Background: Many hospitals rely on improved throughput to maintain high volume in the face of limited inpatient capacity. Earlier discharges may free up inpatient beds, decrease the strain on a crowded Emergency Department (ED), and allow inpatient services to provide timely care to patients by improving throughput from the ED. Although early discharge times are […]

Background: Data suggest that adherence to contact isolation precautions reduces transmission of multi–drug resistant organisms and C. difficile. Compliance with both hand hygiene and contact isolation precautions is suspected to be poor. This study aims to evaluate compliance with contact isolation precautions as documented by direct observation. Methods: We performed sequential observations of 91 healthcare […]

Background: We examined the relationship between workload and patient safety via a survey of an online community of Hospitalists. This analysis examines the predictors of providers reporting an “unsafe” workload, identifying potential targets for quality improvement. Methods: We electronically surveyed 890 self–identified Hospitalists enrolled in QuantiaMD.com, an online physician community which provides continuing medical education […]

Background: American college of physicians’ clinical practice guidelines raises the question of mortality benefit from venous thromboembolism (VTE) prophylaxis and excessive bleeding risk based on newer research outcomes. In this context, a study was designed to measure the impact of electronic order entry based on standardized risk assessment, specialty specific, VTE prophylaxis, and the number […]

Background: Use of computerized provider order entry (CPOE) is on the rise in U.S. hospitals. Order sets are often used in CPOE systems to facilitate efficient order entry; many order sets contain orders for laboratory blood tests. Use of these sets may result in increased utilization of laboratory blood testing, which can cause iatrogenic anemia […]

Background: In–Hospital strokes (IHS) account for 4–17% of all ischemic strokes and are associated with increased morbidity and mortality compared to strokes with onset in the community. As with all strokes, early identification of IHS is of utmost importance. However, stroke syndromes are diverse and many patients in the hospital setting have co–morbid illness, medication […]

Background: Research suggests the optimal method for identifying hospital adverse events (AEs) is a two stage approach using manual chart abstraction. First, clinicians abstract the entire medical record to identify potential AEs using screening criteria. Second, narrative summaries of potential AEs are reviewed by a physician to assess presence, preventability, and severity. We sought to […]

Background: There are over 500,000 hospitalizations annually for patients with community–acquired pneumonia (CAP). While a great deal of attention has been paid to the diagnosis, assessment of severity, and selection and timing of antimicrobial therapy in CAP, few studies have looked at the level of clinical stability necessary for safe discharge. Pneumonia Patient Outcomes Research […]

Background: The incidence of acute diarrhea in the US is 375 million and mortality is 6,000/year. Acute diarrhea is defined as <14 days per WGO and less than 21 days for ACG. One million hospitalizations are attributed to acute diarrhea per year. Additionally, inappropriate workup and management is associated with a significant financial burden. For […]

Background: Venous thromboembolism (VTE) is a common yet preventable complication affecting hospitalized patients. Appropriate VTE prevention has emerged as an important hospital quality measure with emphasis on enforcing routine risk assessment and compliance with VTE prevention guidelines. Several pharmacologic options are available for VTE prevention; however, adherence to thromboprophylactic therapies is largely unknown. In addition, […]