Background: Inpatient experience quality improvement efforts have traditionally been focused on increasing scores on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. Patients’ open-ended responses about their inpatient experiences may represent a previously unexamined resource for understanding patient motivation behind closed-ended responses. We aimed to describe responses to an HCAHPS open-ended survey [...]

Background: Altered mental status (AMS) is prevalent in hospitalized patients, especially the elderly (1). The work up of AMS is based on history, physical exam, pertinent labs and imaging. Common etiologies include fluid and electrolyte disturbances, infections, drug toxicity, drug withdrawal and metabolic derangements. Many routine labs drawn in the evaluation of acute encephalopathy are [...]

Background: Asthma, bronchiolitis, and pneumonia are common pediatric inpatient diagnoses. Viral testing (VT) is not routinely necessary for these diagnoses as it often does not impact management. Our study objectives for each diagnosis are to; 1) describe trends in VT over the last 5 years including seasonal variation (respiratory season- Oct-March versus non-respiratory season- April-Sept), [...]

Background: The utility of procalcitonin (PCT) in pediatrics is debated. Proposed diseases in which PCT elevation is thought to be suggestive of a bacterial process include meningitis, urinary tract infection, pneumonia, neonatal fever, and sepsis of unknown source. However, elevated PCT is non-specific for bacterial infection and the strength of the test is generally felt [...]

Background: Acute kidney injury (AKI) is common in adult hospitalized patients, with the incidence being reported as high as 7.2%. While evaluation of the cause of AKI is often necessary, in hospitalized patients the causes of AKI are more likely to be pre-renal or intrinsic. Previous studies have found that decreased renal perfusion, medications, radiographic [...]

Background: With 81% of Americans having access to smartphones (1) and 58% using the internet for health related questions (2), there is a need for online resources to prepare patients and families for common experiences in the inpatient setting. The creation of Web based sites for patients and caregivers, such as TheHospitalizedPatient.com, attempts to fill [...]

Background: Healthcare organizations are increasingly seeking to improve physician well-being to combat rates of physician burnout. The Stanford Wellness Framework details a multi-pronged solution which includes three domains: personal resilience, culture of wellness, and efficiency of practice. Enhanced communication skills can improve patient-provider relationships and foster personal resilience, while improving efficiency in practice and contributing [...]

Background: Effective nurse-physician communication is imperative to safe, patient-centered care. Poor communication can lead to adverse events, ranging from near misses to patient deaths. It is important for information to be accurate and timely. In addition to patient safety, there are financial implications to poor communication. According to a 2015 study, communication failures in the [...]

Background: As our healthcare system shifts towards a patient satisfaction model, programs focusing on improving physician communication skills have been on the rise. Many of these programs have focused on outpatient providers as it can be more difficult to capture provider-patient communication in the inpatient setting. Most of the patient feedback obtained for inpatient providers [...]

Background: Timely and efficient communication between pharmacists and physician providers in the hospital setting is integral to patient care. Inpatient care involves discussions regarding medication dosing, timing, contraindications, side-effect surveillance, and medication reconciliation during admission and discharge, often requiring pharmacy consultation. The current system of communication in our institution relies on electronic pages to be [...]