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Search Results for IMPROVE
Abstract Number: 277
Hospital Medicine 2020, Virtual Competition
Background: Many hospitalized patients spend most of their admission laying in their hospital beds. This can lead to in-hospital complications such as skeletal muscle atrophy, bedsores, and venous thromboembolism. In-hospital decline in ability to perform ADLs is associated with need for post-acute facility placement and readmission. We aimed to increase the percentage of patients admitted […]
Abstract Number: 282
Hospital Medicine 2020, Virtual Competition
Background: Pneumocystis jirovecii pneumonia (PJP) is an opportunistic infection associated with lymphopenic conditions including HIV/AIDS, hematologic malignancy1, organ transplantation2, and lymphocyte-suppressive therapies such as high dose glucocorticoids3,4. PJP prophylaxis, which is highly effective, is indicated when the incidence of PJP exceeds the rate of adverse events due to prophylaxis.4,7 Guidelines from the American Thoracic Society […]
Abstract Number: 283
Hospital Medicine 2020, Virtual Competition
Background: Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), constitute a major health problem in the United States Health System, with a reported high mortality rate and significant economic toll. Despite the prevalence of VTE and associated mortality, clinicians have struggled in prescribing appropriate VTE prophylaxis for the inpatient population, often […]
Abstract Number: 284
Hospital Medicine 2020, Virtual Competition
Background: Hospitalized patients are often kept fasting for various reasons, including clinical conditions, procedures and imaging, or dysphagia (1). Studies have demonstrated the harm of excessive fasting, including increased post-operative delirium (2), thirst and hunger, and patient dissatisfaction. Accordingly, recent guidelines have promoted a more liberal preoperative fasting strategy, namely, allowing clear liquids up to […]
Abstract Number: 312
Hospital Medicine 2020, Virtual Competition
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 […]
Abstract Number: 332
Hospital Medicine 2020, Virtual Competition
Background: Fingerstick blood glucose (FSBG) testing allows inpatient providers to adjust insulin in real time to protect patients from significant hypo- or hyperglycemia. Admitted diabetic patients are often placed on sliding scale insulin with four times per day FSBG testing, regardless of home insulin use. FSBG test materials cost $9 per use (1). We estimate […]
Abstract Number: 334
Hospital Medicine 2020, Virtual Competition
Background: Physical therapy (PT) is a valuable tool to help prevent the functional decline and loss of mobility hospitalized patients experience. Yet, it is a constrained resource in most hospital settings. The AM-PAC score is a validated tool that has been used to predict discharge destination within 48 hours of admission. It has also been […]
Abstract Number: 347
Hospital Medicine 2020, Virtual Competition
Background: Late afternoon hospital discharges contribute to admission delays, leading to occupancy increase and increased length of stay. However, prominent workplace barriers often exist towards improvement initiatives that target early discharge. Team members cite timing of rounds, absence of early discharge support resources, communication breakdowns, and increased daytime admission volume as barriers to change. Furthermore, […]
Abstract Number: 348
Hospital Medicine 2020, Virtual Competition
Background: There is often little communication across inpatient medicine teams at a busy academic medical center. Although teams comprise trainees across many levels, individual teams often work in parallel without relating shared challenges and experiences. This can be isolating, and practicing in such silos can propagate systems issues and contribute to burn out. Purpose: Create […]
Abstract Number: 368
Hospital Medicine 2020, Virtual Competition
Background: Calls to action to address well-being recommend addressing systems drivers and improving the culture of medicine, in addition to devoting attention to individual self-care. In 2018, an internal medicine residency well-being elective was developed to teach residents about systems and cultural drivers of well-being in residency, and to facilitate deep exploration through individual systems […]