High Value Care

/Tag:High Value Care

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 | 2019-03-18T18:00:19-04:00 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: 593

CHEST PAIN AFTER PHYSICAL ASSAULT: AN UNEXPECTED BLESSING

Case Presentation: A 56 y/o African American male with a history of paroxysmal atrial fibrillation presented with “pounding” chest pain after being assaulted. On presentation, the patient was afebrile and normotensive but significantly tachycardic (heart [...]

By | 2019-03-11T14:30:28-04:00 March 11th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on CHEST PAIN AFTER PHYSICAL ASSAULT: AN UNEXPECTED BLESSING

Abstract Number: 459

VALUE IN TRAINING: AN INTERPROFESSIONAL TRAIN THE TRAINER CURRICULUM ON HIGH VALUE CARE IN EDUCATION AND CLINICAL PRACTICE

Background: Regardless of specialty or discipline, healthcare professionals are tasked with addressing high value care (HVC). It is therefore crucial that hospitalists and other members of the interprofessional team have training in addressing HVC, specifically [...]

By | 2019-03-11T14:26:57-04:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Value in Hospital Medicine|Comments Off on VALUE IN TRAINING: AN INTERPROFESSIONAL TRAIN THE TRAINER CURRICULUM ON HIGH VALUE CARE IN EDUCATION AND CLINICAL PRACTICE

Abstract Number: 452

REDUCING UNNECESSARY CHEST X-RAYS IN THE MEDICAL INTENSIVE CARE UNIT

Background: Chest radiographs (CXRs) aid in the evaluation of clinical status and assess the placement of new lines and tubes in patients in the Medical Intensive Care Unit (MICU). Despite studies documenting the safety of [...]

By | 2019-03-11T14:26:47-04:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Value in Hospital Medicine|Comments Off on REDUCING UNNECESSARY CHEST X-RAYS IN THE MEDICAL INTENSIVE CARE UNIT

Abstract Number: 439

SUPINE-RELATED ANEMIA IN HOSPITALIZED PATIENTS

Background: Hemoglobin and hematocrit, routinely measured in hospitalized patients, are likely affected by shifts in plasma volume related to posture. This could have important ramifications on hemoglobin trends overnight, resulting in over diagnosis of anemia [...]

By | 2019-03-11T14:26:27-04:00 March 11th, 2019|Hospital Medicine 2019, Research, Value in Hospital Medicine|Comments Off on SUPINE-RELATED ANEMIA IN HOSPITALIZED PATIENTS

Abstract Number: 438

DESIGN AND IMPLEMENTATION OF A HOUSESTAFF COUNCIL ON VALUE AND INNOVATION

Background: Delivering HVC is a core component of hospitalist practice, and equipping residents with skills and experience to lead HVC initiatives is a priority for training institutions and for society. We describe the design, founding [...]

By | 2019-03-11T14:26:25-04:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Value in Hospital Medicine|Comments Off on DESIGN AND IMPLEMENTATION OF A HOUSESTAFF COUNCIL ON VALUE AND INNOVATION

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 | 2019-03-11T14:24:45-04:00 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: 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 | 2019-03-11T14:24:14-04:00 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 | 2019-03-11T14:24:12-04:00 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 | 2019-03-11T14:24:11-04:00 March 11th, 2019|Hospital Medicine 2019, Innovations, Quality Improvement|Comments Off on DISMANTLING A BARRIER TO MINDFUL LAB ORDERING: THE ATTENDING PHYSICIAN

Abstract Number: 250

VARIATION IN RATE OF BLOOD CULTURE FOR SKIN AND SOFT TISSUE INFECTIONS IN IMMUNOCOMPETENT CHILDREN

Background: Single-center studies have reported low yield of blood culture for skin and soft tissue infections (SSTIs) in children. Blood cultures are commonly obtained in cases of SSTI, though the degree of practice variation is [...]

