Background: Lost or improperly labeled specimens may be medically detrimental to patients and have legal implications for the medical professionals and healthcare facility involved. Endoscopy is an especially high-risk location for specimen errors given the large number of biopsies obtained and the high volume of patients served daily by the same team. A 61-year-old male [...]

Background: The American Board of Internal Medicine (ABIM) Foundation developed the Choosing Wisely project in 2012 as a way to identify commonly used tests that may be overused or inappropriately used. The Society of Hospital Medicine created a subcommittee in this project focused on recommendations affecting hospitalists, and made the recommendation in 2013 to stop [...]

Background: Hospital overcrowding and extended Emergency Department (ED) wait times are challenges facing most urban hospitals today. There is growing evidence to show that overcrowding in the ED is associated with increased morbidity, mortality and patient dissatisfaction. To improve overcrowding, hospitals have focused on discharge before noon (DBN) as an impactful and sustainable remedy. While [...]

Background: The Vizient Quality and Accountability scorecard is a tool that measures academic medical centers (AMCs) clinical performance, focusing on quality and safety while targeting specific opportunities for improvement. The Vizient quality domains include Mortality, Efficiency, Effectiveness, Equity, Patient Experience, and Patient safety. In an academic setting, the frontline healthcare providers are resident physicians. As [...]

Background: Effectively screening for sepsis in a hospital setting remains an elusive goal. Designed processes have been plagued by poor specificity [3,5], leading to alarm fatigue [2] and overuse of resources. Electronic tools have attempted to automate some or all screening, but thus far to inconsistent success [1]. Furthermore, for patients screened as septic, quickly [...]

Background: Chronic heart failure (CHF) patients with reduced ejection fraction (EF), as defined as EF < 50%, and iron deficiency have shown improvements in symptoms, functional capacity, and quality of life when treated with IV iron, even without overt anemia (1). The FAIR-HF (2009) and CONFIRM-HF (2015) studies showed improvements in New York Heart Association [...]

Background: US healthcare costs are exorbitant and excessive lab utilization contributes significantly1. Daily labs (DLs) are often over-ordered for inpatients.2 This leads to increased costs, iatrogenic anemia, patient discomfort and limits phlebotomy resources 3. The Choosing Wisely® campaign recommends against checking DL in patients who have clinical and lab stability5. Previous quality improvement initiatives have [...]

Background: While hospitalists pursue a primarily clinical role, we have carved a niche in clinical research, particularly Quality Improvement based research. However, clinical research often involves time intensive chart review, which can become a barrier to hospitalists with heavy clinical roles. A mechanism to mitigate this will be revolutionary. Purpose: In this innovations abstract, we [...]

Background: Health information technology (HIT) systems were created with the intent to improve efficiency and streamline clinical workflows. However, evidence suggests HIT systems are a significant source of clinician burnout (Adler-Milstein 2020). A thorough understanding of clinicians’ frustrations is necessary to develop solutions to improve HIT systems. In doing so, efforts from the clinical informatics [...]

Background: Delivering high quality and efficient care is a top priority at our 800-bed quaternary care hospital. We have seen significant improvements in many patient-care domains by implementing hospital-wide standardized interdisciplinary rounds. As part of our ongoing efforts to further improve efficiency and value, we hope to leverage a simple order in our electronic medical [...]