Background: Stony Brook University Hospital (SBUH) identified an opportunity to develop and implement prevention strategies to reduce hospital onset C. difficile infections (CDI). Hospital Onset (HO) CDI are included in National Healthcare Safety Network (NHSN) reporting and included with other hospital-acquired infections as publically reported data. CDI contribute to prolonged hospital stays, inappropriate antimicrobial use, [...]

Background: The hospitalist service at this large Academic tertiary center has a length of stay index that is longer than expected. Despite improvements in multi-disciplinary rounds and co-locating patients on a geographical units, improvements in length of stay slowed. Interviews of hospitalist physicians indicate that there are frequent delays in procedures, imaging and consult recommendations. [...]

Background: Intimate partner violence (IPV) is a serious and prevalent public health issue associated with increased healthcare utilization and worse healthcare outcomes. The majority of IPV outcomes research is conducted in emergency and outpatient populations. Our study aims to investigate how IPV exposure affects hospitalization rates and outcomes in adult patients. Methods: We performed a [...]

Background: Hospitalized patients placed on contact, droplet, or respiratory isolation due to a carrier state or infection with resistant or highly communicable organisms report higher rates of anxiety and loneliness and have fewer physician encounters, room entries, vital sign records, physician and nursing notes in the chart. For these reasons, it has been hypothesized that [...]

Background: Gamification and social incentives, such as family/peer engagement in goal-setting and feedback, are increasingly used by employers and health plans to promote physical activity and lose weight in outpatient settings but these approaches have not been used to improve mobility and reduce hospital-associated functional decline after hospital discharge. Methods: 12-week randomized, controlled trial of [...]

Background: Methicillin-resistant Staphylococcus aureus (MRSA) colonization of hospitalized patients is associated with higher readmission rates and increased morbidity. Depending on the mechanisms of transmission, numerous potential control interventions exist to reduce the burden of disease. These interventions include decolonization, improving hand-washing adherence, and enhanced environment cleaning. To evaluate the impact of various types of control, [...]

Background: Proper hand hygiene is a cornerstone of infection control [1,2]. Despite this, compliance remains a challenge, averaging only 50% across healthcare systems nationwide [1].Several interventions have been trialed to improve compliance, including audit and feedback [3]. Traditionally, hand hygiene audits have occurred through direct observation. Unfortunately, this approach can capture fewer than 1-3% of [...]

Background: Hyperglycemia is directly associated with increased risk for infection, delayed healing, increased morbidity, mortality and increased length of stay following orthopedic surgery.  A process was developed to identify these patients pre-operatively to proactively intervene before surgery and more aggressively after surgery to control glucose levels. Purpose: Retrospective chart reviews and root cause analysis identified [...]

Background: Multiple organizations have published clinical guidelines on hyperglycemia management in the acute care setting in non-critically ill patients [1–3], and the Society of Hospital Medicine offers additional support through its Glycemic Control program [4]. However, there remains little consensus regarding specific dosing regimens when designing insulin protocols in the inpatient setting. At our institution, [...]

Background: An innovative team of practicing physician leaders launched a Physician on Duty (POD) program in order to provide daily, pro-active clinical leadership to our Mission Control center. Our Mission Control includes, in addition to the physician team, a clinical team performing centralized staffing, bed placement, transfer center, RN care expediting, and ambulance dispatch services [...]