By | 2019-03-11T14:21:50-04:00 March 11th, 2019|Hospital Medicine 2019, Pediatrics, Research|Comments Off on VARIATION IN RATE OF BLOOD CULTURE FOR SKIN AND SOFT TISSUE INFECTIONS IN IMMUNOCOMPETENT CHILDREN

Abstract Number: 27

PROFITING FROM THE POKE: A HOSPITALIST PROCEDURE TEAM

Background: Internal medicine residency contains procedural training, including guidance in paracentesis, thoracentesis, lumbar puncture, arthrocentesis, and central line placement. As a result, most hospitalists are able to perform these bedside procedures. However, national trends confirm [...]

By | 2019-03-18T14:09:57-04:00 March 11th, 2019|Finalist Posters - Innovations, Hospital Medicine 2019, Innovations, Value in Hospital Medicine|Comments Off on PROFITING FROM THE POKE: A HOSPITALIST PROCEDURE TEAM

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 | 2019-03-18T13:30:55-04:00 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

HM2018 Abstract Number: 70

THE IMPACT OF A HIGH VALUE CARE CURRICULUM FOR INTERNAL MEDICINE SUB-INTERNS

Background: Healthcare expenditures in the United States have grown from 5% of the gross domestic product in 1960 to nearly 18% in 2015. Despite spending more for healthcare than any other industrialized country, healthcare outcomes [...]

By | 2018-03-19T15:43:54-04:00 March 19th, 2018|Education, Research, Uncategorized|Comments Off on THE IMPACT OF A HIGH VALUE CARE CURRICULUM FOR INTERNAL MEDICINE SUB-INTERNS

HM2018 Abstract Number: 362

Low-value use of procalcitonin testing after introduction at an academic medical center

Background: Procalcitonin (PCT) is a biomarker that correlates with the presence of bacterial infection in certain clinical scenarios; it has increasingly accepted indications for antibiotic stewardship. Most sources suggest that antibiotics should be considered for [...]

By | 2018-03-19T15:44:43-04:00 March 19th, 2018|Research, Uncategorized, Value in Hospital Medicine|Comments Off on Low-value use of procalcitonin testing after introduction at an academic medical center

HM2018 Abstract Number: 260

EMPOWERING MEDICINE RESIDENTS TO THINK BEFORE ORDERING DAILY LABS. A QUALITY IMPROVEMENT STUDY.

Background: Healthcare costs are a challenge; for the greatest impact, high-value care education should begin early in residency training. Routine lab ordering for hospitalized patients is a well-known cause of high costs. This study utilized [...]

By | 2018-03-19T13:24:52-04:00 March 19th, 2018|Hospital Medicine 2018, Innovations, Quality Improvement|Comments Off on EMPOWERING MEDICINE RESIDENTS TO THINK BEFORE ORDERING DAILY LABS. A QUALITY IMPROVEMENT STUDY.

HM2018 Abstract Number: 631

PERIPHERAL SMEAR: A HIGH VALUE CARE ADDITION TO THE WORKUP OF A FEVER OF UNKNOWN ORIGIN

Case Presentation: A 68 year old man with past medical history of rheumatoid arthritis with recent travel to Mexico was admitted after clinically worsening at home roughly a week after a previous 10 day admission [...]

By | 2018-03-19T13:24:19-04:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on PERIPHERAL SMEAR: A HIGH VALUE CARE ADDITION TO THE WORKUP OF A FEVER OF UNKNOWN ORIGIN

HM2018 Abstract Number: 347

CO-CREATION OF SHM ADULT CHOOSING WISELY LIST: ENGAGING OUR PATIENTS AND PUBLIC FROM START TO FINISH

Background: The Choosing Wisely campaign aims to engage clinicians and public in addressing overuse in healthcare. Through adoption in 20 countries and 75 organizations, clinician engagement is largely successful. However, patient and public engagement remains [...]

