Background: Although there are a number of advantages to documenting in an electronic health record (EHR), such as legibility and accessibility, providers nationally have observed that aspects of the quality of provider documentation decline after implementing an EHR. Concerns generally fall into 1 of several categories: “note bloat” (the overinclusion of autopopulated data leading to […]

Background: Many hospitals have focused on discharging patients before noon as a goal to improve throughput and decrease length of stay. However, those patients who can be discharged early in the day may actually represent a loss and not a win for the system, as they could have potentially been discharged the evening before. Methods: […]

Background: Patient satisfaction has attracted increasing attention as a surrogate indicator for quality of care and as a component of the new physician compensation structure. Interpersonal patient–physician relationships, a component of patient satisfaction, may be adversely affected by communication barriers and is of particular concern for the rising United States population of Hispanic/Latino (H/L) patients […]

Background: Health care equity, one of the six domains of high-quality health care as defined by the Institute of Medicine, will only be achieved when health care outcomes do not vary based on patient social characteristics, such as gender, race, ethnicity, geographic location, and socioeconomic status. Readmission is a significant outcome for patients and health […]

Background: Palliative care in seriously ill patients has been shown in some studies to improve satisfaction, symptoms, inpatient mortality rates, healthcare utilization and cost. While inpatient palliative care has been shown to improve symptoms and quality of life measures, the literature on its association with 30-day readmissions have been mixed for heart failure hospitalizations. We […]

Background: Adverse outcomes in surgery account for up to $25 billion expenditure annually. This is despite spending >$30 billion annually on preop testing. Although algorithms and checklists have improved outcomes in a pocketful of areas like infection control and team communication, the same momentum has not been attained in several practice areas including preoperative medical […]

Case Presentation: A 77‐year‐old man with laryngeal squamous cell carcinoma presented with shortness of breath and pleuritic chest pain. He was diagnosed with a pulmonary embolism and started on a heparin infusion. Following multiple failed attempts to advance the guidewire, a peripherally inserted central catheter (PICC) was inserted into the basilic vein of the right […]

Background: Agency of Healthcare Research and Quality reported an increase in Opioid-related hospitalizations from 2005 to 2014. Previous studies in patients undergoing surgery have shown an increased risk of readmission with opioid dependence. This study was intended to identify the all-cause 7 and 30-day readmission rates of hospitalizations with opioid-related disorders, and potential predictors of […]

Background: The Hospital Readmissions Reduction Program (HRRP) incentivizes acute care hospitals to decrease their preventable readmissions by putting hospitals at risk of reduced Medicare reimbursements. There exist many sources of heterogeneity in the actual incentives individual hospitals face each year. The HRRP applies the same methodology to hospitals regardless of their share of Medicare patients, […]

Case Presentation: A 38‐year‐old man presented with sudden‐onset fever and a rash on his face and shoulders that rapidly progressed to his trunk, arms, and lower extremities within a few hours. He denied recent illness, travel, or medications. He reported a 2‐week history of binge drinking and daily use of injection and intranasal cocaine. Initial […]