Background: Neonatal jaundice is a common condition that can result in acute bilirubin encephalopathy if not treated appropriately. Despite evidence–based guidelines for monitoring and treating hyperbilirubinemia, variation in care persists. Previously published quality improvement efforts have focused on monitoring of bilirubin levels in the newborn nursery and outpatient settings. Purpose: The goal of our project [...]

Background: Mandates to shift our care delivery systems from a focus on quality or cost to one of value is challenging. Unnecessary and expensive diagnostic tests contribute to wasteful spending that does little to improve patient outcomes. Poor understanding of test ordering behaviors may further contribute to current practice patterns. Engaging trainees and influencing their [...]

Background: Routine blood tests are performed in the early morning hours at most hospitals. Timely review of those laboratory tests during morning rounds is critical for safe and efficient patient care. However, availability of those results for rounds is variable. The batched approach of morning blood specimens causes an unintended heavy workload for laboratory and [...]

Background: Our hospital medicine practice noted a high number of admissions and readmissions to the internal medicine service for the specific purpose of acute detoxification from alcohol dependence. We noted a lack of a clear system for determining which patients would benefit from inpatient detoxification vs. those who might be safely treated as an outpatient. [...]

Background: Sickle cell vaso–occlusive pain crises (VOC) are associated with considerable morbidity and mortality, prolonged hospital stays and significant resource utilization. Suboptimal treatment of pain during VOC is associated with increased morbidity and mortality. Standardized order sets have been shown to reduce physician error and create efficiency. There are no current evidence based treatment guidelines [...]

Background: The management of acute vaso–occlusive crisis remains a challenge. Long Island Jewish Medical Center is a 500–adult bed tertiary care facility with more than 500 reported admissions for acute vaso–occlusive crisis in 2009. Suboptimal pain management in the Emergency Department (ED) frequently resulted in unrelieved pain, recurrent admissions, prolonged hospitalization, and increased patient dissatisfaction. [...]

Background: Congestive heart failure (CHF) is a leading cause of hospitalization nationwide in people over more than 65. Moreover, CHF exacerbation is one of the leading causes of readmission –— creating a substantial financial burden on the health care system. Unlike oncology patients, those with end–stage CHF are not commonly referred to hospice or palliative [...]

Background: Lung cancer is the leading cause of cancer death in both men and women worldwide. Given that pulmonary nodules are a common finding on chest CT, a judicious plan for follow–up is necessary. A set of generally accepted, evidence–based guidelines have been published but a large proportion of these findings are not followed–up in [...]

Background: Nationally, manifestations of poor glycemic control are one of Medicare’s Hospital Acquired Conditions that are publically reported and no longer reimbursed. Insulin is also one of the JC’s top five high –risk medications. Furthermore, poor glycemic control has been associated with negative patient outcomes. Therefore, initiatives to improve inpatient glycemic control are necessary. Basal–bolus [...]

Background: 1.2 million people in the United States are living with an HIV infection and one in five is unaware of their infection. In Chicago, there are currently over 20,000 people living with HIV/AIDS and estimated that more than 5,000 people in Chicago are HIV–positive but not yet aware of their infection. In order to [...]