Background: Adverse drug events (ADEs) result in more than 770,000 injuries and deaths each year and cost up to $5.6 million per hospital, depending on size. The hospital admission is often where the patient is most vulnerable to ADEs. Medication reconciliation on admission is a formal process by which efforts are made to ascertain a [...]

Background: A lack of standardization in care delivery can lead to variations in outcomes in the high-risk work of neurosurgery. The aim of this program was to develop, implement and evaluate the impact of three standardized interventions to improve neurosurgical patient outcomes and experiences. Methods: Hospitalists partnered with Anesthesia and Neurosurgery leaders from five large [...]

Background: Driven by the current opioid epidemic, drug overdose has become the leading cause of unintentional death nationwide. Efforts are underway to decrease unnecessary opioid prescribing. Hospitalists care for many patients with preexisting opioid prescriptions or appropriately prescribed new opioids at discharge. Though naloxone decreases the morbidity and mortality associated with opioid overdose, most patients [...]

Background: As a group of medical students in a five-week leadership program, we were charged with making a medicine inpatient unit at an urban quaternary care academic medical center the best unit in the hospital. Research shows that the hospital spends an estimated $2721 for every inpatient day (Kaiser, AHA Annual Survey, 2015). Longer lengths [...]

Background: An effective patient safety and quality improvement (QI) curriculum is imperative for graduate medical education (GME) training programs. Yet many health systems are lacking pedagogical training in these methods. Learning often takes the form of group project work, yet projects may not reflect institutional priorities, duplicate ongoing efforts, or remain unfinished after allotted time [...]

Background: As many other hospitals of its size, our tertiary academic care center frequently operates at greater than 100% capacity. Medical admissions boarding in the Emergency Department (ED) while awaiting inpatient beds represent a bottleneck in hospital patient flow. Hospitalist led management of this group of patients has been identified as a potential solution to [...]

Background: Elevated blood pressure (BP) is common among hospitalized patients, with prevalence estimates between 50-70%. Many factors may contribute to this, such as pain, nausea, anxiety, or volume overload. However, true hypertensive emergency requiring rapid reduction in BP is relatively rare. The easy availability of intravenous (IV) antihypertensives may lead to unnecessary treatment of asymptomatic [...]

Background: The high prevalence of diabetes makes it a common co-morbid condition in hospitalized patients. Healthcare systems have increasingly focused on 30-day readmission rates to improve quality and reduce costs. Readmission rates for patients with diabetes are much higher than the rate for all hospitalized patients. In a recent retrospective analysis, formal diabetes education by [...]

Background: Vascular access is an integral part of inpatient care. Difficult access can result in delays and inappropriate access selection or technical placement can have quality and financial implications, particularly those associated with catheter-line associated blood stream infections (CLABSI). At our institution, vascular access had historically been provider driven resulting in non-standardized selection practices with [...]

Background: Readmissions continue to be a significant burden on health systems and in 2017 nearly 80% of all hospitals face financial penalties for 30-day readmissions. There are limited examples of standardized processes for notifying discharging physicians of readmissions real-time and encouraging physician self-reflection on reasons for readmissions. Purpose: In the present study, we created a [...]