Background: Hospitalists are tasked with improving care quality across several different inpatient metrics. These include length of stay, readmission rates, health care associated infections, system capacity and patient satisfaction scores. While most quality metrics are driven by systems of care, it can be challenging for frontline providers to address variations in individual practice, if any, [...]

Background: At our Tertiary Care, Academic, Level 1 Trauma Center, length of stay (LOS) has increased over the past year. This has been associated with increased occupancy, increased boarding in the ED and increased volumes on the Medicine teams. In response, reducing LOS has has been targeted as a strategic priority for the institution. Existing [...]

Background: Measures to reduce hospital readmissions help to improve the quality of care patients receive, as well as reduce healthcare costs. The Institute for Healthcare Improvement’s Triple Aim of improving the quality of care through standardization, decreasing the cost of care by reducing hospital utilization, and patient-centeredness around transitions of care, resonate strongly with readmission [...]

Background: Sepsis is a leading cause of morbidity and mortality in the US. Annually, over 250,000 people die from sepsis nationwide. Therefore, in 2013 New York State mandated that hospitals adhere to standardized protocols designed to improve sepsis outcomes. A recent cohort analysis on the rollout of these standards demonstrated that mortality decreased by 6% [...]

Background: Congestive heart failure (CHF) is a major cause of mortality and morbidity among general population despite recent advancements in goal-directed therapies. The advent of mechanical circulatory devices, the increased availability and improvement in heart transplant techniques have improved some metrics; however, CHF patients continue to have multiple readmissions for acute exacerbations. The frequency of [...]

Background: Prevalence of alcohol use disorder (AUD) on inpatient medicine wards exceeds 40%. Only 50% of these patients develop alcohol withdrawal, of whom only 5-20% develop complicated alcohol withdrawal syndromes (AWS) that warrant treatment and monitoring. Overutilization of the Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised (CIWA-Ar) scale is well-reported in the literature. CIWA-Ar [...]

Background: Over the last 2 decades there has been increasing adoption of Observation (OBS) units across the healthcare facilities in United States. Health reforms like 2 midnight rule and 30 day readmission penalties, congestion in the ED, poor operational outcomes in OBS population mixed with inpatients (IP) etc. further added to the need for dedicated [...]

Background: Catheter occlusion is one of the most common complications associated with Peripherally Inserted Central Catheter (PICC) insertion, affecting 1 in every 8 PICCs placed. Occlusion may have important consequences for patients including inability to use the device, delays in tests or treatment, or if irreversible the need to remove and replace the device. Based [...]

Background: Heart Failure (HF) is an important health care issue given its high prevalence, mortality, and cost of care. By 2030, greater than 8 million Americans will be living with HF. The projected cost will increase to close to 70 billion with the majority of the cost attributed to hospitalization. Despite numerous evidence-based strategies in [...]

Background: Social isolation (SI) is a largely silent and unrecognized social determinant of health that has negative health outcomes, including increased mortality, depression, hospital readmissions, and emergency room visits. In addition, a recent study revealed that SI and loneliness (L) are self-reported as often as food and housing insecurity. While hospitals readily work on food [...]