Background: Proton pump inhibitors (PPIs) are indicated to treat a variety of diseases, including gastroesophageal reflux disease, peptic ulcer disease, and Helicobactor pylori infection. Studies have shown that, despite being linked to an increased risk of pneumonia, fractures, and Clostridium difficile infection, PPIs are being overprescribed. Given the known potential adverse effects of PPIs and [...]

Background: Preventable readmission for Heart Failure (HF) was estimated to be 27.1%. HF readmission may suggest inadequate treatment during a previous stay. For example, only 50% of patients have complete resolution of their congestive symptoms at hospital discharge. Fewer than 50% of the patients were discharged with at least 5‐6 lbs. weight loss. Twenty‐seven percent [...]

Background: High utilizers of health care services are psychosocially complex patients with significant medical and psychiatric co‐morbidity and higher mortality rates. They account for a disproportionately high number of emergency department (ED) visits, inpatient admissions, and health care costs. This quality improvement (QI) intervention creates individualized care plans to coordinate care and reduce unnecessary health [...]

Background: The Joint Commission cited suboptimal communication as one of the root causes in 82% of sentinel events reported on 2010. Face‐to‐face communication is the richest form of communication and is superior to asynchronous modes of communication such as text paging. Additionally, physical dispersion of providers has been characterized as a barrier to ideal communication. [...]

Background: Attending rounds, defined as ward rounding with an attending physician, take place every day at teaching hospitals around the country with remarkably little consensus around best practices. At our institution, there is also no clear standardization of rounds from one team to the next. The rounding literature suggests that there is room for improvement [...]

Background: Geographic localization consist of the co‐localization of physician providers and their patients on the same inpatient units. Structured Interdisciplinary Rounding (SIDR) consists of daily, template‐driven interdisciplinary rounding on patients among care providers. Both geographic localization and SIDR have been proposed as methods to optimize interdisciplinary communication and work efficiency. Among medicine inpatients, adoption of [...]

Background: Pressure ulcer prevention in hospitals is a critical issue since Centers for Medicare and Medicaid Services (CMS) established nonpayment policy for hospital‐acquired conditions in 2008. The objective was to determine the comparative effectiveness of quality improvement (QI) interventions for hospital‐acquired pressure ulcer prevention. Methods: An interrupted time series quasi‐experimental design of pressure ulcer incidence [...]

Background: In 2008, the Center for Medicare and Medicaid Services (CMS) enacted nonpayment policy for hospital‐acquired pressure ulcers (HAPUs). Hospitals responded to policy by increasing HAPU prevention efforts. To quantify adoption patterns of quality improvement (QI) interventions designed to support evidence‐based guidelines for HAPU prevention. Methods: We surveyed wound care nurses at University HealthSystem Consortium [...]

Background: A new order set addressing sedation, analgesia, and delirium was developed referencing the updated Clinical Practice Guidelines for the Management of Pain, Agitation, and Delirium in Adult Patients in the Intensive Care Unit (PAD Guidelines) which was recently published by the Society of Critical Care Medicine (SCCM) while assessing the clinical impact and outcome [...]

Background: Late afternoon patient discharges create admission bottlenecks in the Emergency Department, slow elective admissions, delay transfers out of the Intensive Care Unit and Post Anesthesia Care Unit, and are a major dissatisfier for patients. Still, more than 50% of hospitals across the US have an average discharge time of 3pm or later. Physicians are [...]