Quality Improvement

Abstract Number: 362

ENSURING JUDICIOUS PPI USE THROUGH AN ACTIVE SURVEILLANCE STRATEGY OF WITHDRAWAL AND DOSE – REDUCTION IN INPATIENTS IS SAFE AND STABLE OVER 90 DAYS POST-DISCHARGE

Background: Proton pump inhibitors (PPI’s) are a commonly used class of medications, whose optimal use is important. Aim: To assess if proactive surveillance in inpatients can reduce PPI use for unapproved indications and their effect [...]

By | 2019-03-18T17:55:17+00:00 March 18th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on ENSURING JUDICIOUS PPI USE THROUGH AN ACTIVE SURVEILLANCE STRATEGY OF WITHDRAWAL AND DOSE – REDUCTION IN INPATIENTS IS SAFE AND STABLE OVER 90 DAYS POST-DISCHARGE

Abstract Number: 360

UTILIZING HIGH VALUE CARE – REDUCING INPATIENT PHLEBOTOMY WITH USE OF THE VETERAN’S AFFAIRS NATIONAL UTILIZATION MANAGEMENT DATABASE

Background: The Society of Hospital Medicine (SHM) identifies repetitive CBC & chemistry testing as low-value, and they selected this as a Choosing Wisely Recommendation. Overuse of phlebotomy is associated with hospital-acquired anemia, decreased patient satisfaction [...]

By | 2019-03-18T18:00:19+00:00 March 18th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on UTILIZING HIGH VALUE CARE – REDUCING INPATIENT PHLEBOTOMY WITH USE OF THE VETERAN’S AFFAIRS NATIONAL UTILIZATION MANAGEMENT DATABASE

Abstract Number: 300

DOES EHR EFFICIENCY AFFECT QUALITY OF CARE FOR HOSPITAL MEDICINE PHYSICIANS?

Background: Hospitalists balance efficiency and quality in their daily practice. How a physician’s time management affects care quality is unknown. Accordingly, we aimed to compare the EHR efficiency of hospitalists, as measured by their time [...]

By | 2019-03-18T17:55:39+00:00 March 18th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on DOES EHR EFFICIENCY AFFECT QUALITY OF CARE FOR HOSPITAL MEDICINE PHYSICIANS?

Abstract Number: 296

PATIENTS’ PERSPECTIVES ON WHITEBOARDS AS BEDSIDE VISUAL TOOLS TO ENHANCE COMMUNICATION – A MIXED METHODS STUDY

Background: Inpatient bedside whiteboards enhance patient-provider communication and satisfaction with care, but little is known about patients’ perspectives on the whiteboards. Our objectives were to understand patients’ views on the usability and design/content of these [...]

By | 2019-03-18T17:58:54+00:00 March 18th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on PATIENTS’ PERSPECTIVES ON WHITEBOARDS AS BEDSIDE VISUAL TOOLS TO ENHANCE COMMUNICATION – A MIXED METHODS STUDY

Abstract Number: Oral

COPD AUTOSUBSTITUTION OF INHALERS TO NEBULIZER THERAPY EFFECT IN HOSPITALIZED PATIENTS

Background: COPD is associated with high morbidity and mortality. It is the third-ranked cause of death in the United States, killing more than 120,000 individuals each year. As a consequence of its high prevalence and [...]

By | 2019-03-12T15:46:54+00:00 March 11th, 2019|Hospital Medicine 2019, Oral Presentations, Quality Improvement, Research|Comments Off on COPD AUTOSUBSTITUTION OF INHALERS TO NEBULIZER THERAPY EFFECT IN HOSPITALIZED PATIENTS

Abstract Number: Plenary

EFFECTS OF A REFINED EVIDENCE-BASED TOOLKIT ON MEDICATION RECONCILIATION QUALITY AND SAFETY AT MULTIPLE HOSPITALS: RESULTS OF THE MARQUIS2 STUDY

Background: The first Multicenter Medication Reconciliation Quality Improvement Study (MARQUIS1) demonstrated that implementation of a medication reconciliation best practices toolkit decreased total unintentional medication discrepancies in 5 hospitals. Incorporating lessons learned from MARQUIS1, we implemented [...]

By | 2019-03-12T15:43:39+00:00 March 11th, 2019|Hospital Medicine 2019, Plenary Presentations, Quality Improvement, Research|Comments Off on EFFECTS OF A REFINED EVIDENCE-BASED TOOLKIT ON MEDICATION RECONCILIATION QUALITY AND SAFETY AT MULTIPLE HOSPITALS: RESULTS OF THE MARQUIS2 STUDY

Abstract Number: Plenary

MULTI-DISCIPLINARY AND COMPREHENSIVE DELIRIUM CARE PATHWAY IS ASSOCIATED WITH REDUCTIONS IN LENGTH OF STAY, COST, AND READMISSIONS IN HOSPITALIZED ADULTS

Background: Hospital-acquired delirium is serious, leading to increased falls, pressure ulcers, length of stay, cost, patient institutionalization, and patient and caregiver distress. In addition, it is associated with mortality rates as high as 35-40% within [...]

