Background: Assessing vitals at regular intervals can be disruptive to a patient’s rest and unnecessary if the patient is clinically stable. These interruptions may lead to impaired sleep, parental fatigue and anxiety, delayed discharge, and increased cost of care. Moreover, alarm fatigue has been described with over-monitoring of patients, as has the overuse of staff […]

Background: One of the challenges in hospital medicine is the care of patients overnight, when the primary team is unavailable, and care is being provided by those who are not as familiar with the patient. This is compounded by the high volume of pages at night. At UNC Rex Hospital, these factors resulted in delays […]

Background: After discharge from an acute care hospitalization, cancer patients may choose to pursue rehabilitative care in a skilled nursing facility (SNF). Our objective was to examine receipt of anti-cancer therapy, death, readmission, and hospice use of cancer patients who discharge to a SNF compared to those who discharge home or home with home health […]

Background: Family-centered rounds on our pediatric hospital medicine teaching service, which cares for patients in multiple units throughout the hospital, are often prolonged with unpredictable progression. This contributes to inconsistent nursing participation, inefficiencies in patient care, and variable end times. Through the implementation of scheduled-based rounding, our aims were to: 1) start 90% of rounds […]

Background: Effective nurse-physician communication is imperative to safe, patient-centered care. Poor communication can lead to adverse events, ranging from near misses to patient deaths. It is important for information to be accurate and timely. In addition to patient safety, there are financial implications to poor communication. According to a 2015 study, communication failures in the […]

Background: Physical (PT) and Occupational therapy (OT) are valuable entities, but are overused in hospitals. There is limited published literature on the appropriate utilization of PT and OT evaluations in hospitals. Analysis of all PT/OT referrals for 2018 at NewYork Presbyterian Weill Cornell showed that PT/OT orders were part of the admit order set. These […]

Background: Medically complex patients discharged from hospitals to skilled nursing facilities (SNFs) are at high risk for unintentional errors, re-hospitalization, and mortality. Commonly reported transitional care errors include poor communication of critical information, limited access to medical records, and lack of clarity as to follow-up plans or patients care goals. Telehealth is increasingly used in […]

Background: Length of stay (LOS) is an important quality indicator and has significant financial implications and impact on hospital throughput. Geriatric Fracture Center (GFC) is a co-management program between Hospital Medicine and Orthopedic for patients who are age 60 and above with fragility fracture. Delays in skilled nursing facility (SNF) rehabilitation placement are a major […]