Background: Due to low cost, dependability, and familiarity, one-way alphanumeric paging continues to be a commonly used method of in-hospital communication. However, lack of urgency indicators has been cited as a key limitation. To address this issue, an Interdisciplinary Communication Improvement Taskforce (In-CITe) at an academic medical institution adopted a Priority Structured Paging (PSP) system [...]

Background: With increasing numbers of hospitalist attending as well as demands of documentation and supervision, the # of days an attending physician remains with a team has been reduced at many academic medical centers. This reduction in attending physician continuity may impact the learners (teaching, receiving effective feedback) while potentially improving faculty experience (reduced burnout [...]

Background: Patient recruitment for randomized clinical trials is often challenging, especially when the alternatives being studied may require significant changes or have large consequences for the patient. We describe our experience recruiting patients for a clinical trial comparing the Comprehensive Care Program (CCP), a care delivery model in which physicians focus their practice on caring [...]

Background: Few studies have compared the effectiveness of brief training courses on point-of-care ultrasound (POCUS) skill acquisition of novice faculty vs. trainees. The purpose of this study was to evaluate the change in POCUS image interpretation skills and confidence of novice faculty vs. trainees after a 1-day POCUS training course. Methods: A 1-day POCUS training [...]

Background: The convergence of rising post-acute health care costs with incomparable outcomes havemade reform a priority resulting in the development of new models of care that often extend the scope of practice andjob duties among health professionals. In these new models, aimed to improve clinical and cost effectiveness of care,advance practice “transitionists” diagnose, triage, conservatively [...]

Background:  Transitions of care, whether between or within institutions, are an important source of errors, inefficiency, and unnecessary costs.  Inter-hospital transfers are complicated by incongruent information systems, indirect and asynchronous communication, and geographical distance all in settings of high patient complexity and acuity.  We developed a large database of patients transferred between hospitals to identify [...]

Background: Bridging anticoagulation is commonly prescribed to patients with atrial fibrillation who are initiating therapy or require interruption of anticoagulation for procedures. Current guidelines recommend bridging for patients at high risk of stroke, but no data guide this recommendation. Among patients with atrial fibrillation and one or more risk factors for thromboembolic stroke, the recently [...]

Background: Little is known about the economic value of quality improvement (QI) interventions, including those related to central-line-associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI). Methods: We searched MEDLINE, Econlit, the Centre for Reviews & Dissemination Economic Evaluations, Greylit, and Worldcat from January 1, 2004 to May 15, 2015; examined lists of references; [...]

Background: Venous thromboembolism (VTE) is a common preventable condition in hospitalized medical patients. Chemoprophylaxis with heparin or fondaparinux has been recommended for all hospitalized patients who are not at low risk, and appropriate thromboprophylaxis is a hospital quality measure. However, the specific threshold of VTE risk that warrants prophylaxis has not been defined. We used [...]

Background: Hemorrhagic complications after cardiac catheterization (CC) and percutaneous coronary intervention (PCI) are associated with an increased risk of mortality. In review of a large catheterization registry, blood transfusions were required following 1.4% of radial access and 2.8% of femoral access PCIs, respectively. While there is a standardized protocol for obtaining a blood type and [...]