By | 2019-03-12T15:44:56+00:00 March 11th, 2019|Hospital Medicine 2019, Plenary Presentations, Quality Improvement, Research|Comments Off on MULTI-DISCIPLINARY AND COMPREHENSIVE DELIRIUM CARE PATHWAY IS ASSOCIATED WITH REDUCTIONS IN LENGTH OF STAY, COST, AND READMISSIONS IN HOSPITALIZED ADULTS

Abstract Number: 376

CARDIOVASCULAR EMERGENCIES IN HOSPITAL PRIMARY CARE: ROLE FOR THE INITIAL NURSE TRIAGE SYSTEM

Background: Emergency medicine doctors should take care of patients with a wide range of illnesses at various emergency levels from non-urgent level to that requiring immediate medical attention. Among those, cardiovascular emergencies are not so [...]

By | 2019-03-11T14:24:54+00:00 March 11th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on CARDIOVASCULAR EMERGENCIES IN HOSPITAL PRIMARY CARE: ROLE FOR THE INITIAL NURSE TRIAGE SYSTEM

Abstract Number: 374

IMPROVING PATIENTS’ ABILITY TO IDENTIFY THEIR PHYSICIANS THROUGH THE USE OF PHYSICIAN FACECARDS AND WHITEBOARDS

Background: More often than not, hospitalized patients are not able to correctly identify members of their physician team. Being able to identify physicians is a critical component of developing the patient-physician relationship. The use of [...]

By | 2019-03-11T14:24:52+00:00 March 11th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on IMPROVING PATIENTS’ ABILITY TO IDENTIFY THEIR PHYSICIANS THROUGH THE USE OF PHYSICIAN FACECARDS AND WHITEBOARDS

Abstract Number: 372

IMPROVING HCAHPS PAIN SCORES WITHOUT INCREASED OPIOID PRESCRIPTION

Background: The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) was created to compare health care facilities based on patient satisfaction measures including pain management. There is concern that quality improvement metrics focused on [...]

By | 2019-03-11T14:24:49+00:00 March 11th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on IMPROVING HCAHPS PAIN SCORES WITHOUT INCREASED OPIOID PRESCRIPTION

Abstract Number: 369

DAILY DRAWS: ARE THEY IN OUR VEINS? EDUCATION AND RESIDENT COMMUNICATION TO IMPROVE LAB ORDERING PRACTICES

Background: The Society of Hospital Medicine identified questioning the necessity of repeat labs in stable patients as a Choosing Wisely goal to improve overall value of care. Implications of unnecessary blood draws include over-testing, pain, [...]

By | 2019-03-11T14:24:45+00:00 March 11th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on DAILY DRAWS: ARE THEY IN OUR VEINS? EDUCATION AND RESIDENT COMMUNICATION TO IMPROVE LAB ORDERING PRACTICES

Abstract Number: 366

ARE HOSPITALISTS READY, WILLING AND ABLE TO RESPOND TO CARDIAC ARREST? A MULTI-CENTER SURVEY

Background: In-hospital cardiac arrest (IHCA) is an unpredictable, catastrophic event affecting approximately 200,000 US adults annually. Best outcomes during IHCA result from focused training and credentialing by AHA (ACLS, BLS). Although hospitalists supervise IHCA, best [...]

By | 2019-03-11T14:24:40+00:00 March 11th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on ARE HOSPITALISTS READY, WILLING AND ABLE TO RESPOND TO CARDIAC ARREST? A MULTI-CENTER SURVEY

Abstract Number: 365

‘I WANT TO GO TO MY HOME, NOT A NURSING HOME’: A MOBILITY PILOT TO ALIGN PATIENT AND HOSPITAL GOALS.

Background: Many hospitalized patients spend most of their time in bed leading to increased complications. For elderly patients, hospitalization results in decreased post-hospital independence up to 1 month after discharge, which can be prevented with [...]

By | 2019-03-11T14:24:39+00:00 March 11th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on ‘I WANT TO GO TO MY HOME, NOT A NURSING HOME’: A MOBILITY PILOT TO ALIGN PATIENT AND HOSPITAL GOALS.

Abstract Number: 364

PHYSICIAN CHARACTERISTICS CORRELATE WITH PATIENT READMISSION RATES

Background: The 7- and 30-day patient readmission rates are tracked by hospitals and are used as a metric to measure physicians’ quality of patient care. Several tools currently predict and prevent early readmission rates based [...]

By | 2019-03-11T14:24:38+00:00 March 11th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on PHYSICIAN CHARACTERISTICS CORRELATE WITH PATIENT READMISSION RATES

Abstract Number: 359

INHERITED THROMBOPHILIA TESTING PATTERNS IN AN ACADEMIC MEDICAL CENTER INDICATE OPPORTUNITIES FOR SIGNIFICANT COST SAVINGS

Background: Updated guidelines recommend testing for inherited or acquired thrombophilias only in rare situations in the acute inpatient care setting, as it has little impact on acute management of thromboembolic events, and in some situations, [...]

