Quality Improvement

HM2016 Abstract Number: 282

Implementation of a Routine Inpatient Hepatitis C Virus (Hcv) Screening and Outpatient Linkage to Care Program

Background: Chronic hepatitis C virus (HCV) is a leading cause of liver failure and cancer. Half of 3.5 million infected persons in the U.S. know their status, and 43% have access to care. Despite antivirals [...]

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HM2016 Abstract Number: 280

Personal Photographs in the Clinical Setting (Ppics): Enhancing Patient Experience on Adult Medicine Services

Background: Given that the hospital can be a depersonalizing and stressful environment for patients and families, healthcare teams should help ensure hospitalized patients feel respected as individuals. While studies suggest that displaying personal photographs at [...]

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HM2016 Abstract Number: 279

Screening Tool for Identifying Unmet Palliative Care Needs in Patients with Sepsis

Background: Palliative care (PC) has been shown to improve the quality of life for patients facing life-threatening illness and their families.  PC screening tools have been successfully used in identifying cancer patients in need of [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Innovations Abstracts, Quality Improvement|Comments Off on Screening Tool for Identifying Unmet Palliative Care Needs in Patients with Sepsis

HM2016 Abstract Number: 278

Reducing Unnecessary Chest X-Rays: An Initiative to Implement Choosing Wisely Recommendations in Intensive Care Units

Background: Choosing Wisely ® is a national campaign aimed at promoting high-value care. Vanderbilt University Medical Center (VUMC) has created a steering committee to direct implementation of select Choosing Wisely (CW) recommendations. Our first initiative [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Innovations Abstracts, Quality Improvement|Comments Off on Reducing Unnecessary Chest X-Rays: An Initiative to Implement Choosing Wisely Recommendations in Intensive Care Units

HM2016 Abstract Number: 276

Standardizing the Admission Process Using Lean Six Sigma One Piece Flow

Abstract Text: Background: Safely and efficiently moving patients through the admission process is a key concern for emergency and hospital medicine faculty. Our hospitalist group admits approximately 400 patients per month, each admitting physician evaluates [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Innovations Abstracts, Quality Improvement|Comments Off on Standardizing the Admission Process Using Lean Six Sigma One Piece Flow

HM2016 Abstract Number: 265

Unnecessary Transfusions: Hospital Medicine Leading Institution-Wide Change

Unnecessary Transfusions: Hospital Medicine Leading Institution Wide Change Lesley Schmaltz MD, Shalini Bhattacharya MD, Jisu Kim MD, Amir Jaffer MD MBA, Amanda Tosto RN MS, Scott Hasler MD, Manya Gupta MD Background: It is well [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Finalist, Innovations Abstracts, Quality Improvement|Comments Off on Unnecessary Transfusions: Hospital Medicine Leading Institution-Wide Change

HM2016 Abstract Number: 262

The Use of Lean-Kaizen Methodology to Improve Quality of Care in a Remote Health System in Tribal India

Background: The Lean-Kaizen approach of implementing patient-centered systems change by reducing waste and adding value has been widely used in health systems in the US to provide incremental process improvement. This approach to streamlining health [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Innovations Abstracts, Quality Improvement|Comments Off on The Use of Lean-Kaizen Methodology to Improve Quality of Care in a Remote Health System in Tribal India

HM2016 Abstract Number: 260

A Novel Md-Rn Collaborative Protocol to Prevent and Manage Acute Delirium in Inpatient Wards

Background:  Delirium affects 20-60% of the general hospitalized patients, and up to 85% of intensive care unit (ICU) patients. Its occurrence is associated with higher morbidity and mortality, long-term institutionalization, worse long-term cognitive outcomes, and [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Finalist, Innovations Abstracts, Quality Improvement|Comments Off on A Novel Md-Rn Collaborative Protocol to Prevent and Manage Acute Delirium in Inpatient Wards

