Background: High value care is a key priority in healthcare, but strategies are needed to empower frontline clinicians to work with organizational leadership to reduce healthcare costs and improve care.   Purpose: Caring Wisely (CW) is a program we developed that is designed to engage frontline clinicians and staff, connect them with implementation experts, and [...]

Background: Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD) is the third leading cause of readmissions and is now included in the Medicare Hospital Readmissions Reduction Program (HRRP). Our institution developed an inter-professional program aimed at reducing all-cause 30-day readmissions for patients admitted with AECOPD. Methods: We iteratively developed and piloted our inter-professional COPD HRRP [...]

Background: Some healthcare organizations struggle to improve quality. Identifying characteristics associated with underperformance may help inform approaches to improvement. Therefore, we sought to: (a) Identify organizational factors associated with low-performing healthcare organizations and (b) propose a conceptual framework with actionable domains, which we present as AMP (The Model to Amplify the Missing Potential), to inform [...]

Background: High value care is a key priority in healthcare, but strategies are needed to empower frontline clinicians to work with organizational leadership to reduce healthcare costs and improve care.   Purpose: Caring Wisely (CW) is a program we developed that is designed to engage frontline clinicians and staff, connect them with implementation experts, and [...]

Background: Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD) is the third leading cause of readmissions and is now included in the Medicare Hospital Readmissions Reduction Program (HRRP). Our institution developed an inter-professional program aimed at reducing all-cause 30-day readmissions for patients admitted with AECOPD. Methods: We iteratively developed and piloted our inter-professional COPD HRRP [...]

Background: Some healthcare organizations struggle to improve quality. Identifying characteristics associated with underperformance may help inform approaches to improvement. Therefore, we sought to: (a) Identify organizational factors associated with low-performing healthcare organizations and (b) propose a conceptual framework with actionable domains, which we present as AMP (The Model to Amplify the Missing Potential), to inform [...]

Background: Despite benefits of early Serious Illness Conversations (SICs), including increased satisfaction and earlier hospice referral, rates of SICs remain low. The primary aim of this study is to assess if standardized documentation of SICs increase following implementation of interventions for providers to have more of these conversations with patients admitted to a general medicine [...]

Background: Advance care planning (ACP) informs future medical decision-making, particularly for hospitalized patients with older age or serious illness. The majority of end-of-life conversations are led by hospitalists in the inpatient setting. Despite the importance of ACP in end-of-life care, health disparities exist, with racial and ethnic minorities less likely to have advanced directives and [...]

Background: The first Multi-Center Medication Reconciliation Quality Improvement Study (MARQUIS1) demonstrated that implementation of a medication reconciliation best practices toolkit decreased unintentional medication discrepancies with potential for harm in five hospitals. Purpose: For MARQUIS2 we utilized lessons learned from MARQUIS1 to implement the toolkit across 18 diverse medical centers. Description: MARQUIS2 is a real-world, mentored [...]

Background: Healthcare expenditures in the US have been increasing at an unsustainable rate, and thus there is a strong interest in resource stewardship of low-value diagnostic tests. At our institution, internal data, as well as The Vizient™ Clinical Data Base, showed high utilization of inpatient daily labs (complete blood count (CBC), basic metabolic panel (BMP) [...]