Background: An estimated 68,000 Americans died of opioid-related overdoses between March 2017-2018. In Monroe County NY heroin/fentanyl deaths are up 200% from 2015- 2017. Guidelines recommending naloxone co-prescription for high-risk patients on opioid pain medications have been issued. The inpatient setting provides unique opportunities for identifying patients at risk for opioid adverse events (OAE) and [...]

Background: Clinician prescribing practices are a contributing factor to and potential mitigator of the opioid epidemic in the United States. Several studies have identified the hospital setting as an important entry point into chronic opioid use. The Society for Hospital Medicine (SHM) and the Centers for Disease Control and Prevention (CDC) have made recommendations for [...]

Background: The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) was created to compare health care facilities based on patient satisfaction measures including pain management. There is concern that quality improvement metrics focused on pain control may contribute to increased opioid prescription. In our study, we examined whether improved performance on a non-pharmacologic nursing [...]

Background: Paracenteses are performed frequently at bedside by hospitalists, intensivists, gastroenterologists and emergency medicine providers. They are considered a core procedure that historically have been performed “blind” with only the use of percussion to determine the presence of fluid. With the rise of ultrasound based procedures the majority of paracenteses are now performed with ultrasound [...]

Background: More often than not, hospitalized patients are not able to correctly identify members of their physician team. Being able to identify physicians is a critical component of developing the patient-physician relationship. The use of facecards and whiteboards appears to improve hospitalized patients’ ability to identify their physician and may be associated with improvements in [...]

Background: Interprofessional rounding has improved patient safety and provider engagement (1). Our institution implemented interdisciplinary patient rounds (IPR) similarly described in the literature (2). Despite praise for our nursing safety checklist, declining emphasis on bedside teaching and brief patient interactions lead to provider dissatisfaction. Purpose: To provide high-quality patient care, foster interprofessional collaboration, and provide [...]

Background: Emergency medicine doctors should take care of patients with a wide range of illnesses at various emergency levels from non-urgent level to that requiring immediate medical attention. Among those, cardiovascular emergencies are not so common but life-threatening disorders that must be recognized immediately to avoid delay in treatment and to minimize morbidity and mortality. [...]

Background: Geographic hospitalist staffing and interdisciplinary rounding has been shown to improve staff communication, patient communication, and reduce length of stay. Communication between hospitalist and nurses also play a crucial role in patient safety and hospital throughput. Despite its importance, maintaining geography is difficult and communication between physicians and nurses are often sub-optimal and fragmented. [...]

Background: The Children’s Hospital Association (CHA) Sepsis Collaborative recognizes pediatric sepsis as a significant cause of mortality and nationwide efforts are being developed to improve sepsis recognition. A critical component to decreasing sepsis mortality is early identification of sepsis so that interventions are initiated quickly. At Johns Hopkins All Children’s Hospital, there is a significant [...]

Background: When a patient with cancer or terminal illness is hospitalized, they may benefit from the input of their outpatient, primary oncologist or palliative care provider to inform key decisions. As most oncologists’ and ambulatory palliative care clinics are based outside the hospital, these conversations often happen via unreimbursed phone conversations, making it difficult to [...]