Background: Today’s care of patients in hospitals inevitably involves multiple providers who must coordinate and communicate effectively in an environment that is uncertain and in constant flux. Unfortunately, traditional communication systems, such as pagers or landlines, have limitations that lead to frequent interruptions, inability to indicate the urgency of a message, delay in contacting the [...]

Background: A lack of effective physician-nurse collaboration has long been recognized to adversely impact patient and organizational outcomes.  Despite substantial efforts towards developing strategies to improve interprofessional collaboration (IPC) in the acute care setting, consistent realization of this ideal remains elusive.  Some studies have suggested that nurses and physicians have different perceptions of IPC and [...]

Background: Interprofessional collaboration (IPC) between nurses and physicians can be defined as shared responsibility and decision making in working towards the common goal of quality patient care. The positive effect of greater IPC on patient outcomes and job satisfaction has been described.  Studies have shown discrepancies between nurses’ and physicians’ assessment of their own collaboration. [...]

Background:    There is little evidence that systemic improvements in hospital quality, safety, and cost of care have occurred in the U.S over the last 15 years despite calls to action and intense local efforts.1,2 Ongoing work by The Joint Commission shows that “best practices” from one hospital are unlikely to translate directly to another.3 [...]

Background: There is a growing appreciation of the increasing prevalence of CREs, but limited data exists on the prevalence of invasive infections due to CRE among adult, hospitalized patients in the various geographic regions of the United States (US). Cognizant of this data gap, the study objective was to quantify the prevalence of carbapenem resistance [...]

Background: As part of the ABIM Choosing Wisely initiative, the Society of Hospital Medicine has emphasized repetitive complete blood count (CBC) and chemistry testing among its top 5 practices that physicians and patients should question. Reduction of unnecessary laboratory testing is important not only for cost containment, but also for improved patient experience and avoidance [...]

Background: Interprofessional bedside rounds have been promoted as a strategy to enhance patient engagement; prior studies have been limited by their use of nonvalidated measures and lack of patient and/or family involvement in design of the intervention. Methods: In collaboration with our hospital’s Patient and Family Advisory Council (PFAC), we developed Patient Centered Bedside Rounds [...]

Background: Unintentional medication discrepancies during hospitalization can contribute to patient harm. Discrepancies can be reduced by performing medication reconciliation; however, effective implementation is challenging. The goals of the Multi-Center Medication Reconciliation Quality Improvement Study (MARQUIS) were to operationalize best practices for inpatient medication reconciliation and test their effect on potentially harmful medication discrepancies. Methods: Five [...]

Background: Effective patient-physician communication is integral for meaningful clinical relationships and patient satisfaction; thus, it is measured by the Hospital Consumer Assessment of Hospitals and Health Systems (HCAHPS) survey.  Unfortunately, such surveys often demonstrate significant room for improvement in physician communication.  A critical element of effective communication is the ability of patients to recognize those [...]

Background: Beginning January 1, 2014, under the Affordable Care Act (ACA), 28 states expanded Medicaid eligibility to include additional low-income individuals aged 19-65 years. As a result, an estimated 10.5 million low-income Americans newly gained access to health coverage. Initial projections suggest that Medicaid expansion states will see a 16% reduction in uncompensated care provided [...]