By | 2019-03-11T14:24:31+00:00 March 11th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on INHERITED THROMBOPHILIA TESTING PATTERNS IN AN ACADEMIC MEDICAL CENTER INDICATE OPPORTUNITIES FOR SIGNIFICANT COST SAVINGS

Abstract Number: 358

HANDLING HAND HYGIENE: FACTORS IMPLICATED IN NON-ADHERENCE AT AN ACADEMIC MEDICAL CENTER

Background: Nosocomial infections are one of the leading causes of mortality and morbidity in the United States. Approximately two million people annually are affected by nosocomial infections in the United States and about 80,000 deaths [...]

By | 2019-03-11T14:24:30+00:00 March 11th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on HANDLING HAND HYGIENE: FACTORS IMPLICATED IN NON-ADHERENCE AT AN ACADEMIC MEDICAL CENTER

Abstract Number: 354

UTILIZING AN INTERNAL MEDICINE TRIAGING RESIDENT IN THE EMERGENCY DEPARTMENT REDUCES LOW-IMPACT ADMISSIONS AND IMPROVES TRAINEE EXPERIENCES: A QUALITY IMPROVEMENT STUDY

Background: The Veterans Affairs (VA) hospital is a primary site for internal medicine (IM) residents at our program. It provides trainees with exposure to high-yield general medicine cases and an opportunity to care for a [...]

By | 2019-03-11T14:24:24+00:00 March 11th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on UTILIZING AN INTERNAL MEDICINE TRIAGING RESIDENT IN THE EMERGENCY DEPARTMENT REDUCES LOW-IMPACT ADMISSIONS AND IMPROVES TRAINEE EXPERIENCES: A QUALITY IMPROVEMENT STUDY

Abstract Number: 353

THE IN-STEP PROJECT: IMPROVING ACCESS TO HIV PREVENTION FOR PATIENTS EVALUATED AFTER SEXUAL ASSAULT USING A MULTIDISCIPLINARY, PATIENT-CENTERED APPROACH

Background: Patients evaluated after sexual assault may require non-occupational post-exposure prophylaxis (nPEP) to prevent infection with human immunodeficiency virus (HIV), depending on the assessed risk of HIV transmission in each case1-4. Access to nPEP medications, [...]

By | 2019-03-11T14:24:23+00:00 March 11th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on THE IN-STEP PROJECT: IMPROVING ACCESS TO HIV PREVENTION FOR PATIENTS EVALUATED AFTER SEXUAL ASSAULT USING A MULTIDISCIPLINARY, PATIENT-CENTERED APPROACH

Abstract Number: 352

INITIATIVE FOR PREVENTION AND EARLY IDENTIFICATION OF DELIRIUM IN MEDICAL-SURGICAL UNITS: LESSONS LEARNT IN THE PAST FIVE YEARS

Background: Delirium is an acute change in mental status affecting 10-64% of hospitalized patients, and may be preventable in 30-40% cases. There was no standardized protocol for delirium at our hospital prior to 2014. In [...]

By | 2019-03-11T14:24:21+00:00 March 11th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on INITIATIVE FOR PREVENTION AND EARLY IDENTIFICATION OF DELIRIUM IN MEDICAL-SURGICAL UNITS: LESSONS LEARNT IN THE PAST FIVE YEARS

Abstract Number: 344

QTC’ING THE LIGHT: AVOIDING EKG WASTE IN CARDIAC MONITORING OF ANTIPSYCHOTICS

Background: Antipsychotics can prolong QTc interval and lead to development of the fatal arrhythmia Torsade de Pointes. Accordingly, serial EKG monitoring of QTc in patients newly started on antipsychotics has become common practice in hospitals. [...]

By | 2019-03-11T14:24:09+00:00 March 11th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on QTC’ING THE LIGHT: AVOIDING EKG WASTE IN CARDIAC MONITORING OF ANTIPSYCHOTICS

Abstract Number: 343

NOW QTC IT, NOW YOU DON’T: EKG ORDERING TENDENCIES AMONG HOSPITALISTS, RESIDENTS, AND ADVANCED PRACTICE PROVIDERS MONITORING INPATIENTS NEWLY STARTED ON ANTIPSYCHOTICS.

Background: It is common practice to monitor QTc interval in hospitalized patients newly started on antipsychotics. While some guidelines exist for frequency of ordering EKGs in the outpatient setting, these may not apply to inpatients [...]

By | 2019-03-11T14:24:08+00:00 March 11th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on NOW QTC IT, NOW YOU DON’T: EKG ORDERING TENDENCIES AMONG HOSPITALISTS, RESIDENTS, AND ADVANCED PRACTICE PROVIDERS MONITORING INPATIENTS NEWLY STARTED ON ANTIPSYCHOTICS.

Abstract Number: 342

IMPLEMENTATION OF A HYPERBILIRUBINEMIA PATHWAY FOR THE INPATIENT PEDIATRICS UNIT AT LEHIGH VALLEY HEALTH NETWORK

Background: Hyperbilirubinemia is the most common cause of hospitalization among neonates. Severe, untreated hyperbilirubinemia can lead to acute bilirubin encephalopathy and kernicterus. Although rare, these conditions can pose significant risks for morbidity and mortality in [...]

By | 2019-03-11T14:24:06+00:00 March 11th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on IMPLEMENTATION OF A HYPERBILIRUBINEMIA PATHWAY FOR THE INPATIENT PEDIATRICS UNIT AT LEHIGH VALLEY HEALTH NETWORK

Abstract Number: 341

ASSESSING CONFUSION: AN INVESTIGATION INTO HEALTHCARE PROVIDERS PERCEPTION OF AMMONIA TESTING.

