Background: Clinical decision making pathways (pathways) embedded within electronic medical record (EMR) systems are an innovative tool intended to assist providers in diagnosing and managing patient conditions. Pathways provide clinical decision trees with the ability access online risk score calculators and select orders for lab and imaging tests, medications, and consultations. Studies have shown that [...]

Background: The emergence of hospitalists over the last 25 years as leaders in quality, safety, and value-based care has resulted in improvements in hospital throughput and reduction of in-hospital complications (1). The keys to success are standardizing clinical pathways and interdisciplinary collaboration. At Tampa General Hospital (TGH), our hospitalist team observed significant variability in the [...]

Background: At our urban, academic hospital, use of outdated protocols and unnecessary variations in the care of DKA patients treated with ICU requiring IV insulin protocols have led to multiple safety events, delays in care with associated increased costs, and overtreatment of hyperglycemia with ketosis frequently resulting in unnecessary ICU utilization. After multi-disciplinary stakeholder development [...]

Background: In the emergency department (ED), patients living in unsafe conditions in the community, who do not have a clinical reason to be admitted, present the physician with a dilemma: admit the patient to the hospital, exposing the patient to the hazards of hospitalization, or have them return to the hazards of their living situation. [...]

Background: The inpatient acute care environment has faced increasing capacity constraints since the COVID-19 pandemic. Factors like deferred care, nursing shortages, and a sicker population contribute to these constraints. Many systems have sought to improve patient flow to alleviate these issues. Efficient patient movement through care steps enhances patient satisfaction, reduces stay length, and minimizes [...]

Background: Inequitable healthcare is delivered to those who are incarcerated and have a history of incarceration. Incarceration has a significant multiplicative impact on the health of those who experience it – worsening outcomes related to chronic illness and shortening life expectancy. Hospital based providers tend to interact sporadically with individuals who are incarcerated, limiting the [...]