Background: In 2004 The Surviving Sepsis Campaign Guidelines (SSCG) published specific recommendations to establish guidance to clinicians in the management of sepsis. We sought to determine the frequency that our physicians follow practices outlined in the SSCG before and after their publication and we surveyed the physician's own perception of adherence to the guidelines. Method: […]

Background: Inpatient physicians frequently transfer patient information to cross‐covering physicians. Although there is an increasing interest in formalizing this information transfer, there is little scientific information about the types of problems that cross‐covering physicians are asked to address, or which types of information they need to efficiently solve them. Method: We performed a standardized observation […]

Background: Effective teamwork and communication can prevent error and mitigate harm. High‐performance team training was developed in the aviation industry for flight crews, and is being incorporated in healthcare settings such as emergency departments, operating rooms, and labor and delivery suites. Purpose: We translated and adapted high‐performance teamwork and communication principles from other industries and […]

Background: The pneumococcal vaccination has been shown to reduce the incidence of invasive pneumococcal infection by as much as 75%. Since approximately two‐thirds of patients hospitalized with serious pneumococcal infections have been previously hospitalized at least once during the previous five years, inpatient hospitalization represents an opportune time to provide screening and immunization. Purpose: To […]

Background: Medication misuse was underscored in 1999 when the Institute of Medicine (IOM) recommended that reduction in medication errors be considered a national priority. IOM has emphasized the need to improve health care by adopting a team approach to patient care. New drug entities and increasingly complex regimens drive up health care costs and raise […]

Background: Community hospitals have increasing difficulty providing E.D. and inpatient call coverage for General Surgery patients. Lower professional fees, higher malpractice costs, and a greater number of underinsured patients have made general surgeons less able to provide coverage. Employment of surgical hospitalists is an option for hospitals with this problem. Medical hospitalist programs provide a […]

Background: Discharge from the hospital is a critical transition point in a patient's hospitalization. Poor hand‐offs at discharge can lead to adverse events for the individual patient, and result in avoidable re‐hospitalizations. Care transitions are especially important for elderly and other high risk patients who have multiple co‐morbidities. Standardizing the elements within the discharge process […]

Background: Providing cost‐effective quality pediatric care is a challenge for general community hospitals. Children requiring admission need pediatric expertise and their needs can be compromised in a non‐pediatric environment. High pediatric operating costs can force community hospitals to make difficult decisions: 1.) Carrying a loss, 2.) Making less than optimal arrangements for hospital‐based pediatric care […]

Background: The field of Hospital Medicine continues to evolve as Hospitalists try to define themselves not only by the place they work but in terms of knowledge and skills. These areas of knowledge and skills then become the basis of educating physicians to become effective Hospitalists. Although the classic categorical Internal Medicine program effectively trains […]

Background: Building on the development of order sets and their monitoring, our organization crafted a dashboard to track 25 key quality indicators for the entire organization, with more than half linked to diagnoses managed by the Department of Hospital Medicine. Building on past achievements, the hospitalist group is at the forefront of the movement for […]