Background: Overnight vital sign assessment can disrupt sleep in the hospital and may be unnecessary in clinically stable patients. However, providers may not feel comfortable determining which patients can safely forego overnight vitals. We studied the effect of a clinical decision support (CDS) tool embedded in the electronic health record (EHR) that automatically identified clinically […]

Background: We have previously showed how implementing the Michigan Appropriateness Guide for Intravenous Catheters (MAGIC) to inform peripherally inserted central catheter (PICC) use can lead to more appropriate device use. In this analysis, we assessed the association between appropriateness and PICC-related complications. We hypothesized that improved PICC appropriateness is associated with reduced major PICC complications […]

Background: Patient experience is increasingly recognized as a measure of healthcare quality and patient-centered care. However, there is insufficient understanding of patient expectations during hospitalization, and of how these are perceived by physicians, nurses, and administrators. The best way to apply the HCAHPS ratings remain elusive due to variability in practice environments, patient and clinician […]

Background: Electronic health records (EHR) capture clinical information that may be useful in predicting risk of hospital readmission. This study used EHR data to examine the associations between inpatient medication exposure and risk of hospital readmissions. Methods: The study population consisted of all patients hospitalized and discharged alive from Duke University Hospital between 2007 and […]

Background: Dyad round means when nurses and doctors do patient round together. When the concept of hospitalist came to health care system, doctors became available 24 hours in the care of patients. Nurses and doctors started doing their patient-rounds individually1 and communicate via electronic medical record (EMR) or other electronic methods.On an average, a patient […]

Background: Improving a patient’s experience with the health care system improves outcomes of care. Glickman et al found that higher patient satisfaction is associated with improved adherence and lower inpatient mortality rates. Boulding et al found that higher patient satisfaction was associated with lower 30- day readmission rates for patients with heart failure, acute MI […]

Background: The multiple comorbidities associated with obesity often to lead to or contribute to hospitalization. Hospitalization itself represents a teachable moment during which behavioral interventions have been successful. This study sought to determine whether inpatient weight loss counseling with postdischarge phone follow‐up can result in weight loss at 6 months following discharge. Secondary end points […]

Background: Patients feel “uncomfortable, vulnerable, and exposed” in their gowns while providers are distressed at seeing and caring for their fellow human beings clad in sub-human “threadbare,” “ugly” garments. The purpose of this study was to create a patient gown based on design suggestions by patients and providers (physicians and nurses) and to refine the […]

Case Presentation: A 53‐year‐old African American woman presented with 2 weeks of productive cough not responsive to antibiotics and 1 week of fever, headache, night sweats, and lightheadedness. She also reported a 25‐pound weight loss over 2 months, but she denied dyspnea and chest pain. She had a 15‐pack‐year smoking history and was febrile, tachycardic, […]

Background: “Hospital at Home” (HaH) models of care have existed for over 20 years in the U.S. Recent demand for healthcare value and advances in relevant technologies have driven renewed attention to HaH models, including from the Center for Medicare and Medicaid Services (CMS), and have spawned several pilots within the U.S. Where studied, these […]