Background: Sleep deprivation has deleterious effects on immune function, wound healing, insulin resistance, pain, and even mortality. Patients in hospitals often suffer from sleep deprivation due to environmental noise and interruptions from staff. The American Academy of Nursing Choosing Wisely guidelines recommend not to “wake the patient for routine care unless the patient’s condition or [...]

Background: In 2016, ACGME’s first Clinical Learning Environment Review (CLER) report found that trainees had limited knowledge of Quality Improvement (QI) and patient safety (PS) concepts.. Purpose: We have designed a free, interactive, web-based game named SafetyQuest (http://safetyquest.stanford.edu) to teach QI and PS concepts. Objectives include: 1) Increasing knowledge regarding actions to promote safety such [...]

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: In 2016, ACGME’s first Clinical Learning Environment Review (CLER) report found that trainees had limited knowledge of Quality Improvement (QI) and patient safety (PS) concepts.. Purpose: We have designed a free, interactive, web-based game named SafetyQuest (http://safetyquest.stanford.edu) to teach QI and PS concepts. Objectives include: 1) Increasing knowledge regarding actions to promote safety such [...]

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: Sleep deprivation has deleterious effects on immune function, wound healing, insulin resistance, pain, and even mortality. Patients in hospitals often suffer from sleep deprivation due to environmental noise and interruptions from staff. The American Academy of Nursing Choosing Wisely guidelines recommend not to “wake the patient for routine care unless the patient’s condition or [...]

Background: Hospital Medicine groups are often called upon to lead initiatives that require access to high-quality data from their local health system. These include quality and value improvement (QI) efforts as well as health services and outcomes research. Although these efforts can be important for clinical operations as well as academic advancement, clear mechanisms to [...]

Background: Hospital-acquired delirium is serious, leading to increased falls, pressure ulcers, length of stay (LOS), cost, patient institutionalization, and patient and caregiver distress. In addition, it is associated with mortality rates as high as 35-40% within one year in older patients who develop delirium. Because hospital-acquired delirium is often under-recognized and prevention and treatment involves [...]

Background: Skin and soft tissue infection (SSTI) is a common pediatric diagnosis with substantial economic cost. SSTIs vary in severity and clinical presentation. Providers often fear missing serious systemic infection, causing potential overtesting. However, recent studies suggest that blood cultures (BCx) are not useful in management of simple cellulitis or abscess (uncomplicated SSTIs [uSSTI]), and [...]

Background: The Hospitalist Division at Washington University in St. Louis provides coverage for multiple different services at Barnes-Jewish Hospital. At the present time, there are a total of 68 MDs and 6 NPs caring for greater than 100 patients on a daily basis. Our main Hospital Medicine service is comprised of 11 different Hospitalist attending [...]