Background: For institutions without a fully integrated EMR, providing a complete and legible discharge medication list is challenging. Medication reconciliation forms must serve the needs of both patient safety goal standards and the patient. In attempting do both, paper forms often do not serve either purpose well. Purpose: At our hospital, discharged patients were given [...]

Background: An institutional requirement is lo conduct quarterly morbidity and mortality (M&M) conferences involving the internal medicine house staff. However, traditional MSM conferences often fail to address systems‐based factors or generate solutions to issues raised during discussion. An innovative morbidity, mortality, and improvement (MM&l) conference format is proposed as an alternative model To M&Ms. Purpose: [...]

Background: The results of publicly reported patient care surveys, such as the Hospital Consumer Assessment of Hospitals and Health Systems (HCAHPS), suggest that physician communication with patients could be improved. Patient‐centered care: which attempts to empower patients 1c become active participants in their own care may enhance communication with physicians and lead To improvements in [...]

Background: In 2004, the Centers for Medicare and Medicaid Services (CMS) and the Joint Commission (JC) determined a standard set of discharge instructions must be provided to patients with a principle diagnosis of congestive heart failure (CHF). Compliance with the core measure HF‐1 metric requires that activity, diet, follow‐up, worsening symptoms, weight monitoring, and a [...]

Background: Every hospitalist program needs night coverage. Noctumists are in high demand and short supply and rotating hospitalists from days to nights is a dissatisfier. Night coverage is Typically more expensive than day coverage because of lower volumes. Many practices face similar obstacles in night coverage. Coverage issues are exacerbated in areas where recruiting is [...]

Background: Medication errors are common, costly, and have Ihe potential for harm. In 2006, Ihe Joint Commission challenged hospitals to implement medication reconciliation at transition points across the continuum. At our institution, compliance with this activity on paper was poor (< 50%). related to the process poorly matching our work flows, unclear role delineation in [...]

Background: With today's flow of information, on top of academic and clinical duties, hospitalist face the challenge of staying up‐to‐date to provide the besl care for palients. Web feeds are powered by an extensible markup language (XML) protocol thai constantly provide updates from Web sites of interest, thus saving time for their user. A Web [...]

Background: In 2005, CMS and JCAHO implemented the Heart Failure Core Measures Set along with other core measures, in launching their hospital Performance Measures Initiative. Virginia Mason Medical Center (VMMC) has been able to improve heart failure core measures in their own Institution bul has struggled to reach and maintain 100% compliance. VMMC has had [...]

Background: Teaching quality improvement (01} to house staff is still in its infancy. Using modified root cause analyses (RCAs) in monthly resident‐run conferences has been suggested as one manner to improve resident Ql exposure and skills. In a previously described patient safety curriculum, an internal medicine PGY3, supervised by a hospitalist. leads a modified RCA [...]

Background: Hospital efficiency and throughput has a great impact on available bed‐days. When hospitals run at high capacity, the need to care for patients in the most efficient manner possible is of paramount importance to being able To accommodaTe the greatest number of patients. The ability for admitted patients to move as efficiently as possible [...]