Session Type
Meeting
Search Results for Value
Abstract Number: 345
Hospital Medicine 2019, March 24-27, National Harbor, Md.
Background: Unnecessary laboratory orders are a well-known contributor to healthcare cost. Our residents identified “fear of attending” as a barrier to more mindful lab ordering. This project focused on educating attending physicians on high-value care and promoting resident-attending discussions. Purpose: Data was collected via anonymous pre and post-intervention survey (designed by the study team). Participants […]
Abstract Number: 346
Hospital Medicine 2019, March 24-27, National Harbor, Md.
Background: The United States is in the midst of a health quality crisis; for this to resolve, we must transform to a high-value, low-cost healthcare culture. To achieve such a culture, trainees must learn high-value care habits. We developed a 95-week longitudinal study to promote mindful laboratory habits in an internal medicine residency program. Purpose: […]
Abstract Number: 347
Hospital Medicine 2019, March 24-27, National Harbor, Md.
Background: A previous project targeting Medicine residents’ high-value care practices prompted evaluation of the non-resident hospitalist teams ordering practices. Would exposure to residents (receiving education on high-value care) translate to changes in attending physician ordering on hospitalist-only teams? Purpose: Participants included Medicine physicians attending on the non-resident and resident inpatient services. Data collected from the […]
Abstract Number: 360
Hospital Medicine 2019, March 24-27, National Harbor, Md.
Background: The Society of Hospital Medicine (SHM) identifies repetitive CBC & chemistry testing as low-value, and they selected this as a Choosing Wisely Recommendation. Overuse of phlebotomy is associated with hospital-acquired anemia, decreased patient satisfaction and increased hospital costs. Process improvement techniques have been utilized to reduce inpatient phlebotomy, but prospectively identifying a cohort of […]
Abstract Number: 369
Hospital Medicine 2019, March 24-27, National Harbor, Md.
Background: The Society of Hospital Medicine identified questioning the necessity of repeat labs in stable patients as a Choosing Wisely goal to improve overall value of care. Implications of unnecessary blood draws include over-testing, pain, decreased patient experience, and risk for iatrogenic anemia. Interventions to safely reduce provider lab orders have been applied in various […]
Abstract Number: 394
Hospital Medicine 2019, March 24-27, National Harbor, Md.
Background: As of 2017, 96% of non-federal acute care hospitals had an electronic health record (EHR). Hospitalists interact with the EHR for several hours each day. Many studies have suggested a direct correlation between physician burnout and frustrations with the EHR. Data has been published regarding physician time studies in the outpatient setting, but there […]
Abstract Number: 438
Hospital Medicine 2019, March 24-27, National Harbor, Md.
Background: Delivering HVC is a core component of hospitalist practice, and equipping residents with skills and experience to lead HVC initiatives is a priority for training institutions and for society. We describe the design, founding and implementation of the nation’s first Housestaff Council on Value and Innovation (HCVI) as a platform for engaging trainees in […]
Abstract Number: 439
Hospital Medicine 2019, March 24-27, National Harbor, Md.
Background: Hemoglobin and hematocrit, routinely measured in hospitalized patients, are likely affected by shifts in plasma volume related to posture. This could have important ramifications on hemoglobin trends overnight, resulting in over diagnosis of anemia and potentially unnecessary anemia work-up and treatment. We hypothesized that hemoglobin measured in early morning (supine) samples, after plasma shifts […]
Abstract Number: 444
Hospital Medicine 2019, March 24-27, National Harbor, Md.
Background: The burden of acute care among cancer patients, estimated to exceed $70B by 2020, represents ~50% of all costs of advanced cancer care and accounts for 70% of nationwide regional variation in these costs. The Centers for Medicare and Medicaid Services proposed value-driven Rule OP-35 includes a mandate to reduce acute care use among […]
Abstract Number: 449
Hospital Medicine 2019, March 24-27, National Harbor, Md.
Background: The use of maintenance fluids (MF, continuous intravenous fluid (IVF)) to prevent dehydration is common, yet highly variable in practice. Unnecessary MF can cause patient harm including fluid overload, sleep disruption (associated alarms), and increase falls risks. In 2017, Hurricane Maria destroyed Puerto Rican facilities that were critical in producing IVF, exacerbating an existing […]