Background: When elderly patients are discharged home following an acute hospitalization, they are at high risk of having an unsuccessful transition with untoward health care outcomes. Our team has developed an interdisciplinary, comprehensive intervention to try to make this transfer higher quality and less dangerous. Purpose: The goals of the study were: (1) to assess […]

Background: Physician‐patient communication is of paramount importance in providing efficient, cost‐effective, and compassionate patient care. Many lawsuits stem from poor communication between health care providers and patients. Face‐to‐face contact is essential for providing good patient care but is also time consuming. Hospitalists often face the challenges of communicating with patients they have never seen before. […]

Background: The exchange of clinical information and patient care responsibility between physicians is crucial in the care of hospitalized patients. Many studies have looked at sign‐out/handoffs involving residents and interns and elicited mixed opinions. Very few studies have looked at sign‐outs between hospitalist attendings. Our purpose is to describe a group‐based e‐mail communication/sign‐out system that […]

Background: In July 2003 the ACGME 80/30 work hour regulations went into effect. To maintain compliance with these regulations, new systems of care that might include cross cover and patient handoffs were created. Cross cover is defined as the care provided by a physician while the primary physician team is out of the hospital. Handoffs […]

Background: Low sound levels are important for the normal neurological development of preterm infants. The American Academy of Pediatrics recommends an average noise level of 45 dB for premature infants. However, as a consequence of the nature of the care involved, an infant in a neonatal intensive care unit (NICU) is exposed to average ambient […]

Background: Rapid‐response teams (RRTs) are associated with decreases in unexpected inpatient death, code blue, and unexpected ICU transfer rates. There are many RRT designs, but little has been written about RRTs coordinated by internal medicine residents. As a result of the rapid growth of RRTs in the United States, academic institutions are struggling with incorporating […]

Background: Venous thromboembolic (VTE) disease is a significant burden for hospitalized inpatients. At our institution, we designed an intervention that would force physician users both to rate degree of VTE risk and to intervene with best‐practice therapeutic choices at admission and at transfer of level of care. Using a validated chart review mechanism, we demonstrated […]

Background: In a tertiary‐care setting, the culture of curative medicine can prevent physicians and parents from initiating a palliative medicine consult. Children who most need the service are those with chronic complex disease who have experienced multiple admissions and inpatient and outpatient encounters with numerous specialists. These patients have needs that are often overlooked, with […]

Background: In the age of declining reimbursement and insurance‐driven health care, it has become increasingly important for hospital systems to proactively address their compliance and revenue patterns. In 2003 our institution began to designate all patients anticipated to stay less than 24 hours as having observation status. We successfully decreased our denial rate from 15% […]

Background: Health care organizations have had significant difficulty getting providers to prescribe deep venous thrombosis (DVT) prophylaxis for their patients. Organizations including the Joint Commission on Accreditation of Healthcare Organizations and the Agency for Health Care Research and Quality have begun mandating health care organizations to maintain quality standards in relation to DVT prophylaxis. It […]