Background: Hepatic encephalopathy (HE) is a common complication in patients with end stage liver disease. Variability in presentation can be a source of clinical uncertainty for medical providers. Ammonia levels have historically been used to [...]

By | 2019-03-11T14:24:05+00:00 March 11th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on ASSESSING CONFUSION: AN INVESTIGATION INTO HEALTHCARE PROVIDERS PERCEPTION OF AMMONIA TESTING.

Abstract Number: 340

PILOT STUDY- SCREENING HOSPITALIZED PATIENTS FOR OBSTRUCTIVE SLEEP APNEA

Background: Obstructive sleep apnea (OSA) is a disorder characterized by obstructive apneas and hypopneas due to repetitive collapse of the upper airway during sleep. OSA is the most common sleep-related breathing disorder. The estimated prevalence [...]

By | 2019-03-11T14:24:03+00:00 March 11th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on PILOT STUDY- SCREENING HOSPITALIZED PATIENTS FOR OBSTRUCTIVE SLEEP APNEA

Abstract Number: 338

STUDY OF ALERT FATIGUE, EFFECTIVENESS, AND ACCURACY IN THE DEVELOPMENT OF A NEW SEPSIS BEST PRACTICE ALERT

Background: Best-Practice Alerts (BPAs), utilized to reduce the number of adverse events in medical settings, have limited efficacy partly due to alert fatigue and user desensitization. Alert fatigue often stems from inaccurate alerts firing too [...]

By | 2019-03-11T14:24:00+00:00 March 11th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on STUDY OF ALERT FATIGUE, EFFECTIVENESS, AND ACCURACY IN THE DEVELOPMENT OF A NEW SEPSIS BEST PRACTICE ALERT

Abstract Number: 333

REDUCING INAPPROPRIATE TELEMETRY USE – A MULTIMODAL INTERVENTION

Background: Overuse of non-ICU continuous cardiac (telemetry) monitoring is a well-documented problem that leads to increased hospital cost, alarm fatigue, nursing time loss, and patient discomfort. It is often ordered for detection of clinical deterioration [...]

By | 2019-03-11T14:23:53+00:00 March 11th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on REDUCING INAPPROPRIATE TELEMETRY USE – A MULTIMODAL INTERVENTION

Abstract Number: 331

HEALTH LITERACY AND SOCIOECONOMIC STATUS ROLE IN 30-DAY READMISSIONS

Background: Health literacy (HL) is the measure of a person’s ability to obtain, process and understand basic health information and services to make appropriate health decisions. Previous studies note positive correlation between high HL and [...]

By | 2019-03-11T14:23:49+00:00 March 11th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on HEALTH LITERACY AND SOCIOECONOMIC STATUS ROLE IN 30-DAY READMISSIONS

Abstract Number: 328

CHARACTERIZING INAPPROPRIATE PROPHYLACTIC TRANSFUSION OF BLOOD PRODUCTS IN HOSPITALIZED PATIENTS UNDERGOING PARACENTESIS FROM 2004 TO 2012 IN THE UNITED STATES

Background: Patients with ascites due to cirrhosis frequently have some degree of thrombocytopenia and prolongation of prothrombin time. However, major bleeding rates from paracentesis are reported to be less than 1% without use of any [...]

By | 2019-03-11T14:23:45+00:00 March 11th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on CHARACTERIZING INAPPROPRIATE PROPHYLACTIC TRANSFUSION OF BLOOD PRODUCTS IN HOSPITALIZED PATIENTS UNDERGOING PARACENTESIS FROM 2004 TO 2012 IN THE UNITED STATES

Abstract Number: 327

EVALUATION OF EMORY UNIVERSITY HEALTHCARE INPATIENT CORRECTIVE INSULIN USE: A COMPARISON OF TABLE-BASED VS. FORMULA-BASED ORDERING

Background: Insulin is the preferred agent to manage hyperglycemia in the hospital. However, it is considered a high alert medication due to risk of hypoglycemia and severity of adverse events. In our institution, three hospitals [...]

By | 2019-03-11T14:23:43+00:00 March 11th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on EVALUATION OF EMORY UNIVERSITY HEALTHCARE INPATIENT CORRECTIVE INSULIN USE: A COMPARISON OF TABLE-BASED VS. FORMULA-BASED ORDERING

Abstract Number: 326

REASONS FOR NON ADHERENCE TO SURVEILLANCE COLONOSCOPY POST COLORECTAL CANCER RESECTION: A TERTIARY CARE CENTER EXPERIENCE

Background: Colorectal cancer (CRC) is the third most common cause of cancer related death in the United States. Surgical resection is the primary treatment for patients presenting with non-metastatic disease. Current guidelines from major societies [...]

By | 2019-03-11T14:23:42+00:00 March 11th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on REASONS FOR NON ADHERENCE TO SURVEILLANCE COLONOSCOPY POST COLORECTAL CANCER RESECTION: A TERTIARY CARE CENTER EXPERIENCE

Abstract Number: 323

WHAT VARIABLES ARE ASSOCIATED WITH PERFORMING TRANSTHORACIC ECHOCARDIOGRAM WHEN EVALUATING SYNCOPE?

