Background: Antibiotics are frequently prescribed—and overprescribed—at hospital discharge, leading to adverse-events and patient harm. Antibiotic overuse at discharge varies widely across hospitals, with rates of overuse differing up to 5-fold.(1) Our understanding of what approaches optimize prescribing at discharge is limited. Recently, we published the ROAD (Reducing Overuse of Antibiotics at Discharge) Home Framework which […]

Background: The availability of beds within healthcare systems has been stressed during each wave of the COVID-19 pandemic. Healthcare systems with tertiary hospitals have had increasing patient volumes and face limitations of specialized urgent (e.g., ECMO) and routine (e.g., Percutaneous Coronary Intervention) functions during critical inpatient surge volumes. Reserving the limited capacity at a tertiary […]

Background: Failure to thrive and malnutrition continues to be a common diagnosis in pediatrics contributing to a significant number of hospital admissions (1-5). There is no national practice guideline or consensus recommendation for diagnosis and treatment for patients hospitalized with failure to thrive, contributing to significant clinical practice variation. Unnecessary variability in practice has been […]

Background: Google searches for hospitals typically yield a Google star rating (GSR). These ratings are an important source of information for consumers. The degree to which GSRs are associated with traditional quality measures has not been evaluated recently. We sought to characterize the relationship between a hospital’s GSR, its Hospital Consumer Assessment of Healthcare Providers […]

Background: The advent of internal medicine procedure services within academic medical centers has had a profoundly positive impact on patient care, patient safety, and resident training (1-4). In general, these teams focus on performing invasive bedside procedures, including paracenteses, lumbar punctures, central venous catheter placements, thoracenteses, and ultrasound-guided peripheral intravenous catheter placements. Recently, the procedure service at […]

Background: Rhode Island was hard hit by the COVID pandemic due to a particularly toxic combination of demographic factors. It is a densely populated state, with a large immigrant population. The populace is older, poorer, and less educated than the rest of New England. At Kent Hospital, in Warwick, Rhode Island, the first case in […]

Background: Food insecurity (FI), the lack of access to nutritious food to maintain an active lifestyle, is associated with poor health outcomes and morbidities in both children and adults. COVID-19 has exacerbated FI and disproportionately impacts communities of color and low-income households. Hospitalization can be an important time to address FI as a social determinant […]

Background: Several studies have been conducted worldwide on gender discrimination in the medical field[1]. A Japan-based study showed that although the number of female physicians in the country doubled between 1980 and 2016, less than 10% held significant positions (e.g., professor)[2]. In Japan, discriminatory admission practices in several medical schools were publicized in 2018, revealing […]

Background: Interdisciplinary communication is essential for safe and high-quality patient care. Outside of bedside rounds, paging is the most used means for communication to clinicians (physicians and advanced practice providers (APPs)). Quality improvement (QI) initiatives have aimed to improve patient safety by expanding technology and standardizing paging communications as well as to characterize what types […]

Background: Every year, as many as 98,000 people die from medical errors within the hospital, making medical errors one of the top 10 leading causes of death in the United States(1). While the Accreditation Council for Graduate Medical Education (ACGME) has incorporated healthcare quality and patient safety into the Clinical Learning Environment Review (CLER) program […]