HM2016 Abstract Number: 259

The Early Discharge Plan: Increasing Discharge Efficiency on Teaching and Non-Teaching Medicine Floors at an Urban Academic Hospital

Background: Unnecessary delays in patient discharges can lead to overcrowding, redundant handoffs, and increased inpatient unit and Emergency Department lengths of stay.  Therefore, timely discharge of ready patients is essential to optimizing patient flow.  Our [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Innovations Abstracts, Quality Improvement|Comments Off on The Early Discharge Plan: Increasing Discharge Efficiency on Teaching and Non-Teaching Medicine Floors at an Urban Academic Hospital

HM2016 Abstract Number: 258

Afternoon Discharge Huddles to Increase Early Discharges

Background: Late discharges are a known barrier to patient flow.  Our project was to identify barriers to early discharges and develop processes to increase early discharges from the inpatient medicine teams.   Purpose:  "Daily afternoon multidisciplinary team huddles [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Innovations Abstracts, Quality Improvement|Comments Off on Afternoon Discharge Huddles to Increase Early Discharges

HM2016 Abstract Number: 256

Hepatitis C Antibody Testing: Saving Costs by Preventing Multiple Unnecessary Tests

Background: Healthcare costs continue to represent a growing burden on the American economy.  Current research has focused on methods to eliminate unnecessary tests or procedures to save costs and prevent waste.  Hepatitis C antibody testing [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Innovations Abstracts, Quality Improvement|Comments Off on Hepatitis C Antibody Testing: Saving Costs by Preventing Multiple Unnecessary Tests

HM2016 Abstract Number: 253

Implementation of a Code Blue Event Outcome Tracking System for Resident-Led Teams

Background: Code Blue events, or in-hospital patient emergencies, often require advanced cardiac life support (ACLS) and unfortunately can end in loss of life. Defining and measuring outcomes is an essential step for improvement in any [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Innovations Abstracts, Quality Improvement|Comments Off on Implementation of a Code Blue Event Outcome Tracking System for Resident-Led Teams

HM2016 Abstract Number: 242

Fixing What Is Broken: Quality Improvement in the Critical Lab Value Process

Background: Critical lab values are those results that require rapid notification to clinical staff so that urgent interventions can be made to avoid morbidity or mortality. The Joint Commission requires that hospitals have an effective [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Finalist, Innovations Abstracts, Quality Improvement|Comments Off on Fixing What Is Broken: Quality Improvement in the Critical Lab Value Process

HM2016 Abstract Number: 241

In Pursuit of Happiness: Creating an Academic Hospitalists Wellness Committee

Background: Physician burnout poses a critical threat to the United States health care system.  Finding a solution to this problem is a leadership imperative, as studies report that nearly half of physicians in the U.S. [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Innovations Abstracts, Quality Improvement|Comments Off on In Pursuit of Happiness: Creating an Academic Hospitalists Wellness Committee

HM2016 Abstract Number: 240

Using Lean and A3 Thinking to Improve Code Blue Multidisciplinary Communication

Background: A LEAN principle is that front line staff provide value as defined by the customer (the patient). Within a LEAN framework, an A3 is both a way to understand your problem and a tool [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Innovations Abstracts, Quality Improvement|Comments Off on Using Lean and A3 Thinking to Improve Code Blue Multidisciplinary Communication

HM2016 Abstract Number: 237

Making It Simple – Process Improvement for Outside Medical Records

Background: Outside Medical Records are essential for accurate continuity of care when patients are transferred from one healthcare system to another. Despite their importance, obtaining records in a timely manner is a notoriously difficult process. [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Finalist, Innovations Abstracts, Quality Improvement|Comments Off on Making It Simple – Process Improvement for Outside Medical Records

HM2016 Abstract Number: 236

Man Vs. Machine: A Multidisciplinary Intervention Targeting Dropped High Risk Medications in the Electronic Medical Record

Background: New York State has identified a list of controlled medications that require frequent monitoring and review. New York State law dictates that these medications, when disbursed in a hospital setting, must be reviewed and [...]

