Session Type
Meeting
Search Results for Quality Improvement
Abstract Number: 199
Hospital Medicine 2017, May 1-4, 2017; Las Vegas, Nev.
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 […]
Abstract Number: 203
Hospital Medicine 2017, May 1-4, 2017; Las Vegas, Nev.
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 […]
Abstract Number: 212
Hospital Medicine 2017, May 1-4, 2017; Las Vegas, Nev.
Background: Capacity constraints are a common problem at many academic institutions. At Duke University Hospital (DUH) , capacity constraints continue to result in critical bed shortages. Our affiliated hospital, Duke Regional Hospital (DRH) which is less than 5 miles away, has the capacity and capability to provide care to these general medicine patients. Shifting general […]
Abstract Number: 218
Hospital Medicine 2017, May 1-4, 2017; Las Vegas, Nev.
Background: In the past 20 years, the “10/30” rule for blood transfusions has been replaced with conservative guidelines which have demonstrated improved patient outcomes and reduced overall healthcare costs. Hospitals across the country have enlisted transfusion subcommittees to review the appropriateness of blood transfusions. Within medical training, resident physicians rotate with different attendings who have […]
Abstract Number: 223
Hospital Medicine 2017, May 1-4, 2017; Las Vegas, Nev.
Background: A “safe” hospitalist workload – that is, the point at which caring for too many patients leads to poorer outcomes for each individual patient – has not been defined. We sought to understand whether the workload of a resident-run inpatient team, measured by number of orders entered into the electronic medical record, was associated […]
Abstract Number: 232
Hospital Medicine 2017, May 1-4, 2017; Las Vegas, Nev.
Background: Sepsis is a leading cause of mortality among hospitalized patients. Early detection and intervention reduces sepsis-related mortality. We implemented a novel early warning system (EWS 2.0) based on a machine-learning algorithm to prospectively identify patients with increased risk of severe sepsis or septic shock. Validation suggested excellent predictive characteristics, including a positive likelihood ratio […]
Abstract Number: 254
Hospital Medicine 2017, May 1-4, 2017; Las Vegas, Nev.
Background: Patients are discharged home on medications different than those they were taking before admission. New and discontinued medications as well as dosage changes contribute to medication-related adverse events. Purpose: To help address this problem, interns in our program developed a standard process during their quality improvement (QI) curriculum to ensure that at least 95% […]
Abstract Number: 263
Hospital Medicine 2017, May 1-4, 2017; Las Vegas, Nev.
Background: Care transitions between hospitals, nursing homes, and home are a vulnerable time for patients. Given the increasing elderly population and the shortage of primary care physicians with training in geriatrics or nursing home care, there is a growing need to identify organizational systems to optimize physician practice, enhance quality of care and increase educational […]
Abstract Number: 270
Hospital Medicine 2017, May 1-4, 2017; Las Vegas, Nev.
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 […]
Abstract Number: 281
Hospital Medicine 2017, May 1-4, 2017; Las Vegas, Nev.
Background: Inappropriate antibiotic use is associated with bacterial resistance, adverse events, and an increased risk of Clostridium difficileinfection. However, providers often prescribe antibiotics for viral respiratory infections and treat infections such as bacterial pneumonia for unnecessarily prolonged durations. Serum procalcitonin (PCT)-guided treatment is known to safely reduce antibiotic use and duration of treatment in pneumonia. […]