Background: Geographic localization is the practice of assigning physician and advanced practice provider teams to patients located in the same inpatient unit. Poor localization of hospital medicine teams at our institution was identified as a top cause of increased Emergency Department boarding and Length Of Stay (LOS). The purpose of our process improvement project is [...]

Background: Inpatient utilization of Magnetic Resonance Imaging (MRI) is rapidly expanding, with potential effects on length of stay (LOS). At the same time, current hospital occupancy remains about 10 percentage points higher than before the pandemic and hospitalizations are projected to increase 11% by 2034. Hospital systems are striving to optimize processes to improve bed [...]

Background: Among bedside procedures, factors such as body mass index (BMI), prior spinal procedures, and complex spinal anatomy are known to affect the success of lumbar punctures (LP) [2, 3]. However, the phenomenon of a “dry tap,” where cerebrospinal fluid (CSF) cannot be obtained despite the needle tip being correctly positioned in the thecal sac, [...]

Background: While predictive analytics can help anticipate trends, the specific consequences of a national disaster on the healthcare system are often unpredictable. Recently, the East Coast suffered supply chain disruptions due to hurricane damage, leading to dramatic shortages of saline, intravenous (IV) fluids, and dialysate. The damage to Baxter’s North Carolina facility, which represents 60% [...]

Background: In July 2021, our institution launched the Better Flow Program, aimed at streamlining patient flow by documenting the Medically Ready for Discharge Date (MRDD) and the Discharge Delays (DDs) in the electronic medical record (EMR). The MRDD is the date at which a patient is deemed clinically stable for discharge by their medical team. [...]

Background: Multi-visit patients (MVP) tend to represent a small portion (< 5%) of all admitted patients, yet account for more than 40% of 30-day readmissions based on prior literature (1-2). Among our institution’s MVPs, Heart failure (HF) exacerbations are one of the top disease presentations accounting for 40% of 30-day readmissions in 2022. These patients [...]

Background: Palliative care (PC) is a multidisciplinary consult service aimed at ensuring goal-concordant medical care while optimizing patient/family support. Prior studies have illustrated that palliative care consultation can be associated with a significantly shorter length of stay but without significant change in mortality or disposition. Utilization of standard high-risk descriptive criteria or “triggers” that uniformly [...]

Background: Micronutrients are essential food components that are not a major energy source but are required in small quantities to support normal health. Vitamin A is well known for its role in vision; however, it is also involved in immune function, growth, and development. Deficiency of vitamin A manifests as xeropthalmia in children and night [...]

Background: Acute illness contributes to deconditioning of hospitalized older adults, significantly impacting their short- and long-term outcomes. The Banner Mobility Assessment Tool (BMAT) was developed to guide nurses in assessing mobility when promoting physical activity for their patients. We implemented a quality improvement initiative, “Mobilizing Older Adults using BMAT, Interprofessional Leadership, and Education (MOBILE)”, which [...]

Background: Early administration of antimicrobials is one of the most effective interventions to reduce sepsis mortality. Despite this, delays in antibiotic initiation occur, particularly in patients presenting without hypotension. We sought to understand patient characteristics and presenting symptoms associated with antibiotic delays in this population. Methods: Cohort study of adult patients hospitalized with community-onset sepsis [...]