Background: The Improving Pediatric Patient-Centered Care Transitions (IMPACT) Multi-site Quality Improvement Collaborative aims to improve discharge transitions by testing a patient-centered transition bundle. Teach-back is a core component. This is a well-established method of confirming understanding. However, limited evidence exists about the effect of using teach-back for pediatric discharge education on parental knowledge/understanding of essential [...]

Background: Peripherally inserted central catheters (PICCs) have been associated with venous thromboembolism (VTE) and are a major cause of upper extremity deep vein thrombosis (DVT).  However, mechanisms to identify patients at greatest risk of PICC-associated VTE are limited. Methods:  Using data from the Michigan Hospital Medicine Safety consortium, patients with PICCs that experienced symptomatic, image-confirmed [...]

Background: Over the last several years we have seen the rapid growth of the specialty of hospital medicine across the country. One of the unintended consequences of this expansion has been the decrease in direct teaching responsibilities of the medical subspecialists on the inpatient medical teaching services. As these responsibilities have been subsumed by our [...]

Background: Ensuring hospital-based Patient and Family Advisory Councils (PFACs) include members from diverse, vulnerable and underrepresented communities is important to ensure that all voices are represented and heard when providing input into hospital quality improvement and research efforts. However, ensuring diverse membership of PFACs remains a challenge. This study aims to describe strategies to recruit [...]

Background: Physician shortage and healthcare access is a serious issue in rural America with reports estimating a shortage of more than 45,000 physicians by 2025. The rural and the underserved communities are predominantly served by International Medical Graduates (IMGs). Majority of the IMG physicians work are on a J1 waiver, National Interest Waiver (NIW) program [...]

Background: Like all large academic medical centers (AMCs), we face capacity challenges. On most days, bed occupancy is often greater than 90% and long boarding times in the Emergency Department (ED) leads to poor patient experience, care delays and risk for adverse outcomes. While many AMCs have approached this problem by acquiring new facilities or [...]

Background: In a previous randomized trial we found that shorter ward rotations reduced attending physician burnout at rotation-end. This improvement was offset, however, by negative education outcomes among trainees. Therefore solutions to burnout other than simply shortening rotations are needed to preserve the educational mission. We examined additional data collected (but not yet presented) to [...]

Background: In 2016, ACGME’s first Clinical Learning Environment Review (CLER) report found that trainees had limited knowledge of Quality Improvement (QI) and patient safety (PS) concepts.. Purpose: We have designed a free, interactive, web-based game named SafetyQuest (http://safetyquest.stanford.edu) to teach QI and PS concepts. Objectives include: 1) Increasing knowledge regarding actions to promote safety such [...]

Background: Traditional inpatient procedural fasting practices lead to excessive periods of patient fasting. Patients are unnecessarily ordered to be nil per os (NPO) at midnight, independent of current recommendations and evidence specific to the type of procedure being performed or expected time for the procedure to occur. This approach is based largely on the assumption [...]

Background: Hospital-acquired C. difficile colitis is associated with increased length of stay (LOS) and significant morbidity and mortality. During hospitalization, patients visit many procedural, diagnostic, and treatment areas throughout the hospital, presenting opportunities for spore contamination of surfaces and nosocomial disease transmission. We developed a novel methodology using electronic health record (EHR) data to map [...]