Background: Pharmacist-led peri-discharge interventions reduce adverse drug events. However, evidence is lacking as to whether there is a business case to fund these non-billable interventions. To test whether such interventions could drive reductions in post-discharge health care utilization to help build a business case, we conducted a pragmatic randomized controlled trial (RCT). Methods: The PHARMacist [...]

Background: Sub-optimal communication during care transitions contributes to poor patient outcomes. Patients who undergo interhospital transfer (IHT, the transfer of patients between hospitals) are at especially high risk given their level of illness severity. In examination of the IHT process at Brigham and Women’s Hospital (BWH), a 740-bed tertiary care referral hospital, we previously found [...]

Background: Physicians and nurses often overestimate patients’ understanding of their illness, medications, treatments, and care plans. Fragmented discussions can lead to inconsistent conveyance of key information to patients and their caregivers. Multidisciplinary bedside rounds are an essential opportunity to facilitate patient-centered care. Our medical-surgical units did not have a standardized approach to ensuring consistent, clear [...]

Background: Project IMPACT (Improving Pediatric Patient-Centered Care Transitions) is a multi-center quality improvement collaborative aiming to improve hospital to home transitions. As part of this project, providers attempt to schedule follow-up visits prior to discharge and conduct post-discharge phone calls. Objective: 1.Determine relationship between scheduling post-discharge follow-up visits and 30-day reutilization rates 2. Characterize patients [...]

Background: The hospital discharge is one of the most important aspects of a patient’s hospitalization, yet in residency training, this process often goes overlooked. Most residents are never properly taught how to effectively discharge a hospitalized patient. As a sequelae, patients often lack understanding about their hospitalization, treatment(s), and follow up plans. This uncertainty can [...]

Background: Communication has been cited as the most common root cause in sentinel events, with failed patient care handoffs contributing to an estimated 80% of serious preventable adverse events. Handoffs to sub-acute care such as nursing homes are at particularly high risk for communication breakdown given high patient complexity and comorbidity. Our healthcare system includes [...]

Background: Patients are discharged home on medications different than those they were taking before admission.  New and discontinued medications as well as dosage changes contribute to medication-related adverse events.  Purpose: To help address this problem, interns in our program developed a standard process during their quality improvement (QI) curriculum to ensure that at least 95% [...]

Background: Heart failure (HF) hospital readmissions are a leading cause of US 30-day hospital readmissions. Factors related to clinical complexity and unmet social needs are among the key drivers associated with HF negative clinical outcomes. Digital platforms have shown promise in improving HF outcomes but limitations like patient lack of familiarity with technology and unmet [...]

Background: Inter-hospital transfer (IHT, the transfer of patients between acute care hospitals) exposes patients to risks of discontinuity of care and remains a largely unstudied process of care. In this study, we aimed to investigate patient experiences with IHT.Methods: Interview guides were developed using themes extracted from prior research along with expert opinion and stakeholder [...]

Background: Patients are often transferred between hospitals to provide access to required specialty services. However, prior research suggests that transfer destinations are often chosen based on institutional relationships rather than solely on patient need. In this national study, we evaluated the appropriateness of transfer, as measured by the frequency of required specialty services available at [...]