Background: Some healthcare organizations struggle to improve quality. Identifying characteristics associated with underperformance may help inform approaches to improvement. Therefore, we sought to: (a) Identify organizational factors associated with low-performing healthcare organizations and (b) propose a conceptual framework with actionable domains, which we present as AMP (The Model to Amplify the Missing Potential), to inform [...]

Background: Some healthcare organizations struggle to improve quality. Identifying characteristics associated with underperformance may help inform approaches to improvement. Therefore, we sought to: (a) Identify organizational factors associated with low-performing healthcare organizations and (b) propose a conceptual framework with actionable domains, which we present as AMP (The Model to Amplify the Missing Potential), to inform [...]

Background: Respiratory rate (RR) is a predictor of adverse outcomes and an integral component of many risk prediction scores for hospitalized adults. Despite its clinical value, RRs are often inaccurate and may lead to misclassification of disease severity, potentially jeopardizing patient safety. Purpose: We sought to improve inpatient RR measurement by patient care assistants (PCAs) [...]

Background: Blood cultures are frequently ordered in hospitalized patients, often to work up undifferentiated fever or leukocytosis. This leads to low rates of positive cultures and high burden of false positive results resulting in avoidable interventions and waste. A recent study in hospital medicine patients identified several predictors of blood stream infection (BSI), but the [...]

Case Presentation: A 52-year-old homeless man with a history of a remote stroke with residual left sided hemiparesis and dysarthria, and poorly controlled diabetes presented with fever, diarrhea, left sided body pain and altered mental status for two days.The initial vital: tachycardia and temperature of 101.2 F. On exam, he had poor dentition, dysarthria, left-sided [...]