Background: The transfer of patients between hospitals (interhospital transfer, IHT), exposes patients to risks of discontinuity of care. In this study, we aim to better understand which patients may (or may not) benefit from IHT by evaluating the impact of IHT on clinically important patient outcomes among a variety of patient diagnoses. Methods: We performed [...]

Background: Inpatient antibiotic stewardship programs often use pre-prescription approval (PPA) or prospective audit and feedback (PAF) to reduce fluoroquinolone prescribing. Whether these stewardship strategies targeting inpatient fluoroquinolone use also influence prescribing at discharge is unknown. Therefore, we aimed to evaluate the effect of fluoroquinolone stewardship on discharge fluoroquinolone use in patients with pneumonia or a [...]

Background: The transfer of patients between hospitals (interhospital transfer, IHT), exposes patients to risks of discontinuity of care. In this study, we aim to better understand which patients may (or may not) benefit from IHT by evaluating the impact of IHT on clinically important patient outcomes among a variety of patient diagnoses. Methods: We performed [...]

Background: Inpatient antibiotic stewardship programs often use pre-prescription approval (PPA) or prospective audit and feedback (PAF) to reduce fluoroquinolone prescribing. Whether these stewardship strategies targeting inpatient fluoroquinolone use also influence prescribing at discharge is unknown. Therefore, we aimed to evaluate the effect of fluoroquinolone stewardship on discharge fluoroquinolone use in patients with pneumonia or a [...]

Background: Inter-hospital transfer (IHT, the transfer of patients between hospitals) exposes patients to risks of discontinuity of care. To identify aspects of the transfer process that increase risk, we examined the impact of select transfer process factors on clinical outcomes among patients undergoing IHT. Methods: We performed a retrospective analysis of patients ≥ age 18 [...]

Background: Medical errors commonly occur during transitions of care, but medical trainees receive little formal education in how to recognize and address those patients most at risk. Teaching third year medical students to identify risk factors for adverse events may highlight practice changes to enhance safety during transitions. Purpose: To determine if a Transitions of [...]

Background: Warfarin and other anticoagulants increase the risk of hemorrhagic complications, including upper gastrointestinal hemorrhages (UGIB). Warfarin is commonly used in the management of atrial fibrillation to reduce the risk of ischemic stroke, and frequently resumed following UGIB. However, optimal timing of reinitiation remains unclear. Theory suggests that resuming warfarin immediately after UGIB would lead [...]

Background: Accurate medication reconciliation during transitions of care can decrease medication related adverse drug events. The Joint Commission has prioritized medication reconciliation as one of the national patient safety goals. Effective pharmacist-physician-patient collaboration can improve the medication reconciliation process and thus medication safety for hospitalized patients Purpose: 1. Develop a standardized provider-pharmacist discharge medication reconciliation [...]

Background: Advances in technology and life-sustaining interventions afford patients access to a wider network of subspecialized care through inter-facility transfers. Implicit in these transfers are multiple complex steps that leave patients vulnerable to adverse events. The few guidelines that exist regarding the inter-facility transfer process focus on critically-ill or surgical patients, and emphasize pre-transfer communication [...]

Background: Transition from the inpatient to outpatient setting presents a safety risk to pediatric patients. Project IMPACT (Improving Pediatric Patient-Centered Care Transitions) is a multi-site quality improvement collaborative developed to improve the hospital to home transition for pediatric patients using a transition bundle. One bundle element is the use of teach-back (TB) to confirm caregiver [...]