Background: Hospital Onset Clostridium difficile infection (HOCDI) is one of the most common causes of hospital acquired diarrhea. As per a recent study, the mean healthcare costs attributable to primary Clostridium difficile infection (CDI) is about $24,205 per patient. This would be a lot more if the patients were to be discharged to skilled nursing […]

Background: A substantial proportion of peripherally inserted central catheters (PICCs) are placed for inappropriate indications. We performed a multi-hospital intervention to improve the appropriateness of PICC use. Methods: We conducted a collaborative cohort study of hospitals participating in the Hospital Medicine Safety Consortium. An evidence-based intervention centered on the Michigan Appropriateness Guide for Intravenous Catheters […]

Background: Beginning in 2015 Mission Hospital in Asheville, NC began noticing a rise in the number and associated length of stay (LOS) of patients admitted for medical complications of injection drug misuse. What began as a small team mainly focused on LOS reduction strategies quickly morphed into a multidisciplinary team to formalize a Care Process […]

Background: Stony Brook University Hospital (SBUH) identified an opportunity to develop and implement prevention strategies to reduce hospital onset C. difficile infections (CDI). Hospital Onset (HO) CDI are included in National Healthcare Safety Network (NHSN) reporting and included with other hospital-acquired infections as publically reported data. CDI contribute to prolonged hospital stays, inappropriate antimicrobial use, […]

Background: Geriatric and palliative care patients who have been discharged from hospital and are home-limited face challenges in effectively accessing ongoing healthcare and clinical follow-up after being discharged, leaving them at risk for unnecessary re-hospitalization. Health care video visits present a novel opportunity to expand patient access to clinical care remotely in their home, potentially […]

Background: Endoscopies are commonly performed in the inpatient setting, and successful completion frequently requires close coordination among nurses, hospitalists, gastroenterologists, and anesthesiologists. Given the complexity of this multidisciplinary involvement, as well as variability in patient factors like clinical stability and presentation, endoscopies are prone to delays. These delays may cause frustration amongst care providers and […]

Background: In 2016 70% of venous thromboembolism events at the University of Pittsburgh Medical Center Presbyterian Hospital occurred in patients with BMI>=25. The American College of Chest Physicians recommend weight base dosing for VTE prophylaxis in obese patients (grade 2C) as the standard dosing regimen may not be adequate for these patients. The anti-Xa range […]

Background: One way academic organizations recognize staff achievements and scholarly activities is through four levels of academic appointments: Instructor, Assistant Professor, Associate Professor and Professor. Nurse Practitioners and Physician Assistants (NPPAs) employed by the Mayo Clinic are highly encouraged to pursue an academic appointment. A 2016 survey at our three main sites showed that only […]

Background: Excessive daily routine laboratory testing for hospitalized patients is a contributor to poor hospital sleep, iatrogenic anemia, and excessive costs. Recommendations from the Choosing Wisely™ campaign specifically state to avoid sleep interruptions for routine care (American Academy of Nursing) and to avoid routine labs for stable patients (Society of Hospital Medicine). The purpose of […]

Background: Third International Consensus Definitions for Sepsis and Septic Shock (SEP-3) defines Sepsis as life-threatening organ dysfunction due to a dysregulated host response to infection. In United States about 1.5 million Americans are diagnosed with Sepsis each year and about 250,000 of them die each year. It is also the costliest single diagnosis to treat […]