Background: Hospitalized medical patients transitioning to new house staff at the end of an inpatient resident rotation are associated with an increased risk of mortality as compared with patients not exposed to such handoffs, yet no data exist on improvement strategies targeting this transition. Given the frequency with which residents rotate service, a transition in [...]

Background: Transitions from hospitals to the ambulatory setting are high risk periods for patients. Many interventions have been tried, with varying degrees of success, and often the problem has been with implementation rather than theoretical efficacy of the intervention.Methods: We developed, implemented, refined, and evaluated a multi-faceted, multi-disciplinary transitions intervention across two hospitals and 18 [...]

Background: Transitioning patient care between hospitals and skilled nursing facilities (SNFS) brings many challenges.  Patient and family anxiety, unfamiliarity and even misinformation about SNFs increase the opportunity for unsatisfactory outcomes and readmissions to the hospital..  Previous research has demonstrated frequent and potentially harmful medication discrepancies during hospital to nursing home transitions, and low frequency of [...]

Background: Emergency department (ED) overcrowding is a commonly encountered challenge and is associated with adverse events and poor patient satisfaction.  One of the factors that can contribute to ED overcrowding is the boarding of admitted patients in the ED. Various methods have been implemented to improve this issue with limited success.     Purpose: A collaborative workgroup [...]

Background: Multiple studies have established that delays in discharge summary transmission were associated with higher rates of all-cause hospital readmissions.    It has been recently shown that delaying the completion of discharge summaries beyond 72 hours increased the risk of 30-day readmissions by 9%.  We had embarked on an initiative to improve the rate of discharge [...]

Background: Communication breakdown plays a part in the majority of adverse events in healthcare. Physician to physician handoffs are particularly prone to communication errors, yet have been shown to be more complete when systematized according to a standardized bundle. However,  the degree to which individual elements of this bundle, including written versus verbal handoffs, contribute [...]

Background: Patient understanding of prescription medication regimens is an important aspect of health literacy and inpatient medication reconciliation. There is a lack of data regarding patient knowledge of their own outpatient prescription medications. This study evaluated the ability of patients admitted to a community hospital medicine service to provide, from memory, their preadmission prescription medication [...]

Background: Peripherally inserted center catheter (PICC) use is associated with many complications including thromboembolism. The role of pharmacological prophylaxis in prevention of PICC line related thromboembolism is controversial. In our study,we assessed the role of pharmacological prophylaxis in the prevention of PICC line related thromboembolic complication. Methods: We reviewed the electronic medical records in our center [...]

Background: Approximately 1-2% of the U.S. population gets community-acquired pneumonia (CAP) annually in the U.S. and CAP is associated with substantial mortality, morbidity and costs.  While the incidence of CAP is well-defined, the incidence of outpatients who fail antibiotics and eventually become hospitalized is less clear.  The objective of this study was to provide real-world [...]

Background:  By 2026 the number of prostate cancer survivors is expected to reach 4.5 million. Although the mortality from prostate cancer has been steadily decreasing, cancer survivors usually have poor outcomes compared to their peers without cancer. The majority of the cancer survivors are over the age of 70 and have progressive medical comorbidities. Identifying [...]