Background: Overnight disruptions in sleep during acute care hospitalizations contribute to lower patient satisfaction, higher risk of delirium, and potentially, increased length of stay. One primary offender of quality sleep is high frequency collection of vital signs during overnight hours. Protocols for reduction in collection of overnight vital signs have been successfully implemented at other [...]

Background: Our 165-bed community hospital is in a phase of rapid growth due to demographic changes and expansion of services offered within the hospital. While offering unprecedented level of healthcare access to the community, improvement with emergency department (ED) throughput has emerged as one of our challenges from a patient safety perspective. Unnecessarily prolonged ED [...]

Background: Improvement of discharge times on house staff run medical floors is particularly complicated. Amato-Vealey et al. describe a domino effect of delayed discharges resulting in inability to transfer patients from intensive care units, advancement towards maximum capacity, and failure to move patients from the ER. This leads to delayed procedures, poor patient satisfaction, and [...]

Background: UChicago Medicine (UCM) Office of Operational Excellence (OE) uses an institutional Leadership model called “Engage, Evolve, Excel” (E3L) to improve care delivery with lean, six sigma, and patient centered values. The E3L model focuses on the four domains of value creation, patient-centered care, respect for people, and continuous improvement. A hallmark feature of E3L [...]

Background: VTE is associated with considerable morbidity and mortality, in fact, as many as 10% of deaths of hospitalized patients have been contributed to pulmonary embolism.1 The ACP and AACP in their 2011 and 2012 guidelines, respectively, recommend that all hospitalized patients be evaluated for risk of VTE, and subsequent prophylaxis be initiated if benefits [...]

Background: Malignant bowel obstruction (MBO) is a common complication, estimated 3-15% [1], in patients with gastrointestinal and gynecologic malignancies. It is usually a sign of advanced disease and often necessitates extended hospital admission.Hospitalists are increasingly involved in treating patients with MBO and the major challenge is fragmented nature of medical care and coordination across multiple [...]

Background: Acute Kidney Injury (AKI) is a common hospital problem which may lead to increased mortality, hospital costs, and increased length of stay (1). A leading cause of renal dysfunction in the inpatient population is drug nephrotoxicity. Several studies show that physician prescribers often do not take renal function into account with new or existing [...]

Background: In tertiary care centers, transfers from outside hospitals are a common occurrence. Prior studies have shown that interhospital transfers (IHT) in certain populations are associated with an increased adjusted odds of ICU transfer (Mueller 2019). In the age of the electronic medical record(EMR), patient transfer has been improved by direct access to patient records. [...]

Background: A discharge summary serves as a crucial means of communication between inpatient and outpatient providers. Appropriate transitions of care rely on updates to patient problems, diagnostics, treatment history, and discharge plans. Many studies have identified lacking components in discharge summaries that may lead to poor medical management.In an effort to improve patient transitions of [...]

Background: Social isolation and loneliness (SI+L), two largely silent social determinants of health (SDOH), are associated with negative health outcomes such as the increased risk of cardiovascular disease, higher rates of depression, increased hospital readmissions, and increased use of healthcare services. SI+L are also common, with one in five US adults reporting feelings of SI [...]