Background: Medical teams may take care of patients on multiple units. Traditionally, alpha-numeric pagers have been the primary means for nurses to contact resident physicians off geographic units. However, mobile devices are increasingly being used and there are few studies that have analyzed their effectiveness as a means of communication compared to pagers. Purpose: The [...]

Background: As the aging population with multiple comorbidities continues to grow in our country, appropriate resource utilization and efficiency of care remain a priority for many acute care facilities to reduce hospital acquired debility, healthcare costs, and improve patient experience. The physical therapist’s assessment of the patient’s functional capacity plays a crucial role in discharge [...]

Background: Over 35 million patients are hospitalized annually in the United States, with patients experiencing functional deconditioning due to acute illness and hospital acquired limitations on their mobility such as bed rest orders and lack of timely assessment of their functional status. Other contributing factors include medical devices such as chest tubes, drains, IV lines, [...]

Background: Unnecessary hospitalizations and testing for syncope remain common (1), and physician attitudes continue to favor overuse for syncope (2). Structured protocols, specialized units, and decision support algorithms may reduce health service use, but lack of data precludes the ability to advocate for use of a specific decision support algorithm (3). Purpose: Our primary aim [...]

Background: Overnight disruptions in sleep during acute care hospitalizations contribute to lower patient satisfaction, higher risk of delirium, and potentially, increased length of stay. One primary offender of quality sleep is high frequency collection of vital signs during overnight hours. Protocols for reduction in collection of overnight vital signs have been successfully implemented at other [...]

Background: Our 165-bed community hospital is in a phase of rapid growth due to demographic changes and expansion of services offered within the hospital. While offering unprecedented level of healthcare access to the community, improvement with emergency department (ED) throughput has emerged as one of our challenges from a patient safety perspective. Unnecessarily prolonged ED [...]

Background: Improvement of discharge times on house staff run medical floors is particularly complicated. Amato-Vealey et al. describe a domino effect of delayed discharges resulting in inability to transfer patients from intensive care units, advancement towards maximum capacity, and failure to move patients from the ER. This leads to delayed procedures, poor patient satisfaction, and [...]

Background: UChicago Medicine (UCM) Office of Operational Excellence (OE) uses an institutional Leadership model called “Engage, Evolve, Excel” (E3L) to improve care delivery with lean, six sigma, and patient centered values. The E3L model focuses on the four domains of value creation, patient-centered care, respect for people, and continuous improvement. A hallmark feature of E3L [...]

Background: VTE is associated with considerable morbidity and mortality, in fact, as many as 10% of deaths of hospitalized patients have been contributed to pulmonary embolism.1 The ACP and AACP in their 2011 and 2012 guidelines, respectively, recommend that all hospitalized patients be evaluated for risk of VTE, and subsequent prophylaxis be initiated if benefits [...]

Background: Acute Kidney Injury (AKI) is a common hospital problem which may lead to increased mortality, hospital costs, and increased length of stay (1). A leading cause of renal dysfunction in the inpatient population is drug nephrotoxicity. Several studies show that physician prescribers often do not take renal function into account with new or existing [...]