Background: Guidelines recommend in-hospital evaluation with cardiac monitoring and transthoracic echocardiogram (TTE) to assess syncope in patients that are considered high-risk for major adverse cardiovascular events. We sought to identify variables associated with performing TTE [...]

By | 2019-03-11T14:23:38+00:00 March 11th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on WHAT VARIABLES ARE ASSOCIATED WITH PERFORMING TRANSTHORACIC ECHOCARDIOGRAM WHEN EVALUATING SYNCOPE?

Abstract Number: 322

“DON’T LET THE GOWN GET YOU DOWN”: HOW PATIENTS AND PROVIDERS PERCEIVE HOSPITAL GOWNS

Background: Although the intended purpose of the hospital gown is not to cause harm, it reinforces the role of being subordinate to the physician. Gowns put patients in a vulnerable position because they can be [...]

By | 2019-03-11T14:23:36+00:00 March 11th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on “DON’T LET THE GOWN GET YOU DOWN”: HOW PATIENTS AND PROVIDERS PERCEIVE HOSPITAL GOWNS

Abstract Number: 320

UNDERSTANDING CLINICAL PATHWAY FOR HOSPITALIZED INJECTION DRUG USERS DUE TO INJECTION-RELATED INFECTION SEQUELAE

Background: There have been increases in the incidence of and significant costs associated with hospitalizations due to injection-related infection sequelae both in the U.S. and worldwide. Infection sequelae include but are not limited to cellulitis [...]

By | 2019-03-11T14:23:33+00:00 March 11th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on UNDERSTANDING CLINICAL PATHWAY FOR HOSPITALIZED INJECTION DRUG USERS DUE TO INJECTION-RELATED INFECTION SEQUELAE

Abstract Number: 312

EVOLVING CULTURE FROM “MORE IS BETTER” TO “LESS IS BEST”: A QI PROJECT TO REDUCE USAGE OF MULTILUMEN PICCS

Background: Peripherally inserted central catheters (PICCs) are an increasingly common vascular access device, with more than 4000 devices placed per year at our institution. Though these devices are generally considered safe and effective, they are [...]

By | 2019-03-11T14:23:22+00:00 March 11th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on EVOLVING CULTURE FROM “MORE IS BETTER” TO “LESS IS BEST”: A QI PROJECT TO REDUCE USAGE OF MULTILUMEN PICCS

Abstract Number: 311

A QUALITY IMPROVEMENT PROJECT TO REDUCE HIGH-RISK MEDICATION USE FOR SLEEP IN HOSPITALIZED PATIENTS AT RISK OF DELIRIUM

Background: Hospitalized elderly patients are at risk for delirium. Despite the widely recognized importance of avoiding potentially inappropriate medications on the BEERS list, hospitalized patients often receive high-risk medications such as benzodiazepines for insomnia. This [...]

By | 2019-03-11T14:23:21+00:00 March 11th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on A QUALITY IMPROVEMENT PROJECT TO REDUCE HIGH-RISK MEDICATION USE FOR SLEEP IN HOSPITALIZED PATIENTS AT RISK OF DELIRIUM

Abstract Number: 305

DOES GLUCOSE GEL REDUCE NEONATAL INTENSIVE CARE UNIT ADMISSIONS FOR NEONATAL HYPOGLYCEMIA?

Background: Recent studies suggest that glucose gel is effective for treating neonatal hypoglycemia, thus it may reduce neonatal intensive care unit (NICU) admissions. The purpose of this study is to compare NICU admissions and care [...]

By | 2019-03-11T14:23:12+00:00 March 11th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on DOES GLUCOSE GEL REDUCE NEONATAL INTENSIVE CARE UNIT ADMISSIONS FOR NEONATAL HYPOGLYCEMIA?

Abstract Number: 299

IMPROVING COMMUNICATION OF DISCHARGE PLANS AMONGST RESIDENTS, NURSES, AND PATIENTS: A QUALITY IMPROVEMENT PROJECT

Background: Discharge of hospitalized patients is a multistep process, involving communication amongst numerous healthcare providers. Delays in discharge cause a backlog of patients in the ED and ICUs, leading to prolonged patient wait times and [...]

By | 2019-03-11T14:23:02+00:00 March 11th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on IMPROVING COMMUNICATION OF DISCHARGE PLANS AMONGST RESIDENTS, NURSES, AND PATIENTS: A QUALITY IMPROVEMENT PROJECT

Abstract Number: 298

PHYSICIAN COGNITIVE LOAD AND THE RISK OF BURNOUT AMONG US PHYSICIANS

Background: Medicine is complex with extraneous workload impacting the daily flow of physicians. This may contribute to an increased risk of burnout (BO). Cognitive load from complex systems can decrease performance and increase risk of [...]

By | 2019-03-11T14:23:01+00:00 March 11th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on PHYSICIAN COGNITIVE LOAD AND THE RISK OF BURNOUT AMONG US PHYSICIANS

Abstract Number: 294

NARCOTICS USAGE PATTERNS IN THE INPATIENT SETTING – IDENTIFYING WAYS TO IMPROVE PATIENT SAFETY

Background: Hospital inpatients frequently require opioid analgesics for pain management, with more than half of US patients in acute-care facilities receiving opioids during their stay. With the rise of opioid drug therapy, the need to [...]

