Background: Hospitalists generally work one week on, one week off. Different hospitalists group switch on different days of the week, with almost all days of the week reported as switch days in the literature. It is unclear if choosing a particular day of the week as the switch day has an impact on length of [...]

Background: Interhospital transfer (IHT) is often performed to provide patients with necessary specialized care. While there are numerous examples of racial/ethnic health inequities in our healthcare system, inequities in IHT are not well-characterized. We sought to determine if there are racial/ethnic inequities in IHT among patients with select conditions previously associated with a mortality benefit [...]

Background: Obtaining the Best Possible Medication History (BPMH) is the protocolized gold standard in obtaining medication histories and well known to decrease the total number of medication errors during transitions in care. Trained technicians require an average of 15-30 minutes to collect a BPMH [2]. Our facility conducted a categorical analysis and within subject study [...]

Background: Medication reconciliation programs are a well-recognized important tool in reducing medication discrepancies and subsequently decreasing patient harm, particularly at transitions of care. Medication reconciliation programs have demonstrated error reductions upward of 66% [1-4]. 39% of prescription medication history errors have the potential to cause moderate or severe discomfort or deterioration in a patient’s condition [...]

Background: With growing importance placed on patient safety, it has become necessary to elevate past processes and rethink rolls for experienced healthcare professionals. One of the primary goals identified by The Joint Commission is to “maintain and communicate accurate patient medication information” to “safely prescribe medications in the future” [1]. This task is often complicated [...]

Background: Background: Patients transferred between hospitals undergo a high-risk transition of care, where communication is asynchronous, information is commonly lost, and mortality is disproportionately high. Prior studies have shown that standardizing communication through checklists can improve outcomes, and conversely lost documentation has been associated with higher mortality. The lack of interoperability of electronic health records [...]

Background: Effective discharge planning requires early identification of patients’ post-acute care needs as well as potential barriers to placement. Housestaff receive little formal training on discharge planning and are instead expected to learn “on-the-go”. At the West Los Angeles Veterans Affairs (WLAVA) Medical Center there exists many disposition options that aren’t available to our housestaff [...]

Background: Procalcitonin (PCT) testing has been shown in randomized trials to decrease antibiotic exposure and be a reliable predictor of clinical response to antibiotics in lower respiratory tract infection (LRTI) and sepsis. Although studied to guide antibiotic discontinuation in LRTI and sepsis, optimal strategies for introducing PCT into “real-world” clinical use are unknown. Our study [...]

Background: Myelofibrosis is a chronic myeloproliferative neoplasm characterized by progressive bone marrow fibrosis and extramedullary hematopoiesis leading to splenomegaly. Progressive splenomegaly is common in advanced myelofibrosis, and spleen volume is a predictor of survival. The oral selective small-molecule JAK 1/2 inhibitor ruxolitinib is used for symptomatic management of intermediate-2 and high-risk myelofibrosis, and leads to [...]

Background: Telemetry beyond 48 hours is indicated for a select patient population and when used inappropriately has risk. This includes increased cost of care, skin irritation, delirium contribution, and more likely to have false positives resulting in errors or extending length of stay.To encourage care that is truly necessary, free of harm, not duplicative, and [...]