Background: The Society of Hospital Medicine (SHM)’s Quality Improvement Special Interest Group’s (QI SIG) mission is “to create and maintain a community that promotes quality improvement by connecting quality improvement enthusiasts to each other and the resources necessary to develop and hone quality improvement skills.” The QI Initiative subgroup of QI SIG was charged with [...]

Background: The United States government has made decreasing 30-day unplanned readmissions a national priority, as early hospital readmissions are a common and costly occurrence. Establishment of the Hospital Readmission Reduction Program (HRRP) in 2012 led to financial penalties to hospitals with high 30-day readmission rates. As such, decreasing 30-day unplanned readmissions has become a key [...]

Background: Peripherally inserted central catheters (PICCs) are one of the most widely used means for long term vascular access. When compared to traditional central venous catheters (CVCs), PICCs offer several advantages including safer insertion in the arm, cost-effectiveness, and easier self-care for patients outside the hospital. Despite these advantages, numerous studies have found complications associated [...]

Background: The opioid epidemic, well-recognized as a national emergency, is a wake-up call to physicians. Medication-assisted treatment (MAT) for opioid use disorder (OUD) has been shown to be safe, cost-effective, and reduce mortality; however, MAT use remains low (1-4). More recently, the hospital setting has been seen as a potential starting point for treatment for [...]

Background: The opioid epidemic is a well-recognized, national public health emergency. Patients admitted to the hospital with complications of opioid use disorder (OUD) often have complex infections which frequently require lengthy courses of intravenous (IV) antimicrobial therapy (1). Many in the medical community have valid concerns about patient safety and risk of central line misuse [...]

Background: New Mexico has the highest number of alcohol-related deaths in the country, a title held since 1981. Nationally 1 in 10 deaths in working-aged adults are alcohol-associated whereas in New Mexico the ratio is 1 in 6 deaths. About 130,000 New Mexicans report alcohol dependence or abuse within the past year, but only 3% [...]

Background: Patients admitted to the hospital without a documented code status specifying what, if any, heroic measures they would consent to in the event of an emergency are at risk for receiving medical interventions that are not goal concordant with their wishes1. This invites patient harm, patient and family dissatisfaction, and may increase hospital length [...]

Background: In an increasingly digital world, there are still many manual and paper based workflows in healthcare. Paper scripts are an area that is prevalent and is the gold standard for certain prescribing behaviors. Paper scripts have numerous challenges, they can be lost, are difficult to track, and physically have to be delivered to the [...]

Background: Montefiore Health System (MHS) rapidly expanded from three hospitals in close proximity to eleven hospitals across hundreds of miles. The structure of the new health system follows a hub and spoke model with the concentration of specialty care located at the hub which is the Moses campus in Bronx, NY. In order to best [...]

Background: Inefficiencies in the hospital discharge process can be a source of patient and provider dissatisfaction. Further, gaps in post-discharge care have been associated with increases in 30-day mortality and 30-day unplanned re-hospitalization. Addressing these gaps requires a specific focus on the development of a post-acute care treatment plan, identification of potential barriers to the [...]