Background: The prevalence of pain in hospitalized adults is high and has been associated with reduced quality of life, lower patient satisfaction, and longer length of stay. Refractory pain is a common reason for hospitalization and for palliative care consultation. Effective pain control is a core competency for hospital medicine, a requirement for Joint Commission [...]

Background: Prior studies of surgical co‐management have shown marginal benefits and mostly focused on the care of orthopedic patients. Hospitalized vascular surgery patients typically have multiple severe co‐morbidities, poor functional status, and high peri‐operative cardiac risks and thus may be ideal patients for collaborative care. Purpose: To improve patient care and outcomes in the vascular [...]

Background: Improving throughput and length of stay (LOS) is essential for hospitals to operate efficiently and cost effectively. Patients who require 1‐day admissions who are not placed into observation status hold specific challenges, because the handoffs do not prepare the following ward team to discharge them upon their initial encounter. Due to this “new encounter [...]

Background: Practitioners and policymakers have identified 30‐day readmissions as an important quality indicator to measure hospital care, with the premise that readmissions can be indicators of poor care or coordination of care. Among cancer centers, there is no benchmark data in terms of readmission rates or recommendations in terms of risk adjustment models for cancer [...]

Background: Best‐practice checklists may help reduce medical errors during patient discharge. However, current paper checklists have poor physician support and limited integration with clinical workflows. No previous study has evaluated the impact of using a checklist on physicians’ discharge workflow and productivity. Purpose: To develop a best‐practice discharge checklist for hospital patients using the Electronic [...]

Background: Mortality in healthcare is the most unambiguous clinical outcome. Academic medical centers are ranked on the observed to expected mortality ratio developed by the University Healthcare Consortium (UHC). Emphasis on expected deaths, however, creates an incentive for hospitals to focus on post‐mortem coding and perpetuate a perception that these deaths are inevitable. Many people [...]

Background: Electronic Health Records (EHR) are increasingly becoming the standard of care in inpatient settings. Front line clinicians, including residents, frequently have innovative suggestions for inpatient EHR modifications that can enhance quality, safety and workflow efficiency. Residents,, however, often do not know how to submit requests for changes in information technology (IT) or do not [...]

Background: Individual provider performance drives group performance but appropriate attribution can be challenging, particularly when multiple providers care for a single patient. We sought to develop and operationalize individual provider scorecards that fairly attribute patient‐level metrics to individual hospitalists. Purpose: For patients cared for by hospitalists on a 17 to 24 bed unit from July [...]

Background: Numerous research studies and anecdotal experience show that in healthcare, a small percentage of patients account for a disproportionate number of ED visits and hospital admissions. For some of these patients, their visits are routinely for medically unnecessary reasons. This behavior places them at risk for uncoordinated care from providers who do not know [...]

Background: Peripheral intravenous catheter placement is a common procedure in the pediatric inpatient setting and causes anxiety and pain in children. This can lead to anticipatory anxiety, needle phobia, and may lead to avoidance of health care providers. The treatment of painful procedures in children requires special consideration and planning because preventing pain can reduce [...]