Background: Inpatient hospital care cost $971.8 billion in 2014 and costs are projected to rise by 5.8% per year. Inpatient operational efficiency and waste reduction have become the focus of cost-reduction measures. A recent study found that nearly one in four patients in a pediatric hospital experienced a medically unnecessary prolonged length of stay with [...]

Background: With gender inequalities decreasing in the Western Hemisphere, the number of women physicians has increased. However, women are not equally represented in leadership roles in academic medicine. One heoryabstract?te referenc es  isubmissionseukocytosiser’petition were selected. ors than female mentors. l then be determined iOOn theory in literature to explain this discrepancy is that women have [...]

Background: In 2016, the Centers for Medicare & Medicaid Services (CMS) released a guide to preventing readmissions among diverse patient populations. According to CMS, once the health system effectively picks up the root causes and characteristics that are linked to readmissions – then a process can be initiated that focuses on addressing barriers and developing [...]

Background: It has been detailed in the literature that a patient’s socioeconomic status (SES) may play a role in their risk of readmission for specific diseases. For instance, factors such as low income, low educational level, and Medicaid status have all been associated with significantly higher rates of readmission in patients initially admitted for congestive [...]

Background: The 2011 the updated IDSA guideline on Community Acquired Pneumonia (CAP) in children recommends a blood culture in children with moderate to severe bacterial CAP requiring hospitalization.  This recommendation was included in the Seattle Children’s Hospital (SCH) Clinical Standard Work (CSW) CAP pathway, for several reasons: (1) blood culture results would drive treatment decisions, [...]

Background: Evidence is equivocal that unit-based interventions improve quality on inpatient medical services, but most studies have reported their effect in isolation. These interventions may be better conceptualized as complementary components of a redesigned clinical microsystem. A clinical microsystem is defined as the small group of people who work together in a defined setting on [...]

Background: Audit and feedback improves clinical care by highlighting the gap between current and ideal practice.  Electronic health record (EHR) data can provide contemporaneous data for quality improvement but has not yet been studied extensively.  We conducted a randomized trial to determine whether audit and feedback leveraging EHR data with modern web-based dashboards could improve [...]

Background: Delays in care may lead to increased length of stay and cost. Identifying and quantifying the reasons for these delays could help target interventions and reduce unnecessary hospital days. Methods: We conducted a cross-sectional observational study at a large tertiary academic medical center, from October 16, 2016 to November 20, 2016. The study participants [...]

Background: The measurement of fluid balance (FB) for hospitalized patients has been a standard of nursing practice for many years, but its utility and accuracy is questioned in the literature. There is no gold standard benchmark for accuracy of FB measurement. From a clinician’s standpoint, FB data are essential in guiding treatment decisions.  The inaccuracy [...]

Background: Patient complaints reflect their unmet expectations and are a valuable resource to understand key drivers of patient experience. It is unclear, however, how patient complaints can be used to improve service quality and guide improvement work Purpose: Our objective was to identify a strategy to decrease the number of patient complaints and enhance patient [...]