By | 2018-03-19T13:17:44-04:00 March 19th, 2018|Hospital Medicine 2018, Innovations, Value in Hospital Medicine|Comments Off on CO-CREATION OF SHM ADULT CHOOSING WISELY LIST: ENGAGING OUR PATIENTS AND PUBLIC FROM START TO FINISH

HM2018 Abstract Number: 352

DESCRIBING VARIABILITY OF INPATIENT CONSULTATION PRACTICES ON GENERAL MEDICINE SERVICES: PATIENT, ADMISSION, AND PHYSICIAN-LEVEL FACTORS

Background: Appropriate use of consultation can improve mortality and decrease cost of care. However, inappropriate consultation may carry risks to patients. Little is known about the variability of inpatient consultation. We aim to describe patient-, [...]

By | 2018-03-19T13:03:19-04:00 March 19th, 2018|Hospital Medicine 2018, Research, Value in Hospital Medicine|Comments Off on DESCRIBING VARIABILITY OF INPATIENT CONSULTATION PRACTICES ON GENERAL MEDICINE SERVICES: PATIENT, ADMISSION, AND PHYSICIAN-LEVEL FACTORS

HM2018 Abstract Number: 365

AN INNOVATIVE COST ANALYSIS METHOD FOR ROUTINE LABORATORY TESTS

Background: As hospitals are increasingly reimbursed for value-based care, quality improvement projects addressing overutilization of routine “daily labs” have become commonplace. Although there are many published studies of daily labs reduction initiatives, there is little [...]

By | 2018-03-19T13:03:06-04:00 March 19th, 2018|Hospital Medicine 2018, Innovations, Value in Hospital Medicine|Comments Off on AN INNOVATIVE COST ANALYSIS METHOD FOR ROUTINE LABORATORY TESTS

HM2018 Abstract Number: 119

CHARACTERISTICS OF SYNCOPE ADMISSIONS AMONG HOSPITALS OF VARYING TEACHING INTENSITY

Background: Previous work suggests that hospitals’ teaching status is correlated with readmission rates, cost of care, and mortality. This research has focused on conditions closely tracked by the Centers for Medicare and Medicaid Services (CMS). [...]

By | 2018-03-19T12:59:35-04:00 March 19th, 2018|Hospital Medicine 2018, Outcomes Research, Research|Comments Off on CHARACTERISTICS OF SYNCOPE ADMISSIONS AMONG HOSPITALS OF VARYING TEACHING INTENSITY

HM2018 Abstract Number: 208

SAVE THEM THE POKE: REDUCING VENIPUNCTURES IN ADULT HOSPITALIZED PATIENTS

Background: Obtaining blood work through venipuncture is an important part of the diagnosis and management of hospitalized patients. Through formal and informal patient complaints, we found that patients admitted to the University of Colorado Hospital [...]

By | 2018-03-19T12:58:30-04:00 March 19th, 2018|Hospital Medicine 2018, Innovations, Quality Improvement|Comments Off on SAVE THEM THE POKE: REDUCING VENIPUNCTURES IN ADULT HOSPITALIZED PATIENTS

HM2018 Abstract Number: 358

DON’T BLEED: A HIGH VALUE CARE INITIATIVE TO DECREASE DIAGNOSTIC PHLEBOTOMY

Background: High value healthcare has been increasingly emphasized during residency training. The Choosing Wisely campaign, an initiative of the American Board of Internal Medicine foundation and the Society of Hospital Medicine recommend against performing repetitive [...]

By | 2018-03-19T12:53:30-04:00 March 19th, 2018|Hospital Medicine 2018, Research, Value in Hospital Medicine|Comments Off on DON’T BLEED: A HIGH VALUE CARE INITIATIVE TO DECREASE DIAGNOSTIC PHLEBOTOMY

HM2018 Abstract Number: 363

THE END OF THE LINE: UNDERSTANDING PRESCRIBER AWARENESS OF MAINTENANCE FLUID USE IN HOSPITALIZED PATIENTS DURING A CRITICAL SHORTAGE OF IV FLUIDS

Background: Continuous intravenous (IV) infusions aimed at avoiding dehydration are often referred to as “maintenance fluids” (MF). These infusions are common in clinical practice. Though guidelines exist for MF use in other countries (NICE 2017), [...]

