Background: Interprofessional bedside rounds have been promoted as a strategy to enhance patient engagement; prior studies have been limited by their use of nonvalidated measures and lack of patient and/or family involvement in design of the intervention. Methods: In collaboration with our hospital’s Patient and Family Advisory Council (PFAC), we developed Patient Centered Bedside Rounds […]

Background: Unintentional medication discrepancies during hospitalization can contribute to patient harm. Discrepancies can be reduced by performing medication reconciliation; however, effective implementation is challenging. The goals of the Multi-Center Medication Reconciliation Quality Improvement Study (MARQUIS) were to operationalize best practices for inpatient medication reconciliation and test their effect on potentially harmful medication discrepancies. Methods: Five […]

Background: Effective patient-physician communication is integral for meaningful clinical relationships and patient satisfaction; thus, it is measured by the Hospital Consumer Assessment of Hospitals and Health Systems (HCAHPS) survey.  Unfortunately, such surveys often demonstrate significant room for improvement in physician communication.  A critical element of effective communication is the ability of patients to recognize those […]

Background: Beginning January 1, 2014, under the Affordable Care Act (ACA), 28 states expanded Medicaid eligibility to include additional low-income individuals aged 19-65 years. As a result, an estimated 10.5 million low-income Americans newly gained access to health coverage. Initial projections suggest that Medicaid expansion states will see a 16% reduction in uncompensated care provided […]

Case Presentation: A previously healthy 13-year-old Korean-American girl presented with acute altered mental status. She had fatigue, leg and abdominal pain, and was initially diagnosed with “the flu.” Two days later she progressed to worsening pain, emesis, and inability to walk. On admission she was afebrile and had nystagmus, delayed responses, slow speech, weakness, myoclonic […]

Background: Transitions from hospitals to the ambulatory setting are high risk periods for patients. The advent of the Patient-Centered Medical Home (PCMH) and Accountable Care Organizations (ACOs) provide an opportunity for true collaboration in which both inpatient and outpatient providers contribute to improving transitions in care. The goal of this study is to develop, implement, […]

Background: One hopes that all hospitals strive for service excellence, and by 2010 there were more than 30,000 hospitalists delivering the lion’s share of inpatient care in our nation’s hospitals. Although patient satisfaction metrics like Press Ganey attempt to measure service excellence, no empiric research has characterized optimal hospitalist comportment. Methods:  Respected clinicians in Hospital […]

Background: Transitions from hospitals to the ambulatory setting are high risk periods for patients. The success of efforts to improve transitional care practices likely depends in part on baseline practices and local resources, culture, and leadership. Several studies have suggested that often there is more variation in the performance of best practices within than between […]

Background: Many hospitals have tried to improve their medication reconciliation processes, with mixed results. Currently, there are insufficient data to guide hospitals in the best ways to improve their practices. In the Multi-Center Medication Reconciliation Quality Improvement Study (MARQUIS), sites chose to implement one or more components from a multi-faceted toolkit. The goal of this […]

Background: Physicians frequently prescribe antibiotics to inpatients without knowledge of medication cost. It is not well understood whether providing cost data would change prescribing behavior. Methods: To evaluate the effect of providing cost data alongside culture and antibiotic susceptibility results in two tertiary care hospitals, we conducted a quasi-experimental pre-post analysis. During a 12-month baseline […]