Background: A small number of patients account for a disproportionate number of hospital readmissions. The Complex High Admission Management Program (CHAMP) is designed to improve care and reduce hospitalizations for frequently readmitted patients. Non-randomized studies of CHAMP found reductions in readmission but may be subject to regression to the mean. We conducted a randomized trial [...]

Background: Many institutions rely on informal training for internal medicine (IM) residents about how to provide effective discharge communication to patients and their caregivers. Complete instructions are essential to safe transitions of care. At our institution, we evaluated baseline knowledge of these topics among IM residents, and assessed how an educational module impacted residents’ knowledge, [...]

Background: Community acquired pneumonia (CAP) is one of the leading causes of hospitalization in the United States.[1] In an effort to improve the quality of care for this resource-intensive disease, our institution implemented a clinical decision support (CDS) pathway for CAP comprised of three phases: (1) education on best practices, (2) education and a CDS [...]

Background: Medical short stay units (SSU) are increasing in prevalence and frequently care for patients with infections. Antibiotic misuse at discharge from acute hospitalization is common. SSUs, which have rapid patient turnover, could have increased risk for antibiotic misuse during care transitions. Thus, we aimed to characterize antibiotic misuse at discharge from SSUs. Methods: We [...]

Background: Hospital discharges represent an important transition of care between the inpatient and outpatient setting. Discharge summary documentation enables providers to convey clinical reasoning and important updates in patient care; however, reviews of these documents suggest error rates as high as 36.4% (1.42 errors per document) (McMillen, et. al. 2006). Formalized resident discharge summary curricula [...]

Background: With the rising predominance of shift work in healthcare, provider handoffs are important to facilitate the flow of patient information in a way that supports continuity and quality patient care. The Joint Commission has identified poor communication at handoffs as a major source of adverse events (1) which has led to significant work in [...]

Background: A small number of patients account for a disproportionate number of hospital readmissions. The Complex High Admission Management Program (CHAMP) is designed to improve care and reduce hospitalizations for frequently readmitted patients. Non-randomized studies of CHAMP found reductions in readmission but may be subject to regression to the mean. We conducted a randomized trial [...]