By | 2018-03-19T12:52:53-04:00 March 19th, 2018|Hospital Medicine 2018, Research, Value in Hospital Medicine|Comments Off on THE END OF THE LINE: UNDERSTANDING PRESCRIBER AWARENESS OF MAINTENANCE FLUID USE IN HOSPITALIZED PATIENTS DURING A CRITICAL SHORTAGE OF IV FLUIDS

HM2017 Abstract Number: 313

DOES EVERYONE NEED DAILY LABS? CHOOSE WISELY AND REDUCE THE OVERUSE: A HIGH VALUE CARE PROJECT

Background: As part of the ABIM Foundation’s Choosing Wisely campaign the Society of Hospital Medicine recommended providers avoid performing repetitive CBC and chemistry testing in the face of clinical and lab stability. In 2014 as [...]

By | 2018-03-15T20:50:28-04:00 April 20th, 2017|Research Abstracts, Value in Hospital Medicine|Comments Off on DOES EVERYONE NEED DAILY LABS? CHOOSE WISELY AND REDUCE THE OVERUSE: A HIGH VALUE CARE PROJECT

HM2017 Abstract Number: 311

THE DEVELOPMENT AND VALIDATION OF A HIGH VALUE CARE ROUNDING TOOL USING THE DELPHI METHOD

Background: In response to skyrocketing healthcare costs, providing high value care is an increasing priority for health care systems. Physicians are responsible for translating high value care (HVC) to the bedside, however there is a [...]

By | 2018-03-15T20:50:28-04:00 April 20th, 2017|Research Abstracts, Value in Hospital Medicine|Comments Off on THE DEVELOPMENT AND VALIDATION OF A HIGH VALUE CARE ROUNDING TOOL USING THE DELPHI METHOD

HM2017 Abstract Number: 304

CONTINUOUS BLOOD COLLECTION: A REVIEW OF CURRENT CBC UTILIZATION, PROVIDER SURVEY, AND PILOT INTERVENTION AT A LARGE ACADEMIC MEDICAL CENTER

Background: Inappropriate laboratory utilization in hospitalized patients is a significant contributing factor to health care expenditures, iatrogenic anemia, downstream testing, and poor patient satisfaction. For these reasons, the Society of Hospital Medicine has recommended through [...]

By | 2018-03-15T20:50:29-04:00 April 20th, 2017|Research Abstracts, Value in Hospital Medicine|Comments Off on CONTINUOUS BLOOD COLLECTION: A REVIEW OF CURRENT CBC UTILIZATION, PROVIDER SURVEY, AND PILOT INTERVENTION AT A LARGE ACADEMIC MEDICAL CENTER

HM2017 Abstract Number: 297

DRIVERS OF OVERUSE OF PANCREATIC ENZYME LAB TESTING AT AN ACADEMIC MEDICAL CENTER

Background: Decades-old clinical data and practice guidelines support the use of lipase over amylase in the workup and management of acute pancreatitis. Yet, laboratory testing for amylase continues to cost the Center for Medicare and [...]

By | 2018-03-15T20:50:08-04:00 April 20th, 2017|Research Abstracts, Value in Hospital Medicine|Comments Off on DRIVERS OF OVERUSE OF PANCREATIC ENZYME LAB TESTING AT AN ACADEMIC MEDICAL CENTER

HM2017 Abstract Number: 284

RESIDENT PERSPECTIVES ON LABORATORY OVER-UTILIZATION: DIFFERENCES BETWEEN RESIDENCY PROGRAM SITES

Background: Unnecessary diagnostic testing contributes to the escalating cost of health care in the US and can cause harm to patients. Daily blood work has become a routine part of care for hospitalized adults though [...]

