Background: The 2014 ACC/AHA Perioperative Guidelines suggest using the Revised Cardiac Risk Index (RCRI), myocardial infarction or cardiac arrest (MICA), or American College of Surgeons (ACS)-NSQIP calculators for combined patient-surgical risk assessment. Alrezk and colleagues recently published a new geriatric-sensitive cardiac risk index (GS-CRI) to predict MI or cardiac arrest in the geriatric population. We [...]

Background: Code Blues, or in-hospital cardiopulmonary arrests, are high intensity, often fatal events occurring frequently within the hospital. National data reviews estimate that survival to discharge following an in-hospital cardiac event is about 24.4%. Further analysis has shown lower survival rates when comparing night shift physicians with day shift physicians (20.7% and 27.5% respectively), but [...]

Background: Data dashboards are used in many industries to track performance, however their development and efficacy in hospital medicine has not been well described. Data availability, provider attribution, feedback timeliness, and data accuracy have been cited as barriers to developing and implementing an effective performance dashboard. Purpose: We developed a hospital medicine clinical data dashboard [...]

Background: Overtreatment or low value care, including overutilization of laboratory testing, has an estimated annual cost of waste of $75.7 to 101.2 billion annually. Providing performance feedback to hospitalists has been shown to be an effective way to encourage the practice of quality improvement focused medicine. There remains limited data regarding implementation of performance feedback [...]

Background: Hospitalists vary in their ordering practices related to labs, imaging, and discharge order times. Variations in these practices has been associated with over-utilization of services and inefficient clustering of discharges later in the day. Prior studies suggest that peer comparison can be effective to change provider behavior and reduce unnecessary variation in ordering practices, [...]