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HM2016 Abstract Number: 235

Resident-Based Telemetry Utilization Innovations Lead to Improved Outcomes

Background: Inpatient telemetry monitoring is commonly used to identify arrhythmias, ischemia, and QT prolongation. The American College of Cardiology and American Heart Association (ACC/AHA) guidelines identify groups in which telemetry use (1) is indicated, (2) [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Innovations Abstracts, Quality Improvement|Comments Off on Resident-Based Telemetry Utilization Innovations Lead to Improved Outcomes

HM2016 Abstract Number: 230

Managing Challenging Patients: From Conflict to Teaching Opportunity

Background: Challenging patients exhibit disruptive behaviors that lack conformity with normal work flow. Examples of such behaviors include drug seeking, violence, non-compliance, exchanging drugs with visitors, unauthorized departure from hospital premises, etc. Patients engaging in [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Finalist, Innovations Abstracts, Quality Improvement|Comments Off on Managing Challenging Patients: From Conflict to Teaching Opportunity

HM2016 Abstract Number: 227

Improving Goals of Care Documentation at an Academic Medical Center with Electronic Health Record-Based Alerting

Background: Hospital admission presents an important opportunity to engage with patients about goals of care (GOC) and advanced care planning. The significant and sensitive nature of GOC conversations requires that documentation of a patient’s goals [...]

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HM2016 Abstract Number: 226

Implementation of a Pay-for-Perfomance Structure for Hospitalist-Led Quality Improvement Projects

Background: Pay-for-performance incentives allow for engagement and motivation of participating physicians. Hospitalist compensation structure commonly combines base salary with performance and/or productivity-based incentives. Frequently used quality measures are value based purchasing metrics, patient satisfaction scores, [...]

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HM2016 Abstract Number: 225

Interprofessional Approach to Improving Malnutrition Screening and Diagnosis at a Va Medical Center

Background: Malnutrition affects up to 30% of inpatients, but is rarely diagnosed. This leads to under-treatment and poor patient outcomes including: infections, pressure ulcers, and poor wound healing. In the MS-DRG system, malnutrition is considered [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Innovations Abstracts, Quality Improvement|Comments Off on Interprofessional Approach to Improving Malnutrition Screening and Diagnosis at a Va Medical Center

HM2016 Abstract Number: 224

Increasing Ambulation with Fitbits in Hospitalized Medicine Patients

Background: Ambulation is significantly reduced when patients are hospitalized, which leads to decreased muscle strength and aerobic capacity. A recent study of geriatric inpatients found daily median step counts of 478 to 846, much lower [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Innovations Abstracts, Quality Improvement|Comments Off on Increasing Ambulation with Fitbits in Hospitalized Medicine Patients

HM2016 Abstract Number: 217

Post-Tace Race: Improving Discharge Times Through Creation of a Hospitalist-Based Service

Background: Early, yet safe hospital discharges are a constant area of focus at tertiary care centers in order to maintain efficiency and patient flow. This is especially true at our institution, which acts as a [...]

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HM2016 Abstract Number: 213

Project Sleep: A Multidisciplinary Quality Improvement Project

Background: Acute hospitalization can precipitate insomnia- the insomnia being related to the underlying illness, medications, change from usual nighttime routines and a sleep disruptive hospital environment.  Both insomnia and the drugs used to treat it [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Innovations Abstracts, Quality Improvement|Comments Off on Project Sleep: A Multidisciplinary Quality Improvement Project

HM2016 Abstract Number: 210

Residency Run Initiative to Improve Appropriateness of Telemetry Use

Background: Inpatient telemetry monitoring began over 4 decades ago. However, recently hospitals have started to implement programs that aim to improve the appropriateness of telemetry use. Quality initiatives take the American Heart Association (AHA) guidelines [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Innovations Abstracts, Quality Improvement|Comments Off on Residency Run Initiative to Improve Appropriateness of Telemetry Use

