Background: Total joint arthroplasties (TJA) are the most frequently performed orthopedic surgeries in the USA. Given the aging US population, the number of TJA surgeries is expected to grow by 559% by 2060. Additionally, the average medical comorbidity for patients undergoing TJA surgery is increasing, a trend that is expected to continue. Given both the [...]

Background: Up to 50% of the American healthcare spending is estimated to be wasteful. The largest type of wasteful spending is on overuse of tests and treatments. Among the diagnostic tests that are overused, excessive phlebotomy stands out due to its multifaceted implications, including hospital-acquired anemia, patient discomfort, provider burden, and avoidable downstream testing. The [...]

Background: Communication failures, particularly when patients transition between care settings, are leading causes of medical errors and sentinel events.1-2 The perception of inadequate intradisciplinary communication have been demonstrated to be a key driver in low patient satisfaction scores. Efforts to standardize handoffs have led to improvements in patient safety and experience.3 Purpose: To improve the [...]

Background: Healthcare institutions have chronic bed shortages and a medically and socially complex patient population that makes optimal management of post-discharge care especially important. Effective and timely follow up post-hospitalization can improve clinical outcomes by delivering transitional care when patients are the most vulnerable. We developed a multimodal design that delivers education to patients and [...]

Background: Patients in hospitals often face various physical constraints, such as being monitored, having internal or external catheters inserted, or being tethered to an IV pole. These limitations act as barriers to mobilization, contributing to the deconditioning of patients who initially mobilized independently or with assistance, leading to increased falls, excessive use of physical therapy [...]

Background: Critical illness requires initiation of several classes of medications to treat or prevent different conditions. These include nebulizers, PPIs, antipsychotics, antibiotics, steroids, anticoagulants, opioids, benzodiazepines, & several others. Continuation of these medications upon transfer from MICU to the floor is a common occurrence with downstream implications including side effects or potential harm to patients, [...]

Background: Interdisciplinary rounding at the bedside is associated with improvements in patient flow metrics, interdisciplinary communication, and patient perception of teamwork among care team members. At UC San Diego Health, FIT (Focused Interdisciplinary Team) Rounding has been the standard of care on seven diverse patient care units since 2017. However, with the arrival of the [...]

Background: The Society of Hospital Medicine’s Choosing Wisely recommendations include avoiding repetitive Complete blood count (CBC) and serum electrolyte panels (SEPs). SEPs include basic and comprehensive metabolic panels (BMP, CMP respectively). Unnecessary routine lab can cause increased costs(1)(2), unnecessary downstream testing and procedures, hospital acquired anemia(2)(3)(4) and patient discomfort. Multiple QI project has been successful [...]

Background: The existing literature suggests there is no significant difference in risk adjusted inpatient mortality between patients whose preferred language is English and those who preferred a non-English language.1 However, these studies typically exclude patients with missing language data from analysis. Purpose: In our health system, missing language data is specified in the electronic health [...]

Background: Burnout is prevalent among healthcare workers (HCW) within the United States and has only increased since the COVID-19 pandemic.1,2,3,4 Approximately 52% of HCWs–including physicians, nurses, pharmacists, and physical therapists–reported burnout during the COVID-19 pandemic.1 Social isolation is an important factor associated with burnout among HCWs.5 Despite the rise in burnout, interventions to address burnout [...]