Background: Patients with refractory ascites often require large volume paracentesis (LVP) on a frequent basis. Most of the studies examining the clinical effects of LVPs, however, have looked only at one-time procedures. In addition, patients with ascites commonly present to the emergency department or require hospital admission for this procedure, leading to high health-care utilization. Our [...]

Background: : Low patient satisfaction can result in financial loss for hospitals, and potentially for individual physicians or groups and patient satisfaction is known to be lower on academic services.1 Increasingly, Medicare funds will be withheld from hospitals for underperformance in patient satisfaction due to Value Based Purchasing (VBP).  We identified a low performing, academic [...]

Decreasing Use of Continuous Pulse Oximetry in Pediatric Inpatients Lavanya G. Shankar, MD, Lurie Children’s at Northwestern Medicine Central DuPage Hospital. Abstract Text: Background: Pediatric inpatients with simple respiratory diagnoses and hypoxia do not have clear guidelines on when Continuous Pulse Oximetry (CPO) may be discontinued after initially being placed. As a result, patients who have been [...]

Background: The observation unit functions to care for patients requiring problem focused management for a variety of conditions requiring less than 48 hours of care. Patients are selected based on conditions that will likely resolve in 24 to 36 hours, require care by a specialty service or require monitoring following a procedure. Despite these guidelines, [...]

Engaging Residents in QI, the SMART way. Authors: Gabriella Sherman, MD and Luis Dimen, MD Background: Residency programs across the country have implemented various quality improvement (QI) lecture series in an effort to engage residents in QI projects.  Despite the many resources available to residents, they have limited time to utilize the tools to complete [...]

Background: Defined approaches to reducing rates of hospital readmissions rates assume that patients are invested in their healthcare and in preventing readmissions. However, the extent to which patients believe that readmission is a “bad” outcome and feel that it is inevitable have not been defined. Further, the ability of patients to anticipate their own readmissions [...]

Background: There is a glaring lack of published evidence based strategies to improve HCAHPS patient satisfaction scores on the physician domain. Anecdotally, various hospitals have improved their physician domain scores through training programs to improve physician communication and etiquette. Role of physician self-reported etiquette based bedside behavior has not been reported. Methods: After collecting 1 [...]

Background: Since the 1999 IOM report To Err is Humanhighlighted that up to 98,000 preventable deaths occur annually in U.S. hospitals, efforts have intensified to understand and eliminate preventable mortality. At our institution, we developed an in-person, near real-time, multidisciplinary mortality review to capture the insight of frontline providers and improve care. In the analysis presented [...]

Background: The ability to accurately identify diabetic patients from electronic data can be a critical component of quality improvement (QI), performance measurement, and research applications. Poor case-finding definitions may produce unreliable reports and inaccurate information. Multiple methods have been described for automated diabetes case-finding. The development of case-finding definitions can be challenging and is dependent [...]

Abstract Text: Background: Safely and efficiently moving patients through the admission process is a key concern for emergency and hospital medicine faculty. Our hospitalist group admits approximately 400 patients per month, each admitting physician evaluates approximately 7.5 patients per  shift, utilizing individual approaches. We aimed to improve the quality of our admissions by  standardizing our [...]