Background: Audit and feedback is a commonly used strategy to improve performance among providers. Most prior studies on its efficacy were done in the outpatient setting and showed a modest benefit. Certain factors, such as clear targets and repeated frequency of feedback may increase the likelihood of improved performance; however, there is still no consensus [...]

Background: Audit and feedback is a commonly used strategy to improve performance among providers. Most prior studies on its efficacy were done in the outpatient setting and showed a modest benefit. Certain factors, such as clear targets and repeated frequency of feedback may increase the likelihood of improved performance; however, there is still no consensus [...]

Background: In the inpatient setting, opioids are the most commonly prescribed medication and the 2nd most frequent cause of adverse drug events (ADE).  Identifying patients at high risk for ADEs related to narcotics is essential.  These ADEs include ileus, altered mental status, and respiratory depression. Obstructive sleep apnea, organ impairment, and other medication use (i.e. [...]

Background: Audit and feedback improves clinical care by highlighting the gap between current and ideal practice.  Electronic health record (EHR) data can provide contemporaneous data for quality improvement but has not yet been studied extensively.  We conducted a randomized trial to determine whether audit and feedback leveraging EHR data with modern web-based dashboards could improve [...]

Background: Anticoagulants are among the highest-risk medications in hospitalized patients. Studies have demonstrated that a majority of in-hospital anticoagulant adverse drug events are not only preventable, but are the result of excessive dosing. This is especially true for warfarin dosing, which is complicated by a lack of consensus among validated initial dosing nomograms. As part [...]

Background: Hospital Medicine is a young and growing specialty. About 50% of our academic hospital medicine group of nearly 70 physicians are in their first 5 years out of residency. And about 90% of our faculty are millennials (born 1982-2000), the fastest-growing generation in the workforce and the first generation to grow up in a [...]

Background: A hospitalist “triagist” physician assesses patients for admission and supports the transition of patients from the outpatient to inpatient setting [1]. Active bed management and triaging by hospitalists have been reported to improve emergency room (ER) patient flow and ER to ICU throughput, while hospitalist-directed transfer and admission of stable ER patients may shorten [...]

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: Provider-level practice variation is common and may impact clinical outcomes, such as length of stay and imaging ordering. However, it is unclear which provider characteristics lead to variations in practice. Using individual performance data from a provider-level dashboard, we aimed to evaluate variability in clinical performance and predictors of high or low performance. Methods: [...]

Background: In Hospital Medicine, triaging a patient is the process of evaluating an admitted patient and assigning the patient to an appropriate service. Triaging patients is a manual and challenging process which burdens Hospitalists. As with any manual process, there is an inherent risk of missed steps, and in the case of patient triage, the [...]