Background: Time‐motion studies have been used since the early 20th century to provide minute‐by‐minute accounts of how time is spent in factories and office settings alike. More recently, time‐motion methodology has been used in the hospital setting. We undertook a systematic review of published time‐motion studies performed in the hospital setting. Methods: We searched MEDLINE, [...]

Background: Assessments of intensive care unit (ICU) performance currently rely on risk‐adjusted rates of in‐hospital mortality. These rates do not account for deaths occurring shortly after hospital discharge that may be attributable to the quality of care at the discharging hospital. Factors predicting early postdischarge mortality among ICU patients are unknown. Methods: Thirty‐five California hospitals [...]

Background: Research shows that continuity of care in the outpatient setting improves care and reduces risk of rehospitalization. However, the effects of continuity of care in the inpatient setting have not been studied. We know that the growth of hospitalists with rotating schedules and night float services often lead to 1 physician admitting the patient [...]

Background: Hospitalization of older persons is accompanied by a disproportionate risk of poor outcomes and adverse events such as functional decline, delirium, and falls. Several process measures potentially associated with increased quality of care for this vulnerable population exist. The Acute Care for the Elderly (ACE) service is a hybrid of a general medical service [...]

Background: Blood glucose (BG) control is difficult to achieve in the hospital setting, and the best approach to BG control in non‐critically ill patients is unclear. A few quality improvement studies have demonstrated improvements in glycemic control with the use of education and standardized physician orders, but most of these studies showed only modest improvements [...]

Background: Quality measurement is increasingly important for medical centers. Regulatory organizations and payers are demanding quality care and quality improvement initiatives. Measurement is a foundation for all improvement methodologies but can be costly. Administrative data are used for external reporting, but local stakeholders often question its validity. Providers are particularly concerned given the move toward [...]

Background: Observational studies conducted prior to the hospitalist movement demonstrate improved patient outcomes in intensive care units (ICUs) staffed by intensivists compared with those staffed by nonintensivists. A large and growing nationwide intensivist shortage, however, precludes ICU staffing exclusively by intensivists. Although many hospitalists care for ICU patients in the United States, no formal investigations [...]

Background: Pain control is a key part of care for hospitalized patients. Despite calls from major health care organizations to improve provider awareness and training about pain control, pain management remains inadequate for many hospitalized patients. The quality of pain control among hospitalized patients is typically measured using retrospective reports of pain, which are often [...]

Background: An accurate prediction model for perioperative outcomes of patients who have been clinically optimized prior to elective noncardiac surgery has not been well studied. We sought to develop a nomogram that would help physician and patient to accurately estimate the likelihood of postoperative survival. Methods: We studied consecutive patients who were systematically evaluated and [...]

Background: Many hospitals have instituted rapid response teams (RRTs) to prevent potentially avoidable deaths in general medical surgical unit patients. However, studies to date have not found consistent improvement in clinical outcomes as a result of these RRTs. This may be a result of RRT activation relying primarily on recognition of critically abnormal vital signs [...]