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Oral Presentations
Hospital Medicine 2018; April 8-11; Orlando, Fla.
Background: Inpatient margins and hospital reimbursement have become increasingly dependent upon improving key metrics, such as length of stay and 30-day readmissions. Hospitalists typically lack access to credible, timely, and insightful metrics that inform their practice. In addition, individualized metrics, when available, struggle to properly normalize for patient complexity, warranted variations in care, shared decision-making, […]
Oral Presentations
Hospital Medicine 2019, March 24-27, National Harbor, Md.
Background: Deep vein thrombosis (DVT) is typically diagnosed from ultrasound (US) Doppler evaluation and anticoagulation therapy is the standard treatment to prevent life threatening pulmonary embolism (PE). In our hospital, the treating provider is alerted to the positive test result by phone and/or text in the imaging result. There is an absence of clinical decision […]
Oral Presentations
Hospital Medicine 2018; April 8-11; Orlando, Fla.
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 […]
Oral Presentations
Hospital Medicine 2017, May 1-4, 2017; Las Vegas, Nev.
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 […]
Oral Presentations
Hospital Medicine 2018; April 8-11; Orlando, Fla.
Background: Approximately 5-10% of the US population reports a Penicillin (PCN) allergy. Only 1 in 10 of these patients are found to have a positive reaction to PCN. This label comes at a grave cost, with higher incidences of multidrug-resistant nosocomial infections reported among these patients. With the lack of novel antibiotics and the alarming […]
Oral Presentations
Hospital Medicine 2016, March 6-9, San Diego, Calif.
Background: The Center for Medicare and Medicaid Services (CMS) instituted the Readmissions Reduction Program to incentivize improvements in care transitions for patients with several common and serious illnesses, including heart failure, acute myocardial infarction, pneumonia, and more recently COPD exacerbations. The HOSPITAL score has been shown to accurately identify medical patients at high-risk for 30-day […]
Oral Presentations
Hospital Medicine 2018; April 8-11; Orlando, Fla.
Background: Inpatient antibiotic stewardship programs often use pre-prescription approval (PPA) or prospective audit and feedback (PAF) to reduce fluoroquinolone prescribing. Whether these stewardship strategies targeting inpatient fluoroquinolone use also influence prescribing at discharge is unknown. Therefore, we aimed to evaluate the effect of fluoroquinolone stewardship on discharge fluoroquinolone use in patients with pneumonia or a […]
Oral Presentations
Hospital Medicine 2019, March 24-27, National Harbor, Md.
Background: Clinically stable inpatients may receive potentially unnecessary care, such as overnight vital sign assessment. Nighttime vital signs can disrupt sleep and adversely affect patient satisfaction and contribute to delirium. However, it may be difficult for individual clinicians to determine which patients could safely forego overnight vital signs. Purpose: We developed a predictive algorithm designed […]
Oral Presentations
Hospital Medicine 2017, May 1-4, 2017; Las Vegas, Nev.
Background: Advance care planning can be challenging for both patients and providers. Barriers to understanding patients’ goals of care include patient and provider discomfort with the topic, as well as family and cultural dynamics. The Stanford Letter Advance Directive (LAD) is a simple tool written at a fifth grade reading level in eight different languages […]
Oral Presentations
Abstract Number: 8
SHM Converge 2024
Background: Facilitating safe transitions of care is a common concern for the discharging hospitalist. Telephone calls are the most common method of contact for post-discharge outreach. These are labor-intensive and therefore limited in scope. To better support patients after hospital discharge, we designed and implemented a 30-day automated texting program. In a pilot study, this […]