By | 2017-04-25T22:23:24-04:00 April 20th, 2017|Research Abstracts, Value in Hospital Medicine|Comments Off on RESIDENT PERSPECTIVES ON LABORATORY OVER-UTILIZATION: DIFFERENCES BETWEEN RESIDENCY PROGRAM SITES

HM2017 Abstract Number: 286

STUDENT HIGH VALUE CARE COMMITTEE: A MODEL FOR STUDENT-LED IMPLMENTATION

Background: Formal curricula for teaching medical students high value care are lacking, and there is little evidence identifying strategies that can effectively impact students’ knowledge and skills. Research is needed to develop models for student-led [...]

By | 2017-04-20T18:08:56-04:00 April 20th, 2017|Innovations Abstracts, Value in Hospital Medicine|Comments Off on STUDENT HIGH VALUE CARE COMMITTEE: A MODEL FOR STUDENT-LED IMPLMENTATION

HM2017 Abstract Number: 222

BEDSIDE ASSESSMENT OF THE NECESSITY OF DAILY LAB TESTING FOR PATIENTS NEARING DISCHARGE

Background : As part of the Choosing Wisely campaign, the Society of Hospital Medicine recommends against performing "repetitive complete blood count [CBC] and chemistry testing in the face of clinical and lab stability.” This recommendation [...]

By | 2017-04-20T17:34:38-04:00 April 20th, 2017|Innovations Abstracts, Quality Improvement|Comments Off on BEDSIDE ASSESSMENT OF THE NECESSITY OF DAILY LAB TESTING FOR PATIENTS NEARING DISCHARGE

HM2017 Abstract Number: 176

APPLYING A USER-CENTERED DESIGN PROCESS TO CO-CREATE INPATIENT EXPERIENCE IMPROVEMENT STRATEGIES

Background: Practical and financial pressures have placed a renewed focus on improving the human experience of healthcare from both the patient and provider perspective. Despite this, aligning patients and interdisciplinary providers around meaningful experience improvement [...]

By | 2017-04-20T17:35:52-04:00 April 20th, 2017|Innovations Abstracts, Quality Improvement|Comments Off on APPLYING A USER-CENTERED DESIGN PROCESS TO CO-CREATE INPATIENT EXPERIENCE IMPROVEMENT STRATEGIES

HM2016 Abstract Number: 361

Occam’s Conference: Overuse As a Medical Error

Background: Medical overuse, defined as the provision of services for which harms outweigh benefits, is increasingly recognized as a driver of high cost and poor clinical outcomes in the U.S. health care system. Despite increasing [...]

By | 2016-02-01T08:00:34-05:00 February 1st, 2016|Innovations Abstracts, Value in Hospital Medicine|Comments Off on Occam’s Conference: Overuse As a Medical Error

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 | 2016-02-01T08:00:34-05:00 February 1st, 2016|Innovations Abstracts, Quality Improvement|Comments Off on Residency Run Initiative to Improve Appropriateness of Telemetry Use

HM2016 Abstract Number: 31

Medical Students As Value Advocates in Academic Hospital Medicine

Background: An estimated one-third of national healthcare spending is waste, with the largest contribution stemming from unnecessary use of services. Published efforts to enhance cost consciousness have largely focused on residents and practicing physicians. Few [...]

By | 2016-02-01T08:00:34-05:00 February 1st, 2016|Education, Innovations Abstracts|Comments Off on Medical Students As Value Advocates in Academic Hospital Medicine

HM2016 Abstract Number:

Caring Wisely: A Program to Support Frontline Providers and Staff in Improving Healthcare and Reducing Costs

Background: High value care is a key priority in healthcare, but strategies are needed to empower frontline clinicians to work with organizational leadership to reduce healthcare costs and improve care.   Purpose: Caring Wisely (CW) [...]

By | 2016-02-01T08:00:34-05:00 February 1st, 2016|Innovations Abstracts, Oral Presentations|Comments Off on Caring Wisely: A Program to Support Frontline Providers and Staff in Improving Healthcare and Reducing Costs