Background: Vaso-occlusive acute pain crises are the leading cause for hospitalization in adult sickle cell patients. For our academic hospitalist group at a quaternary care center in New York, acute pain crises in 2017 accounted for 65 admissions, with an average length of stay (LOS) of 10.28 days, and readmission index (observed-over-expected ) of 1.10. [...]

Background: Hospitalized elderly patients are at risk for delirium. Despite the widely recognized importance of avoiding potentially inappropriate medications on the BEERS list, hospitalized patients often receive high-risk medications such as benzodiazepines for insomnia. This quality improvement (QI) project aimed to reduce the proportion of at-risk inpatients (defined as any hospitalized patient at age 65 [...]

Background: Peripherally inserted central catheters (PICCs) are an increasingly common vascular access device, with more than 4000 devices placed per year at our institution. Though these devices are generally considered safe and effective, they are not without risks, particularly of catheter-related infection and thrombosis. These risks increase exponentially with increasing number of lumens. At our [...]

Background: In an attempt to enhance the quality of the care we deliver as a Group in the hospital, we undertook the formation of a Quality Assurance Committee. It is composed of 3 MD’s, one of whom is Administration level, an APRN and a PAC. It is peer level and protected, and we invited all [...]

Background: After a patient death, experienced physicians have reported feelings of sadness, guilt, and self-doubt. Residents and interns experience a strong emotional impact to these deaths as well, and previous studies have shown that they only feel adequately supported 50% of the time. Residents feel more supported by their attendings and are better able to [...]

Background: Patient experience is one of the key foundations of quality care. The Hospital Consumer Assessment of Healthcare Providers and Systems Survey (HCAHPS) is the standard measurement of patient experience, and higher scores have been linked to improved clinical outcomes and reduced readmissions. Few published interventions have improved HCAHPS scores in inpatient settings. Interventions utilizing [...]

Background: Despite advances in pharmacologic care for side effects of Hematopoietic stem cell transplant, patients often suffer from long hospitalizations, multiple side effects including fatigue, insomnia, nausea, anxiety, and poor sleep. Non-pharmacologic treatments for side effects of therapy are attractive adjuncts due to a low side effect profile. Purpose: To develop, implement and evaluate a [...]

Background: Avoidable readmissions result in unnecessary hospital stays for patients, over utilization of beds, and increased waiting time for other patients. Multiple interventions have examined reducing readmissions, mostly focusing on pre-discharge and out of hospital post-discharge interventions. An additional potential target in reducing avoidable readmissions are the population of patients returning to the Emergency Department [...]

Background: Geographic Accountable Care Units (ACUs) have been in existence for years at our institution. The ACUs have demonstrated improved throughput, quality and patient experience metrics. Our hospitalists have embraced the ACU philosophy due to ease of rounding, interdisciplinary approach to patient care and its 7on/7off scheduling, which is not standard at our institution. Overall [...]

Background: Veterans in care at Veterans Affairs (VA) medical centers have a higher prevalence of Hepatitis C (HCV) antibody positivity than the general population1,2. Despite high tolerability and cure rates approaching 95% with new direct-acting antiviral (DAA) drugs, a significant proportion of veterans have not been initiated on treatment due to barriers including active substance [...]