Background: Hospital medicine has expanded significantly over the last two decades but faces a higher physician turnover rate compared to other specialties1 and a critical shortage of providers. A survey conducted in 2019 and again in 2022 showed a reduction in the number of hospitalists identified as being “very satisfied” with their career (from 55% [...]

Background: Transthoracic echocardiography (TTE) is a valuable diagnostic tool widely used for cardiac patients, but its accessibility and convenience have contributed to overuse. Although Appropriate Use Criteria (AUC) were developed to address this, inpatient TTE use continues to rise, with 5–8% annual increases. Studies reveal that while most TTEs meet AUC standards, fewer than one-third [...]

Background: High hospital readmission rates have both clinical and financial consequences which are associated with worse healthcare outcomes for our patients and costly financial penalties for the hospital. The average cost of a readmission estimated to be at $15,200 and adds burden on hospital systems, resources, and cause further harm to our patients, leading to [...]

Background: Diagnostic errors (DE) are common in hospitalized patients, especially those with an unintended escalation of care, and cause substantial harm. However, individual hospitals currently lack methods to analyze local diagnostic process failure patterns to identify targets for quality improvement efforts. Purpose: The AHRQ funded UPSIDE study identified key diagnostic process failures across a national [...]

Background: Prior studies have described the negative collateral effects of a hospital’s closure on the efficiency, access, and quality of care delivered at nearby hospitals that bear the brunt of care transfers and patient dispersion. However, few studies have addressed quality at the institution that is closing, as it is closing, and when the closure [...]

Background: Accurate clinical documentation is essential for capturing patient severity of illness (SOI) and risk of mortality (ROM). These metrics directly influence hospital quality reporting, including rankings like Vizient and metrics such as Observed-to-Expected Mortality (O:E) ratios. Traditional documentation methods rely heavily on manual input, which in busy clinical practices, results in underrepresented patient risk [...]

Background: The Joint Commission (TJC) defines a sentinel event as one related to patient safety resulting in death, permanent, or severe harm.(1) In TJC Sentinel Event Data Annual Review for 2022, communication breakdowns were identified as the root cause for these events. With stricter duty hour restrictions in hospitals nationally, the number of patient caregivers [...]

Background: Communication failure during patient handoffs is a common cause of harmful medical errors. Therefore, the Joint Commission recommends that healthcare facilities standardize communication during this process. Intrahospital patient transport represents an instance in which it is crucial to have a standardized handoff approach – as patients are monitored less closely, may experience interruptions in [...]

Background: Patients with substance use disorders (SUDs) are at high risk for blood borne viruses (BBV) and sexually transmitted infections (STIs).1 Syphilis infections, in particular, have dramatically increased over the past decade. More patients with syphilis infections are reporting injection drug use.2 Hospitalization is considered a “reachable moment” for this vulnerable patient population.3 Yet, screening [...]

Background: Patients with limited English proficiency (LEP) have a primary language other than English. During the hospital discharge process, patients with LEP may experience challenges communicating with members of the healthcare team and in our division, they have increased readmission rates and reported increased difficulty understanding discharge instructions compared to English proficient patients. Purpose: To [...]