By | 2019-03-11T14:22:56+00:00 March 11th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on NARCOTICS USAGE PATTERNS IN THE INPATIENT SETTING – IDENTIFYING WAYS TO IMPROVE PATIENT SAFETY

Abstract Number: 293

HOSPITAL MEDICINE MANAGEMENT OF PENDING TESTS AFTER DISCHARGE: A QUALITY IMPROVEMENT INTERVENTION

Background: Inpatient physicians often discharge patients while diagnostic tests are still pending. The discharging attending is responsible for following-up these results, even if they have rotated off service. This can lead to delayed and/or missed [...]

By | 2019-03-11T14:22:54+00:00 March 11th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on HOSPITAL MEDICINE MANAGEMENT OF PENDING TESTS AFTER DISCHARGE: A QUALITY IMPROVEMENT INTERVENTION

Abstract Number: 291

REINFORCING TEAMWORK IN A HIGH CALL VOLUME STEP DOWN UNIT: A COLLABORATION AMONG THE NIGHT FLOAT RESIDENTS, NURSING, AND HOSPITALISTS TO IMPROVE WORKFLOW AND PATIENT OUTCOMES

Background: The Progressive Care Unit (PCU) is an intermediary unit between the ICU and the general medical ward. Unit coverage is provided by a dedicated Hospitalist during the day. During the hours of 7pm to [...]

By | 2019-03-11T14:22:51+00:00 March 11th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on REINFORCING TEAMWORK IN A HIGH CALL VOLUME STEP DOWN UNIT: A COLLABORATION AMONG THE NIGHT FLOAT RESIDENTS, NURSING, AND HOSPITALISTS TO IMPROVE WORKFLOW AND PATIENT OUTCOMES

Abstract Number: 290

THE ACCESSIBILITY OF RESOURCES FOR WOMEN’S NEEDS IN A LARGE ACADEMIC HOSPITAL

Background: Women make up 78.7% of the workforce in healthcare and healthcare-associated fields; further, nearly a third of practicing physicians and surgeons and roughly half of all medical students are women. Whether they are physicians, [...]

By | 2019-03-11T14:22:50+00:00 March 11th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on THE ACCESSIBILITY OF RESOURCES FOR WOMEN’S NEEDS IN A LARGE ACADEMIC HOSPITAL

Abstract Number: 286

PRANDIAL INSULIN ADMINISTRATION WITH A LA CARTE ORDERING: A PRAGMATIC OBSERVATIONAL STUDY

Background: Glucose management of hospitalized patients with hyperglycemia has many challenges. One of these challenges is the timing of insulin administration in coordination with meal delivery. The Endocrine Society recommends assessing glucose levels within 60 [...]

By | 2019-03-11T14:22:44+00:00 March 11th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on PRANDIAL INSULIN ADMINISTRATION WITH A LA CARTE ORDERING: A PRAGMATIC OBSERVATIONAL STUDY

Abstract Number: 283

“LESS IS MORE WHEN MORE IS TOO MUCH”: REDUCTION OF UNNECESSARY LAB ORDERS ON INPATIENT MEDICAL SERVICES

Background: The practice of routinely ordering daily labs not based on clinical indication on patients in the hospital is a wasteful clinical practice. Routine daily labs can also lead to patient harm by causing pain [...]

By | 2019-03-11T14:22:40+00:00 March 11th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on “LESS IS MORE WHEN MORE IS TOO MUCH”: REDUCTION OF UNNECESSARY LAB ORDERS ON INPATIENT MEDICAL SERVICES

Abstract Number: 281

THE IMPLEMENTATION OF CROSS-DISCIPLINARY PROTOCOL CHANGES FOR INPATIENT GLYCEMIC CONTROL IN DIABETICS

Background: Hyperglycemia in hospitalized patients is well-known to be associated with adverse outcomes, such as infectious complications, increased length of stay, and increased mortality. To that effect, aggressive treatment of inpatient hyperglycemia has been shown [...]

By | 2019-03-11T14:22:36+00:00 March 11th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on THE IMPLEMENTATION OF CROSS-DISCIPLINARY PROTOCOL CHANGES FOR INPATIENT GLYCEMIC CONTROL IN DIABETICS

Abstract Number: 279

PUMPING IRON: MANAGEMENT OF ANEMIA IN A COHORT OF PATIENTS WITH HEART FAILURE (HF) ON THE TEXAS-MEXICAN BORDER

Background: Anemia is common in patients with HF with a prevalence ranging from 10-40%. Studies have shown that these patients have worse outcomes compared to those who don’t. The most common etiology remains iron deficiency [...]

By | 2019-03-11T14:22:33+00:00 March 11th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on PUMPING IRON: MANAGEMENT OF ANEMIA IN A COHORT OF PATIENTS WITH HEART FAILURE (HF) ON THE TEXAS-MEXICAN BORDER

Abstract Number: 278

COMPLICATION RATES WITH MIDLINE CATHETERS (MLS) VERSUS PERIPHERALLY INSERTED CENTRAL CATHETERS (PICCS)

Background: Vascular access devices (VADs) play an integral role in the treatment of patients, since they can be utilized for the administration of intravenous medications (including antibiotics and chemotherapy), and often on a long term [...]