HM2016 Abstract Number: 208

Integrated Clinical Decision Support Focused on Early Recognition and Standardized Treatment of Sepsis

Background: Despite widespread awareness of best practices in the early management of sepsis, sepsis continues to burden our healthcare systems with high mortality, prolonged length of stay and excessive cost.  Early recognition of sepsis and [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Innovations Abstracts, Quality Improvement|Comments Off on Integrated Clinical Decision Support Focused on Early Recognition and Standardized Treatment of Sepsis

HM2016 Abstract Number: 209

Resident Progress Note Improvement Via a Standardized Template

Background: The daily progress note is the foundation of inpatient documentation and communication for healthcare providers. With the advent of the electronic medical record, copy-and-pasting, note bloat, inconsistencies, erroneous data, and lack of cognitive processing [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Innovations Abstracts, Quality Improvement|Comments Off on Resident Progress Note Improvement Via a Standardized Template

HM2016 Abstract Number: 206

Evaluating the Quality of Patient Pass-Offs

Background: Patient pass-offs represent a known vulnerability in patient care.   The Hospital Medicine Unit at Massachusetts General Hospital has several specialized roles including an admitting hospitalist, a rounding hospitalist, and a nocturnist.  Our on-service time [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Innovations Abstracts, Quality Improvement|Comments Off on Evaluating the Quality of Patient Pass-Offs

HM2016 Abstract Number: 201

Building a Comprehensive Patient-Centered Readmission Reduction Program

Background: Traditional readmission case review processes at our tertiary-care academic institution failed to identify obvious target processes for readmission reduction.  Looking for a more nuanced method of readmission review, we turned to our patients.   We [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Innovations Abstracts, Quality Improvement|Comments Off on Building a Comprehensive Patient-Centered Readmission Reduction Program

HM2016 Abstract Number: 199

Skip the Drips: Reining in Unnecessary Continuous Intravenous Infusions

Background: Continuous intravenous infusions – or “drips” – can be burdensome for patients and clinicians. With this in mind, we identified three scenarios for which providers could safely “skip the drip” in favor a therapeutic [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Innovations Abstracts, Quality Improvement|Comments Off on Skip the Drips: Reining in Unnecessary Continuous Intravenous Infusions

HM2016 Abstract Number: 197

Reducing Routine Blood Draws

Background:   In line with the American Board of Internal Medicine's (ABIM) Choosing Wisely® initiative, the Society of Hospital Medicine (SHM) recommends not performing repetitive complete blood count (CBC) and chemistry (CHEM7) testing in the face of clinical and lab stability.  [...]

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HM2016 Abstract Number: 196

Reducing Emergency Room Length of Stay for Medicine Admissions

Background: Keeping admitted patients in the emergency room (ER) carries negative operational and clinical consequences. Prolonged stays reduce ER bed turnover, thereby limiting access for other patients. Furthermore prolonged ER length of stay (LOS) has [...]

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HM2016 Abstract Number: 195

Take Your Patient’s Polst: An Advance Care Planning Quality Improvement Initiative in Hospital Medicine!

Background: The Physician Orders for Life-Sustaining Treatment (POLST) form is an important tool to elicit and document patients’ treatment preferences in a way that is valid across health care settings. Studies on its efficacy have found [...]

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HM2016 Abstract Number: 193

A Multidisciplinary Approach to Improving Congestive Heart Failure (Chf) Specificity Documentation

Background: Appropriate documentation of Congestive Heart Failure (CHF) specificity is still a major documentation problem in most hospitals in the United States despite the frequent presence of Clinical Documentation Improvement Specialists (CDIs) to assist with [...]

By | 2016-02-01T08:00:34+00:00 February 1st, 2016|Innovations Abstracts, Quality Improvement|Comments Off on A Multidisciplinary Approach to Improving Congestive Heart Failure (Chf) Specificity Documentation