Background: Microaggressions (adapted from Sue et al. 2007) are “brief and commonplace verbal, behavioral, or environmental indignities, whether intentional or unintentional, that communicate hostile, derogatory, or negative slights and insults with regards to race, gender, religion, or sexual orientation that target a person or group”. In healthcare, studies have examined microaggressions’ effect on trainee experience, [...]

Background: The Palo Alto VA Hospital has an interdisciplinary Clinical Command Center (C3) that includes “Flow” nurse practitioners (NPs) who work closely with case management, social work and primary medical teams to identify and address barriers to care and assist in discharge planning and coordination. We have created a novel collaboration between a C3 Flow [...]

Background: Prioritizing hospital discharges to improve throughput and safety is a common theme in hospital systems. More recently, there has been an increasing importance placed on early discharges. Earlier discharges help to improve flow for admitted patients through the emergency department. In addition, by expediting patient care, patients are able to have their questions answered [...]

Background: An estimated 68,000 Americans died of opioid-related overdoses between March 2017-2018. In Monroe County NY heroin/fentanyl deaths are up 200% from 2015- 2017. Guidelines recommending naloxone co-prescription for high-risk patients on opioid pain medications have been issued. The inpatient setting provides unique opportunities for identifying patients at risk for opioid adverse events (OAE) and [...]

Background: 22% of the hospitals overall STAR rating is based on readmission reduction for the following disease specific groups: pneumonia, chronic obstructive pulmonary disease, acute myocardial infarction and congestive heart failure. Creating strategies surrounding prevention of readmissions that create workload balance leads to improved ability to manage these patients. The hospitalist medicine, emergency medicine, pulmonary, [...]

Background: Medication reconciliation is a complex process intended to identify and resolve discrepancies by maintaining the most accurate medication list for a patient to provide ultimate care. The Joint Commission National Patient Safety Goals emphasize completion of medication reconciliation on admission within an organization to reduce the likelihood of harm to patients.1 Our medical center [...]