Background: Hospitals are nationally ranked on the basis of comparisons of quality of care, mortality, readmissions and health care associated infections.1 Center for Medicare and Medicaid Services (CMS) looks at these top 6 illnesses; stroke, pneumonia, heart failure, chronic obstructive pulmonary disease, acute myocardial infarction and coronary artery bypass graft (CABG) to compare hospital’s specific [...]

Background: Overuse of non-ICU continuous adult cardiac (telemetry) monitoring is a well-documented problem that can lead to increase hospital cost, alarm desensitization, nursing time loss, and patient discomfort 1,2. Previous studies assessing reduction of inappropriate telemetry use have employed a combination of electronic health record (EHR) order, nursing protocol changes, intensive educational, and/or feedback initiatives [...]

Background: In order to reduce overuse, many hospitals have conducted studies and implemented protocols with the goal of reducing non-indicated telemetry monitoring. A common tool that institutions utilize for these changes are the clinical decision support systems (CDSS). In this report, we will present the telemetry protocol utilized by our hospital and review its effects [...]

Background: Whether or not a specialty medical center provides better patient outcomes and lower cost compared to a general hospital is controversial. In addition, few studies have focused on the specialty orthopaedic centers. The objective of our study is to evaluate if hospital length of stay (LOS) and cost were improved after the building of [...]

Background: The designation of a patient as outpatient versus inpatient status at time of discharge affects how hospitals bill Medicare for services because the center for Medicaid and Medicare services (CMS) reimburses hospitals at a higher rate for inpatient when compared to outpatient designation(1). Since the fiscal year of 2014, one of the major benchmarks [...]

Background: The most recent guidelines regarding telemetry monitoring use and indications was published by the American Heart Association (AHA) in 2017.(1) However, most institutions lack evidence-based protocols to guide telemetry usage which could improve overuse. Telemetry monitoring overuse in non-critical patients has been recognized as a contributing factor to healthcare cost, length of stay and [...]

Background: Background Fatalities caused by drug-overdose have increased in recent years across the US and are now the leading cause of injury-related death in the United States. Drug related deaths with cointoxicants are being seen more often and the increase in prevalence of opioid overdoses with possible concomitant medication use is a public health concern [...]

Background: Telemetry over utilization increases wasted spending, increases alarm fatigue, and creates patient safety risks. Despite the presence of American Heart Association (AHA) practice guidelines, patients are often placed on telemetry for inappropriate reasons at the discretion of the medical provider and are monitored for longer than anticipated. The goal of this quality improvement project [...]

Background: Obstructive sleep apnea (OSA) is defined as a sleep disorder marked by pauses in breathing of 10 seconds or more causing unrestful sleep and accompanied by loud or abnormal snoring, daytime sleepiness, irritability, and depression. According to the National Sleep Foundation, more than 18 million Americans have OSA, 80% of whom are undiagnosed. The [...]

Background: Hospital discharge is a complex process that requires coordination from various parties. There still remains a significant rate of readmission, with a reported 30 day readmission of roughly 20% and annual cost of $18 Billion to Medicare. Patients with adequate discharge planning have a decreased readmission rate. Recent studies that demonstrated that high risk [...]