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: 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: 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: Research and quality improvement programs may differentially reach some population groups and not others, thereby worsening health disparities. RE-AIM is a well-established implementation science framework used to evaluate the impact of interventions across five domains: Reach, Effectiveness, Adoption, Implementation, and Maintenance. This study aimed to summarize past applications of RE-AIM to evaluate for disparities [...]

Background: Adverse drug events are common during transitions of care and often due to patient misunderstanding of the medication regimen or non-adherence. Challenges exist that may influence the ability of new interventions to address this issue. As part of the Smart Pillbox study, a randomized controlled trial of an electronic pillbox, we explored barriers and [...]

Background: Sub-optimal discharge preparation during hospitalization may adversely impact safety and lead to a poor patient experience. As part of an AHRQ-funded study, we designed and developed interactive digital health tools (Figure 1) to engage patients and caregivers in self-assessing discharge preparedness: an educational video and 16-item discharge checklist addressing 4 domains (understanding the plan, [...]

Background: Approximately 12% of hospitalizations are related to substance use disorder (SUD), an estimated 20% of hospitalized patients may have SUD, and patients with SUDs are nearly twice as likely to be readmitted. Pharmacotherapies for SUD are underutilized in hospitals, especially in Texas, due to lack of training, structures, and organizational cultures to support evidence-based [...]

Background: The AHRQ-funded REdesigning SystEms to Improve Teamwork and Quality for Hospitalized Patients (RESET) study was designed to improve teamwork and quality for hospitalized patients by providing mentorship and resources to hospitals as they implemented 5 interventions, which included (1) Unit-based Physician Teams, (2) Unit Nurse-Physician Co-leadership, (3) Enhanced Interprofessional Rounds, (4) Unit-level Performance Reports, [...]

Background: The REdesigning SystEms to Improve Teamwork and Quality for Hospitalized Patients (RESET) study sought to improve teamwork and quality for hospitalized patients by providing mentorship and resources to hospitals as they implemented: (1) Unit-based Physician Teams, (2) Unit Nurse-Physician Co-leadership, (3) Enhanced Interprofessional Rounds, (4) Unit-level Performance Reports, and (5) Patient Engagement Activities. Two [...]