By | 2019-03-11T14:22:32+00:00 March 11th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on COMPLICATION RATES WITH MIDLINE CATHETERS (MLS) VERSUS PERIPHERALLY INSERTED CENTRAL CATHETERS (PICCS)

Abstract Number: 277

IMPROVING RATES OF APPROPRIATE ICD DEACTIVATION DISCUSSIONS IN ADMITTED PATIENTS MADE DNR AND/OR COMFORT CARE

Background: Implantable cardioverter defibrillator (ICD) shocks can be traumatic for patients and families, particularly at the end of life. Studies estimate between 51-65% of ICDs remain active at time of death, with 24-31% of patients [...]

By | 2019-03-11T14:22:30+00:00 March 11th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on IMPROVING RATES OF APPROPRIATE ICD DEACTIVATION DISCUSSIONS IN ADMITTED PATIENTS MADE DNR AND/OR COMFORT CARE

Abstract Number: 276

ASSESSMENT OF VITAMIN LEVELS ON ATHEROSCLEROTIC CARDIOVASCULAR DISEASE RISK: A RESIDENT DRIVEN QUALITY IMPROVEMENT INITIATIVE

Background: Hypertension is a significant risk factor for cardiovascular disease. According to the Centers for Disease Control and Prevention (CDC) half of all United States citizens with hypertension (HTN) do not have their blood pressure [...]

By | 2019-03-11T14:22:29+00:00 March 11th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on ASSESSMENT OF VITAMIN LEVELS ON ATHEROSCLEROTIC CARDIOVASCULAR DISEASE RISK: A RESIDENT DRIVEN QUALITY IMPROVEMENT INITIATIVE

Abstract Number: 275

SELF-STEWARDSHIP OF TESTING AS A METHOD FOR REDUCING HOSPITAL ACQUIRED CLOSTRIDIUM DIFFICILE

Background: Clostridium difficile associated diarrhea (CDAD) is an infectious diarrheal illness associated with high morbidity and mortality. Patients with CDAD have diarrhea symptoms and a positive test for a toxin-producing Clostridium difficile organism. However, patients [...]

By | 2019-03-11T14:22:28+00:00 March 11th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on SELF-STEWARDSHIP OF TESTING AS A METHOD FOR REDUCING HOSPITAL ACQUIRED CLOSTRIDIUM DIFFICILE

Abstract Number: 273

DECREASING ICU LENGTH OF STAY BY IMPROVING PATIENT TRANSFER PRACTICES TO TELEMETRY UNITS

Background: Prolonged intensive care unit (ICU) length of stay (LOS) has been shown to delay patients’ recovery, increase their exposure to the risk of infections, upsurge healthcare costs, and reduce care availability to other critically [...]

By | 2019-03-11T14:22:25+00:00 March 11th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on DECREASING ICU LENGTH OF STAY BY IMPROVING PATIENT TRANSFER PRACTICES TO TELEMETRY UNITS

Abstract Number: 272

COMBATING CLOSTRIDIUM DIFFICILE ONE BOWL MOVEMENT AT A TIME

Background: Clostridium difficile infection is a common infection encountered by hospitalists. While C. difficile colitis is an important cause of morbidity and mortality in the United States, C. difficile can be a normal colonizer of [...]

By | 2019-03-11T14:22:24+00:00 March 11th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on COMBATING CLOSTRIDIUM DIFFICILE ONE BOWL MOVEMENT AT A TIME

Abstract Number: 269

THE PROVIDERS DID WHAT?! WORKFLOW-DRIVEN DECISION SUPPORT OF INPATIENT QUALITY MEASURES

Background: Nebraska Medicine is dedicated to the continuous, goal-directed improvement of: 1. Central venous catheter (CVC) duration 2. Indwelling urinary catheter (IUC) duration 3. Telemetry duration 4. VTE prophylaxis 5. Non-violent restraint order renewal Clinical [...]

By | 2019-03-11T14:22:20+00:00 March 11th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on THE PROVIDERS DID WHAT?! WORKFLOW-DRIVEN DECISION SUPPORT OF INPATIENT QUALITY MEASURES

Abstract Number: 267

EFFECTS OF DATA-DRIVEN STAFFING CHANGES ON HOSPITALIST ATTITUDES, PERCEPTION OF WORKLOAD, AND BURNOUT

Background: Increased hospital utilization and admission can lead to increased provider stress and decreased hospital throughput. Hospital rounding and admitting service design may not appreciably change to accommodate for increased utilization. We hypothesized that a [...]

By | 2019-03-11T14:22:17+00:00 March 11th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on EFFECTS OF DATA-DRIVEN STAFFING CHANGES ON HOSPITALIST ATTITUDES, PERCEPTION OF WORKLOAD, AND BURNOUT

Abstract Number: 266

USING CONTINUOUS QUALITY IMPROVEMENT METHODOLOGIES TO REDUCE CLOSTRIDIUM DIFFICILE TESTING DELAYS

Background: Timely Clostridium difficile Infection (CDI) testing is challenging but is important for faster and appropriate isolation and treatment of patients. Few studies have specifically addressed effective methods to hasten CDI testing without relying on [...]

