stewardship models rely upon a central team, often led by ID specialists, to oversee prescribing in an [...]

By | 2019-03-11T14:22:09+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on CRUSH THE RESISTANCE: A MULTIDISCIPLINARY PILOT PROJECT TO IMPROVE ANTIBIOTIC UTILIZATION

Abstract Number: 260

BEE QUIET: AN INNOVATIVE STRATEGY TO IMPROVE SLEEP QUALITY AND REDUCE FALLS

Background: Sleep disturbance has negative impact on physical coordination, metabolism, cognitive performance, immune function, coagulation cascade, cardiac risk and is associated with an increased risk of falls in hospitalized patients. The number of adverse events [...]

By | 2019-03-11T14:22:08+00:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on BEE QUIET: AN INNOVATIVE STRATEGY TO IMPROVE SLEEP QUALITY AND REDUCE FALLS

Abstract Number: 20

AN INNOVATIVE ALCOHOL WITHDRAWAL PROTOCOL REDUCES LENGTH OF STAY, RESTRAINT USE, AND TRANSFERS TO INTENSIVE CARE

Background: Alcohol withdrawal is a common disorder faced by hospitalists. The pharmacologic standard of care involves the use of benzodiazepines, administered either as fixed doses or with doses adjusted per patient symptoms. At our institution, [...]

By | 2019-03-18T13:41:35+00:00 March 11th, 2019|Finalist Posters - Innovations, Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on AN INNOVATIVE ALCOHOL WITHDRAWAL PROTOCOL REDUCES LENGTH OF STAY, RESTRAINT USE, AND TRANSFERS TO INTENSIVE CARE

Abstract Number: 19

THE PRE-REVIEW: A MULTIDISCIPLINARY INITIATIVE TO IMPROVE THE QUALITY OF PUBLICLY REPORTED MORTALITY DATA

Background: Publically reported data is increasingly important to a hospital’s reputation and bottom line. Programs such as CMS Hospital Value Based Purchasing (HVBP) place 2% of a hospital’s base payments at risk, while the CMS [...]

By | 2019-03-18T13:33:35+00:00 March 11th, 2019|Finalist Posters - Innovations, Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on THE PRE-REVIEW: A MULTIDISCIPLINARY INITIATIVE TO IMPROVE THE QUALITY OF PUBLICLY REPORTED MORTALITY DATA

Abstract Number: 18

IMPROVING TIME TO ANTIBIOTICS IN SEPSIS ON ACUTE CARE FLOORS: A QUALITY SCHOLARS PROJECT

Background: Third International Consensus Definitions for Sepsis and Septic Shock (SEP-3) defines Sepsis as life-threatening organ dysfunction due to a dysregulated host response to infection. In United States about 1.5 million Americans are diagnosed with [...]

By | 2019-03-18T13:31:55+00:00 March 11th, 2019|Finalist Posters - Innovations, Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on IMPROVING TIME TO ANTIBIOTICS IN SEPSIS ON ACUTE CARE FLOORS: A QUALITY SCHOLARS PROJECT

Abstract Number: 16

PROMOTING ACADEMIC APPOINTMENT FOR NURSE PRACTITIONERS AND PHYSICIAN ASSISTANTS

Background: One way academic organizations recognize staff achievements and scholarly activities is through four levels of academic appointments: Instructor, Assistant Professor, Associate Professor and Professor. Nurse Practitioners and Physician Assistants (NPPAs) employed by the Mayo [...]

By | 2019-03-18T13:29:14+00:00 March 11th, 2019|Finalist Posters - Innovations, Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on PROMOTING ACADEMIC APPOINTMENT FOR NURSE PRACTITIONERS AND PHYSICIAN ASSISTANTS

Abstract Number: 14

ENDING ENDOSCOPY DELAY: A MULTIDISCIPLINARY APPROACH TO REDUCE INPATIENT ENDOSCOPY DELAYS

Background: Endoscopies are commonly performed in the inpatient setting, and successful completion frequently requires close coordination among nurses, hospitalists, gastroenterologists, and anesthesiologists. Given the complexity of this multidisciplinary involvement, as well as variability in patient [...]

By | 2019-04-17T09:30:11+00:00 March 11th, 2019|Finalist Posters - Innovations, Hospital Medicine 2019, Innovations, Quality Improvement, Winners|Comments Off on ENDING ENDOSCOPY DELAY: A MULTIDISCIPLINARY APPROACH TO REDUCE INPATIENT ENDOSCOPY DELAYS

Abstract Number: 13

THE FEASIBILITY AND ACCEPTABILITY OF VIDEO VISITS FOR HOME-LIMITED ADULTS, A PILOT PROGRAM

Background: Geriatric and palliative care patients who have been discharged from hospital and are home-limited face challenges in effectively accessing ongoing healthcare and clinical follow-up after being discharged, leaving them at risk for unnecessary re-hospitalization. [...]

By | 2019-03-18T13:27:24+00:00 March 11th, 2019|Finalist Posters - Innovations, Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on THE FEASIBILITY AND ACCEPTABILITY OF VIDEO VISITS FOR HOME-LIMITED ADULTS, A PILOT PROGRAM

Abstract Number: 12

A PROCESS APPROACH TO DECREASING HOSPITAL ONSET CLOSTRIDIUM DIFFICILE INFECTIONS

Background: Stony Brook University Hospital (SBUH) identified an opportunity to develop and implement prevention strategies to reduce hospital onset C. difficile infections (CDI). Hospital Onset (HO) CDI are included in National Healthcare Safety Network (NHSN) [...]

By | 2019-03-18T13:27:00+00:00 March 11th, 2019|Finalist Posters - Innovations, Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on A PROCESS APPROACH TO DECREASING HOSPITAL ONSET CLOSTRIDIUM DIFFICILE INFECTIONS