Background: Diagnose and treat. That is the role of the physician. But the practice of medicine in recent years has been beaten hollow; its patient mission eclipsed by unwieldy technology and its practitioners so inundated with documentation and data entry, resulting in disengaged, frustrated, and burned out clinicians. The hospitalist has access to the entirety [...]

Background: Ensuring compliance with CMS requirements for inpatient admission orders and improving medication reconciliation at discharge are crucial aspects of patient safety and regulatory adherence. However, challenges such as missing admission orders and medication errors during transitions of care persist. In response, we implemented two strategic EHR interventions, Best Practice Advisories (BPAs), to enhance workflows, [...]

Background: Around one in five Americans live in rural areas, but only 5 percent of physicians practice in these same areas. As such, hospital located in rural area such as Roosevelt Rehabilitation and Specialty Hospitals (RRHS) struggle with physician staffing. Tele-hospital medicine has expanded rapidly since the Coronavirus Preparedness and Response Supplemental Appropriations Act in [...]

Background: Immunosuppression regimens are highly effective at preventing rejection but carry risk of toxicity and can be complex. Clinical decision support (CDS) tools embedded in electronic health records have presented opportunity to systematically aid providers ordering such medications appropriately. However, discrepancy between a clinically-documented plan for use and provider orders may exist. Natural language processing [...]

Background: The inpatient acute care environment has faced increasing capacity constraints since the COVID-19 pandemic. Factors like deferred care, nursing shortages, and a sicker population contribute to these constraints. Many systems have sought to improve patient flow to alleviate these issues. Efficient patient movement through care steps enhances patient satisfaction, reduces stay length, and minimizes [...]

Background: Point-of-care-ultrasound is increasingly used as a diagnostic tool in a variety of specialties. Multiple studies have shown that POCUS may reduce time to diagnosis with similar accuracy to radiology scans (Healey, Fischer), may improve procedural safety (Cho, Rodrigues), and may reduce the need for additional studies and ionizing radiation (Soni). As such there is [...]

Background: The Accreditation Council for Graduate Medical Education (ACGME) states that residents must participate in quality improvement (QI) and patient safety (PS) initiatives during their residency training. At our institution, we have embedded multiple levels of QI and PS education into our internal medicine residency program. Our longitudinal QIPS curriculum begins in each resident’s intern [...]

Background: Hospital discharge is a complex process for patients, caregivers, and providers. A patients’ understanding of new diagnoses, medications, and appointments improves the capacity for self-care and post-discharge outcomes. A new “Team Discharge” initiative was piloted to improve patients’ understanding of the discharge plan through patient-centeredness and interdisciplinary communication during the critical transition from hospital [...]

Background: Hospital discharge is a vulnerable moment in healthcare delivery that impacts patient safety and experience. Improving this care transition necessitates a focus on the most error-prone and potentially hazardous parts of the process, including discharge logistics (e.g., transportation), medication safety, follow-up plans, and contingency planning. Many interventions have been investigated to improve discharge processes; [...]

Background: Our healthcare institution serves a large low-income, minority, and historically underserved population. The shortage of primary care physicians (PCPs) in our city and the high complexity of patients that are cared for by our organization is a challenge. Patients are in need of transitional care our institution and need help to connect to other [...]