Background: The HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) survey is the first national, standardized, publicly reported survey of patient perspectives of hospital care. HCAPS scoring is tied not only to hospital compensation, but also is an important indicator of and reflection of interactions with patients. Specifically at Rhode Island Hospital, the goal […]

Background: Timely treatment of sepsis is the cornerstone of reducing sepsis-related morbidity and mortality, and a large body of work has demonstrated improved patient outcomes with initiation of early empiric antibiotics. Time to antibiotics after first sepsis recognition has increasingly gained attention as a quality of care metric with Surviving Sepsis Guidelines recommending initiation of […]

Background: There is recognition by educational regulatory bodies that physicians need to have some level of leadership skills. In 2007 the Residency Review Committee for Family Medicine approved a new requirement for training in leadership during family medicine residency. Seven years later in 2014, the Journal of Graduate Medical Education published the relationship between physician […]

Background: Morbidity and Mortality (M&M) conferences are common practice among internal medicine (IM) residency programs, but their effect on education and patient safety (PS) is inconsistent.[1,2] Existing research reports have struggled to identify best practices for implementing M&M conferences due to inherent variability in personnel and adverse event analysis processes. We need interventions that account […]

Background: Acute exacerbations of Chronic Obstructive Pulmonary Disease (AECOPD) are a major driver of hospitalizations. With a goal of reducing AECOPD admissions at the Cleveland VA Medical Center (VAMC), an interdisciplinary team was developed after a literature review and discussion with high-performing VA groups. Purpose: Primary aim was to decrease AECOPD hospitalizations and readmissions at […]

Background: Feedback in clinical training is essential to reinforce positive behaviors and to provide areas for improvement. Numeric ratings from student performance evaluations are helpful but are not sufficient to guide the learner in areas where they excel and where they may need additional development. Narrative written feedback both reinforces verbal feedback and provides support […]

Background: Appropriate and timely documentation of rapid response events has been shown to have a significant impact on patient care and outcomes. Prior to January 2021, our institution did not have a standardized rapid response note template to facilitate best clinical documentation practices. A review of rapid response events at our institution that occurred during […]

Background: Telemetry overuse contributes to excess healthcare costs, unnecessary workup of incidentalomas, and alarm fatigue. To curb overuse, guidelines such as the 2017 AHA/ACC continuous ECG monitoring practice standards have outlined appropriate telemetry use standards. The aim of this study was to perform a rapid “plan-do-study-act” (PDSA) cycle and assess whether a nursing (RN)-driven checklist […]

Background: An estimated 1 in 5 patients are at risk for being readmitted to the hospital within 30 days of discharge. Readmissions put a large financial strain on the United States healthcare system and increase risk for poor patient care outcomes. The Centers for Medicare/Medicaid Services publicly report readmission data and have financial penalties for […]

Background: Physical therapy (PT) in the inpatient setting is a limited and valuable resource. Inappropriate PT consultation is costly and can lead to delays in care. Overutilization of inpatient PT services is an increasingly recognized problem. Patients with minimal or no functional limitations frequently receive PT evaluation, diverting resources and delaying care for the patients […]