Background: Properly designed, hospital units have potential to optimize outcomes for patients, staff, and trainees. Such units would be of great value if they converge high high–performing teams with active management while promoting principles of safety, timeliness, effectiveness, efficiency, equitable care, and patient–centeredness. Purpose: We sought to redesign a medical ward to systematically integrate physician [...]

Background: ICU patients account for over 18 million patient days annually in the United States and cost 1 % of GDP. The Leapfrog group recommended that ICU patients be managed exclusively by board–certified intensivists for their 40% reduction in ICU mortality. However, due to shortages in the intensivist work force, only about 23 % of [...]

Background: Institutions that focus on patient–family centered care have seen improvements in their patient and staff satisfaction. Bedside rounding with the patient/family involved is a tool that hospitalists can use to deliver care that centers on patient and family whilst improving their efficiency. Purpose: To evaluate the effectiveness of physician led team rounds at the [...]

Background: Hospital –based medicine could be more effective when there is collaboration and open communication from sub specialties, nursing and discharge planning. To facilitate this effort the hospitalist group partnered with nursing leadership to establish a daily process in which the hospitalist, nursing and discharge planning migrated from a task orientated approach to a process [...]

Background: Developing collaborative practice models is emerging as a core strategy in creating an ideal patient safety climate, improving patient care outcomes, and increasing patient satisfaction. However structuring a workflow for team members that allows for open and timely patient–centered dialogue is often more an art than a science. Furthermore, although there are various means [...]

Background: Hospitalist groups strive to perform at a high level on multiple measures, including readmissions and patient satisfaction. Individual hospitalists, however, may find it difficult to become actively involved in quality improvement (QI) due to a busy clinical schedule, lack of formal training in QI, and lack of a structure encouraging members to become involved. [...]

Background: Medication reconciliation (MR) was identified as a National Patient Safety Goal in 2006 and during the summer of 2011 the Joint Commission is tracking it as a part of the accreditation process. Beyond its ties to regulatory bodies, MR is first and foremost a patient safety issue. Studies have shown that unintended medication discrepancies [...]

Background: The Joint Commission requires that pregnancy and lactation information for a patient must be accessible to practitioners who participate in the management of the patient’s medications. To facilitate this process, we developed computer–based decision support to collect and display pregnancy and breastfeeding information for female patients. Purpose: To screen for and document electronically the [...]

Background: Core measures are publicly reported measures that gauge the quality of the process of patient care reflecting compliance to standards of care. This organization has employed many real–time electronic record enabled tools and clinical decision support to optimize the process of care for every patient every time. After discharge, a random sample of patients [...]

Background: The average time of discharge at a hospital is more than the average time of admission and this creates a bottleneck in patient flow. Patients have to wait longer for an available bed. Pushing back the average patient discharge time from late afternoon to morning is vital to increasing efficiency, quality of care, and [...]