Background: High-quality medication reconciliation is key to reducing medication errors during care transitions. This concept is of paramount importance to Veterans living in rural areas due to less access to clinical pharmacy services. We adapted MARQUIS (Multicenter Medication Reconciliation Quality Improvement Study), in which hospitalists mentored teams in implementation of best practices for inpatient medication [...]

Background: Unintentional discharge delays account for up to 20% of total patient hospital days. Previous studies identified bed availability, scheduling logistics for studies, and poor communication as causes of delay factors. Although discharge requires a team approach, no single study has examinedperceptions of discharge delays among interprofessional team members, including residents and hospitalists, at an [...]

Background: Inpatient handoffs have been recognized as a vulnerable time during a patient’s hospitalization and are widely associated with adverse events and near misses. A variety of strategies have been implemented in order to improve shift handoffs. To date, no study has described how residency program leadership views these strategies, or how the implementation of [...]

Background: Inpatient service handoffs have been recognized as a vulnerable time during a patients’ hospitalization. Prior studies have suggested the need for more systematic, team-based, and patient-centered handoff models. We hypothesized that performing the service handoff at the patients’ bedside may more efficiently transfer patient information between physicians, while further integrating the patient into their [...]

Background: ZHH is an inpatient psychiatric facility with an average daily census of 220 patients. It is located adjacent to LIJ, our tertiary medical center. On average, 300-400 cases are transferred from LIJ to ZHH each year, as well as 200-300 cases transferred from ZHH to LIJ. Traditionally, there were 3 internists covering medical consults [...]

Background: Poor communication among health providers during transitions of care (TOC) between inpatient and outpatient settings is being increasingly recognized as responsible for subpar health outcomes, wasteful healthcare spending and low patient satisfaction. Such poor communication remains the status quo as it becomes part of the implicit curriculum in residency training when residents are not [...]

Background: Adults with sickle cell disease (SCD) seeking treatment for vaso-occlusive crises (VOCs) often encounter barriers based on health care provider (HCP) concerns regarding opioid abuse and addiction. Consensus treatment guidelines for painful VOCs in SCD patients (pts) call for prompt and adequate analgesic use, including opioids and individualized treatment regimens when available. Herein, we [...]

Background: Given the convenience of placement and long term viability, PICC (peripherally inserted central catheter) utilization has been on a steady increase nationally over the last decade. Despite their advantages, PICCs are associated with minor complications such as dislodgement, luminal occlusion and superficial thrombophlebitis, and major complications including upper extremity thromboses and central line blood [...]

Background: Inappropriate use of antibiotics can lead to resistance, increased cost, and adverse outcomes and complications (Clostridium difficile infection, intravenous catheter-related, etc.). Procalcitonin (PCT) is a biomarker that has shown specificity for bacterial infection and its utility has been demonstrated when guiding antibiotic therapy in clinical algorithms for respiratory infections, sepsis, postoperative infections, and ventilator-associated [...]

Background: The United States has the highest expenditure per capita and fastest growth when it comes to health care. Imaging is one of the fastest growing services in medicine reaching approximately $100 billion annually. There have been criticisms that imaging studies are often over utilized and inappropriate which results in unnecessary costs and waste. Our [...]