Background: In April 2015, CMS released first ever star ratings on Hospital Compare related to patient satisfaction. Based on the HCAHPS survey scores, hospitals received scores between 1 and 5 on 12 domains, including a summary star rating for the hospital. Critics contend that star ratings may be a gross over simplification and misleading. Elite […]

Background: Patient discharge is a complex process, requiring effective coordination between physicians, the interdisciplinary care team, patients, and their families. Patients often remain in the hospital after they are medically ready for discharge due to avoidable delays and inefficiencies in the discharge process.   Purpose: Consequences of delayed discharge include patient dissatisfaction, increased potential for […]

Background: Previous studies have shown that malnutrition, which is associated with increased medical complications in older patients, can be attenuated by providing oral nutritional supplements (ONS). This study evaluates the cost-effectiveness of an ONS in malnourished older hospitalized patients using data from a randomized controlled trial. Methods: A multicenter, prospective study (NOURISH) was conducted in […]

Background: Audit and feedback is a commonly used strategy to improve performance among providers. Most prior studies on its efficacy were done in the outpatient setting and showed a modest benefit. Certain factors, such as clear targets and repeated frequency of feedback may increase the likelihood of improved performance; however, there is still no consensus […]

Background: The Center for Medicare and Medicaid Services (CMS) instituted the Readmissions Reduction Program to incentivize improvements in care transitions for patients with several common and serious illnesses, including heart failure, acute myocardial infarction, pneumonia, and more recently COPD exacerbations. The HOSPITAL score has been shown to accurately identify medical patients at high-risk for 30-day […]

Background: Improper care transitions account for more than 12 billion dollars in estimated added health care costs.  In a prospective observational study performed at our institution to identify gaps in care transitions, only 37% of primary care physician’s (PCP’s) were contacted by hospitalist upon discharge. The objective of this study was to evaluate the effect […]

Background: Communication is one of the foundations on which safe, high quality care is built. The nature of hospital medicine requires that providers be efficient and effective in communicating with multiple disciplines. This need for timely communication must continually be balanced with the need to minimize interruptions in workflow.  Interruptions not only lead to distraction, […]

Background: In 2014, The Federal Register published part II of the centers for Medicare & Medicaid Services; including a section related to food and dietetic services. It states that Registered dietitians (RDs) are the professionals who are best qualified to assess a patient’s nutritional status and to design and implement a nutritional treatment plan in consultation […]

Background: Interdisciplinary clinical rounds at the bedside can promote the core principles of patient- and family-centered care, including promoting respect and dignity, information sharing, and participation by the patient in the care and decision making.  However, despite rounding at the bedside, the patient can still be a bystander as the team presents a care plan […]

Background: Communicating to physicians about electronic health record (EHR) software updates is important for maintaining clinical workflow and preserving patient safety. However, reaching providers with mass e-mails is challenging; the optimal strategy for educating providers about EHR updates remains unclear. Purpose: Modify our communication strategy to improve inpatient physicians’ understanding of EHR software updates. Description: […]