Background: Hospitalists increasingly rely upon electronic handoff tools to communicate important patient care information. Our institution transitioned from a paper/verbal handoff process to a completely electronic system in April 2017 for day-to-night patient care handoff. In the fall of 2016, the same system had been adopted for end-of-week service change. Purpose: This study set out [...]

Background: Sepsis, which is life-threatening organ dysfunction occurring in response to systemic infection, is a frequently fatal syndrome for which early recognition and treatment are paramount. While there are some reports that female and black patients with sepsis experience greater delays in time to antibiotics, there is an overall paucity of published data on whether [...]

Background: Adverse drug events (ADEs) are responsible for up to 770,000 inpatient injuries and deaths annually in the United States, most of which are from prescribing errors. Electronic order sets are designed to improve quality by reducing care variability and increasing efficiency of order entry, but may also facilitate prescribing errors via automation bias. There [...]

Background: Heparin-Induced Thrombocytopenia (HIT) is an antibody-mediated pro-thrombotic disorder which occurs after exposure to heparin product. Diagnosis of HIT type II is rather challenging as affected individual often has other causes of thrombocytopenia and a delayed discontinuation of heparin in HIT type II is associated with a mortality rate of 20-30%. 4Ts score is a [...]

Background: Since the advent of Electronic Health Record(EHR) and subsequent workload of clinical documentation, Hospital Medicine physicians are finding themselves spending more time in front of the computer and less with their patients. The implementation of EHR was intended to help physicians improve productivity and quality, however, data shows we are spending up to 25% [...]

Background: Telemetry is utilized on high risk cardiac patients for monitoring of arrthymias. Guidelines providing clear monitoring indications have been published by AHA to reduce overuse of this resource, which can lead to increased care costs and false positive alerting. Despite the above evidence, our hospital has a high volume of patients on telemetry causing [...]

Background: The Intermediate Care Unit (IMU) was developed in the 1960s – 1970s as a level of care between general medicine (GMU) and intensive care units (ICU) [1]. The Society of Critical Care Medicine has established guidelines for admitting patients to an IMU based on severity of illness or need for frequent or complex nursing [...]

Background: The use of IV insulin is one of the primary therapeutic options for the treatment of hyperkalemia. Unfortunately the available literature reports that hypoglycemia is a common occurrence as a result of the treatment of hyperkalemia. During our safety event review process, we identified the same issue within our own institution. Due to reports [...]

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 [...]

Background: Electronic prescribing (eRx) at discharge enhances safety and quality of care transitions. It results in improved medication adherence and a decreased chance of readmission. Stage 3 Meaningful Use goals include discharge eRx rates of greater than 25%. As of September 2017, our large academic medical center had a year-to-date discharge eRx rate of 18.3%, [...]