Background: Osteoporosis is common and carries a significant burden of morbidity and mortality. Early pharmacologic therapy for osteoporosis can reduce osteoporotic fractures. Thus, the USPSTF recommends dual energy x-ray absorptiometry (DXA) screening for osteoporosis in women above the age of 65. Screening for osteoporosis is often seen as a responsibility of the primary care provider. [...]

Background: Choosing Wisely ® is a national campaign aimed at promoting high-value care. Vanderbilt University Medical Center (VUMC) has created a steering committee to direct implementation of select Choosing Wisely (CW) recommendations. Our first initiative successfully reduced unnecessary daily lab testing across multiple hospital services. Our second initiative targets chest x-ray (CXR) utilization in intensive [...]

Background: Palliative care (PC) has been shown to improve the quality of life for patients facing life-threatening illness and their families.  PC screening tools have been successfully used in identifying cancer patients in need of PC services and increase hospice utilization. However, a PC screening tool specific to hospitalized septic patients is lacking, despite sepsis [...]

Background: Given that the hospital can be a depersonalizing and stressful environment for patients and families, healthcare teams should help ensure hospitalized patients feel respected as individuals. While studies suggest that displaying personal photographs at the bedside can increase the delivery of empathic care, the impact of photographs on patient experience in the hospital is [...]

Background: Hospitalized patients are at an increased risk of Venous Thromboembolism (VTE) and guidelines recommend risk assessment for all patients. The Padua score is one of several VTE risk assessment models and has 11 clinical components scored as either 1, 2 or 3 points. The most subjective component of the score is the reduced mobility [...]

Background: Chronic hepatitis C virus (HCV) is a leading cause of liver failure and cancer. Half of 3.5 million infected persons in the U.S. know their status, and 43% have access to care. Despite antivirals that make HCV curable, barriers persist including insufficient screening and late diagnosis. Many infected individuals access healthcare but are not [...]

Background: While telemetry was designed to improve patient safety, the volume and low positive predictive value of telemetry alarms can endanger patients by desensitizing healthcare providers to those alerts. To address this safety concern, the Joint Commission requires hospitals to establish specific policies and procedures to balance alarm fatigue and patient safety in their alarm [...]

Background: Previous studies examining continuous patient monitoring in the ICU and emergency department suggest that substantial telemetry alarm burden combined with a high proportion of false positive alerts may jeopardize patient outcomes. Currently, little is known about the burden and value of specific alarms on the general wards. Methods: As part of a quality improvement [...]

Background: Improving patient-provider communication is crucial for promoting a shared understanding of the care plan among patients and providers. Increasingly, hospitals are focusing on efforts to engage patients in establishing recovery goals and understanding their plan of care, in part by leveraging technology. We designed, developed, and implemented an acute care patient portal (Figure 1) [...]

Background: Communication in acute care settings is fragmented and inefficient, and consequently, patients and providers are often not “on-the-same-page” with regard to the plan of care. Care team members frequently communicate asynchronously via alpha-numeric pagers, email, internal electronic health record messaging, and increasingly, non-secure texting. To improve the acute care communication space, we engaged stakeholders [...]