Background: There is a growing emphasis on teaching Quality Improvement (QI) to resident physicians and medical students. Successful QI training for residents and students requires faculty role models, teachers and mentors. However, faculty with QI skills and knowledge is lacking at many academic medical centers. Active learning programs to improve faculty capacity for QI have [...]

Background: Health literacy (HL) is the measure of a person’s ability to obtain, process and understand basic health information and services to make appropriate health decisions. Previous studies note positive correlation between high HL and patient understanding of their condition. Patients with low HL have greater needs in transitional care domains, citing inadequate caregiver support [...]

Background: Sepsis is a leading cause of death in US hospitals, and is a major contributor to hospital mortality and length of stay. Much has been done in hospitals nationwide to identify and treat sepsis early. Similarly, at Bridgeport Hospital, a clinical redesign was initiated to identify and act on patients with signs of sepsis [...]

Background: Overuse of non-ICU continuous cardiac (telemetry) monitoring is a well-documented problem that leads to increased hospital cost, alarm fatigue, nursing time loss, and patient discomfort. It is often ordered for detection of clinical deterioration or higher level of nursing care, without corroborating evidence. Several studies have looked at different interventions to reduce inappropriate telemetry [...]

Background: Telemetry utilization for a long time has been dependent on individual physician experiences, preference as there were no good randomized controlled trails or guidelines from any scientific organization. American Heart Association has released the guidelines for appropriate use of telemetry in Oct 2004. Even more than a decade of these guidelines been available there [...]

Background: Hospital discharges before noon have become a common institutional goal in order to improve hospital throughput, reduce emergency department boarding time, and enhance patient satisfaction. Evaluation of baseline rates at Brigham and Women’s Faulkner Hospital (BWFH), a 100-bed academically-affiliated community hospital, demonstrated <10% of patients were discharged before noon. Purpose: To improve rates of [...]

Background: Current guidelines from the AABB (formerly known as the American Association of Blood Banks) recommend a red blood cell transfusion for hospitalized patients who are hemodynamically stable if the hemoglobin is 7 g/dL or less. This threshold also includes critically ill patients who are hemodynamically stable in the intensive care unit. The guidelines also [...]

Background: Pressure injuries are tissue damage caused by pressure and shear. Susceptible patients are the elderly, acute, critically ill and malnourished. Pressure injuries severely deplete hospital performance measures in the U.S. Currently, over 2.5 million patients develop pressure injuries at a national cost of about $25 billion each year and are implicated in 50,000 deaths. [...]

Background: Best-Practice Alerts (BPAs), utilized to reduce the number of adverse events in medical settings, have limited efficacy partly due to alert fatigue and user desensitization. Alert fatigue often stems from inaccurate alerts firing too often as well as poor physician perception of the efficacy of the alerts, both of which lead to reduced physician [...]

Background: First year hospitalists have higher inpatient and 30 day post discharge mortality than hospitalists with at least a year of experience. The Joint Commission found that improper orientation and training is the second leading cause of sentinel events in hospitals. There is neither literature nor guidelines to inform best practices for Hospital Medicine (HM) [...]