Do Housestaff Provide Adequate Work Rounds? Results from 17 Training Programs

Background: Effective hospital work rounds require attention to multiple components: physicians should be able to review patients' course, test results, and treatment plan while attending to their comfort and answering questions. In general, it also [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Do Housestaff Provide Adequate Work Rounds? Results from 17 Training Programs

Predictors of Selfreported Handoff Behavior at Hospital Discharge and Its Association with 30Day Readmissions

Background: Poor handoffs may lead to adverse health outcomes. We sought to determine rates of self–reported handoffs from inpatient to outpatient providers, to examine predictors of successful handoffs, and to determine the association between successful [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Predictors of Selfreported Handoff Behavior at Hospital Discharge and Its Association with 30Day Readmissions

Perceived Control & Sleep in Hospitalized Adults: A Sound Hypothesis?

Background: Although sleep is important for recovery from acute illness, it is often hampered by noise in hospitals. Interestingly, some patients are more vulnerable to noise disruptions, which is now a publicly reported quality measure [...]

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Factors Contributing to 7Day Readmissions in an Urban Teaching Hospital

Background: Avoidable hospital readmissions may be reflective of poor quality of inpatient healthcare and may be used as a metric to guide reimbursement rates to hospitals. Most existing risk prediction models rely on administrative databases [...]

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Computerized Patient Record Order Sets for Venous Thromboembolism (Vte) Prophylaxis and Associated Rates of Vte

Background: Venous thromboembolism (VTE) is a known complication of hospitalization; implementation of proven prophylactic modalities should reduce VTE rates. One potential strategy is the use of computerized order sets. The objective of this study is [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Computerized Patient Record Order Sets for Venous Thromboembolism (Vte) Prophylaxis and Associated Rates of Vte

Unsafe Use of Intravenous Haloperidol Pervasive in Hospitalized Elderly

Background: Delirium, an acute decline in attention and cognition, is present in 11–24% of elderly patients on hospital admission, and another 6–56% will develop delirium during their hospital stay. Off–label intravenous (IV) administration of haloperidol [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Unsafe Use of Intravenous Haloperidol Pervasive in Hospitalized Elderly

Does Physicianinduced Demand Explain Geographic Variation in Discretionary Procedures?

Background: There is an extensive literature on geographic variation in utilization intensity. Although system capacity (e.g. hospital bed, physician, and scanner density) has been implicated as a factor, the drivers of this variation have not [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Does Physicianinduced Demand Explain Geographic Variation in Discretionary Procedures?

Mortality Reduction Associated with Structure, Process, and Management Redesign of a Hospital Medicine Unit

Background: Opportunities exist to re–create hospital units as effective and reliable microsystems. We used specific structure, process, and management design features to re–launch a hospital medicine unit: 1. Unit–based physician teams, 2. Structured Interdisciplinary Bedside [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Mortality Reduction Associated with Structure, Process, and Management Redesign of a Hospital Medicine Unit

Failure of the Swift Score to Predict Readmission to the ICU

Background: Despite initial recovery from critical illness requiring intensive care unit (ICU) admission, many patients remain at risk of subsequent deterioration and unplanned readmission to the ICU. Readmitted patients have higher mortality rates and significantly [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Failure of the Swift Score to Predict Readmission to the ICU

Pilot of a Triage System to Increase Efficiency in Handoffs Between Ward Teams and a Single Nocturnal Covering Provider in a Tertiary Care Teaching Hospital

Background: Since the advent of resident hour restrictions in 2003, hand–offs between providers have become increasingly prevalent. The process of hand–offs can require a substantial amount of time depending on the number of patients being [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Pilot of a Triage System to Increase Efficiency in Handoffs Between Ward Teams and a Single Nocturnal Covering Provider in a Tertiary Care Teaching Hospital

Lean Inpatient Unit Base Care Model

Background: The hospital is an urban facility with 453 licensed beds. The hospitalist group is the only hospitalist service operating in the hospital and will perform over 14,000 admissions in 2011. In 2009, we recognized [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Lean Inpatient Unit Base Care Model

Improving Inpatient Glycemic Control Using a Multifaceted Approach

Background: Nationally, manifestations of poor glycemic control are one of Medicare's Hospital Acquired Conditions that are publically reported and no longer reimbursed. Insulin is also one of the JC's top five high –risk medications. Furthermore, [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Improving Inpatient Glycemic Control Using a Multifaceted Approach

Patient Plan of Care Rounds: Success of Teambased Inpatient Rounding

Background: Developing collaborative practice models is emerging as a core strategy in creating an ideal patient safety climate, improving patient care outcomes, and increasing patient satisfaction. However structuring a workflow for team members that allows [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Patient Plan of Care Rounds: Success of Teambased Inpatient Rounding

Deliberate Practice Makes Perfect: Expertise Training on the Wards

Background: Academic productivity is a key component of advancement in academic medicine and development of expertise, however many new attendings lack the knowledge and experience to publish a paper. For example, a multi–institutional survey of [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Deliberate Practice Makes Perfect: Expertise Training on the Wards

One Patient at a Time: Identifying a Community Outbreak of Shigella Infection

Case Presentation: This is a 17–year–old–man who is part of a strict religious community in Brooklyn, NY, with no significant past medical history who presents to the emergency room with the complaint of diarrhea for [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on One Patient at a Time: Identifying a Community Outbreak of Shigella Infection