Background: Asking patients “what matters” to them is one of the 4 evidence-based elements of care developed by the Age-Friendly Health Systems initiative to improve the care of older adults, and the question “what matters most” has been extended to other settings. We conducted a study to assess the frequency and categories of responses to [...]

Background: Diabetes Mellitus is a growing concern in the USA, affecting around 10.5% of the population or approximately 34.2 million people. West Virginia has the highest prevalence of adult diabetes, with 16.2% of the population diagnosed in 2018. In noncritical care hospitalized patients, new-onset hyperglycemia and patient with diabetes make up 25-30% of the census. [...]

Background: Constipation is commonly encountered in patients admitted to the hospital, with a variety of possible treatments to choose from. Docusate is often prescribed to treat constipation, though evidence suggests it is ineffective. Utilizing an ineffective medication adds to patients’ pill burden, health care costs, and may delay the use of effective medications with downstream [...]

Background: Evidence-based guidelines/protocols for electrolyte replacement that safely encourage oral (PO) and/or intravenous (IV) dosing attain goal levels more successfully than standard care.1-17 PO is generally more comfortable and less dangerous than IV. Between 5/2017-11/2017, Jefferson dosed ~300,000 doses of potassium (K) and magnesium (Mg), with 30% and 19% of doses being PO, respectively. Guiding [...]

Background: Project Caring for Patients with Opioid Misuse through Evidence-Based Treatment (COMET) launched in 2019 to provide patients with opioid use disorders (OUD) individualized and evidence-based care at Duke University Hospital (DUH). Patients with OUD have higher rates of self-directed discharge (SDD) which is associated with higher healthcare utilization costs, hospital readmissions, and adverse health [...]

Background: Facing challenges of capacity strain, many hospitals have implemented programs to prioritize discharges in the morning as a strategy to improve patient throughput, decrease emergency room boarding, and improve patient satisfaction/experience. (1) However, evaluations of these practices have had mixed results. (2) Like many other complex health interventions, priority discharge interventions may fail to [...]

Background: Alcohol use disorder (AUD) is a pervasive disease affecting 28.6 million (11.3%) American adults in 2021.1 Medications for AUD (MAUD), including naltrexone, acamprosate, and disulfiram, are effective, yet less than 5% of these patients received treatment.1,2    Inpatient encounters of patients with AUD present a crucial opportunity to initiate MAUD, prompting this quality improvement [...]

Background: Many U.S. emergency departments (EDs) and hospitals experience critical overcrowding and capacity challenges which has been exacerbated by the COVID-19 pandemic.(1) ED boarding has been associated with a range of adverse outcomes, and pre-pandemic data suggests that racial minority patients may be disproportionately impacted.(2-4) We aim to identify the effects of patient race and [...]

Background: The emergence of hospitalists over the last 25 years as leaders in quality, safety, and value-based care has resulted in improvements in hospital throughput and reduction of in-hospital complications (1). The keys to success are standardizing clinical pathways and interdisciplinary collaboration. At Tampa General Hospital (TGH), our hospitalist team observed significant variability in the [...]

Background: Hospital length of stay (LOS) serves as a key quality metric for evaluating efficient hospital management within health systems. improving LOS enables hospitals to effectively handle both elective and emergent admissions. Excessive demand without corresponding capacity results in emergency department and unit crowding, leading to unfavorable mortality outcomes, impacts patient and provider experiences, contributes [...]