By | 2019-03-11T14:22:16+00:00 March 11th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on USING CONTINUOUS QUALITY IMPROVEMENT METHODOLOGIES TO REDUCE CLOSTRIDIUM DIFFICILE TESTING DELAYS

Abstract Number: 265

PREVALENCE OF CLOSTRIDIUM DIFFICILE CARRIERS IN AN URBAN ACADEMIC MEDICAL CENTER

Background: There are 400,000 cases and 30,000 deaths from Clostridium difficile (C. diff) infections in the United States annually. Efforts to reduce the transmission of C. diff have focused on patients with diarrhea, however, many [...]

By | 2019-03-11T14:22:14+00:00 March 11th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on PREVALENCE OF CLOSTRIDIUM DIFFICILE CARRIERS IN AN URBAN ACADEMIC MEDICAL CENTER

Abstract Number: 264

HOW WELL DO WE DO? AN IN-DEPTH ANALYSIS OF ATRIAL FIBRILLATION CARE BASED UPON THE 2016 ACC/AHA CLINICAL PERFORMANCE AND QUALITY MEASURES FOR ADULTS WITH ATRIAL FIBRILLATION

Background: Atrial fibrillation (AFIB) is the most common recognized arrhythmia in the United States. Currently affecting more than 6 million people, this number is expected to double by 2050. Along with increased costs ($26 billion/year), [...]

By | 2019-03-11T14:22:13+00:00 March 11th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on HOW WELL DO WE DO? AN IN-DEPTH ANALYSIS OF ATRIAL FIBRILLATION CARE BASED UPON THE 2016 ACC/AHA CLINICAL PERFORMANCE AND QUALITY MEASURES FOR ADULTS WITH ATRIAL FIBRILLATION

Abstract Number: 263

USING QUALITY IMPROVEMENT METHODOLOGIES TO REDUCE HEART FAILURE READMISSIONS

Background: Heart failure (HF) is one of the most common discharge diagnoses for Medicare beneficiaries. As part of the Affordable Care Act, the Center for Medicare and Medicaid Services initiated the Hospital Readmission Reduction Program [...]

By | 2019-03-11T14:22:12+00:00 March 11th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on USING QUALITY IMPROVEMENT METHODOLOGIES TO REDUCE HEART FAILURE READMISSIONS

Abstract Number: 262

KNOWLEDGE AND PRESCRIBING PATTERNS OF INTERNAL MEDICINE RESIDENTS ON PROTON PUMP INHIBITORS IN GASTROESOPHAGEAL REFLUX DISEASE

Background: Proton pump inhibitors (PPI) are the mainstay of treatment and symptomatic remission in GERD. Recently, PPI over-utilization has been a major concern due to associated increased risk of adverse events and unnecessary healthcare cost. [...]

By | 2019-03-11T14:22:11+00:00 March 11th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on KNOWLEDGE AND PRESCRIBING PATTERNS OF INTERNAL MEDICINE RESIDENTS ON PROTON PUMP INHIBITORS IN GASTROESOPHAGEAL REFLUX DISEASE

Abstract Number: 17

EVALUATION OF THE ORDER S.M.A.R.T.T. (SLEEP: MAKING APPROPRIATE REDUCTIONS IN TESTING AND TIMING) LABS: AN INITIATIVE TO REDUCE PHLEBOTOMY AND IMPROVE SLEEP FRIENDLY LABS ON RESIDENT AND HOSPITALIST GENERAL MEDICINE SERVICES

Background: Excessive daily routine laboratory testing for hospitalized patients is a contributor to poor hospital sleep, iatrogenic anemia, and excessive costs. Recommendations from the Choosing Wisely™ campaign specifically state to avoid sleep interruptions for routine [...]

By | 2019-03-18T13:30:55+00:00 March 11th, 2019|Finalist Posters - Research, Hospital Medicine 2019, Quality Improvement, Research|Comments Off on EVALUATION OF THE ORDER S.M.A.R.T.T. (SLEEP: MAKING APPROPRIATE REDUCTIONS IN TESTING AND TIMING) LABS: AN INITIATIVE TO REDUCE PHLEBOTOMY AND IMPROVE SLEEP FRIENDLY LABS ON RESIDENT AND HOSPITALIST GENERAL MEDICINE SERVICES

Abstract Number: 15

EVALUATING ADEQUACY OF VTE PROPHYLAXIS FOR OVERWEIGHT AND OBESE PATIENTS

Background: In 2016 70% of venous thromboembolism events at the University of Pittsburgh Medical Center Presbyterian Hospital occurred in patients with BMI>=25. The American College of Chest Physicians recommend weight base dosing for VTE prophylaxis [...]

By | 2019-03-18T13:28:42+00:00 March 11th, 2019|Finalist Posters - Research, Hospital Medicine 2019, Quality Improvement, Research|Comments Off on EVALUATING ADEQUACY OF VTE PROPHYLAXIS FOR OVERWEIGHT AND OBESE PATIENTS