Background: Penicillin is the most commonly documented drug “allergy” on hospital admission. Patients with listed penicillin allergies have higher rates of treatment failures, antibiotic resistance, and average length of stay. This has downstream implications impacting healthcare utilization, infection prevalence, and cost. However, the majority of these reported allergies are inaccurate, and over 90% of these [...]

Background: Mortality rates are a critical quality metric for hospitals, influencing both clinical outcomes and institutional reputation. The Centers for Medicare and Medicaid Services (CMS) incorporates 30-day mortality rates into its Value-Based Purchasing (VBP) program and Star Ratings, directly impacting hospital reimbursement and public perception. Similarly, U.S. News & World Report factors 30-day mortality into [...]

Background: Most primates, including humans, belonging to the suborder Haplorrhine lack the innate ability to synthesize ascorbic acid (Vitamin C) and hence exclusively depend on dietary intake (generally plant-based diets) to prevent deficiency. Modern humans’ trend of consuming ultra-processed foods that lack crucial micronutrients places us at risk for developing micronutrient deficiencies. Currently, there is [...]

Background: Geographic localization is the practice of assigning physician and advanced practice provider teams to patients located in the same inpatient unit. Poor localization of hospital medicine teams at our institution was identified as a top cause of increased Emergency Department boarding and Length Of Stay (LOS). The purpose of our process improvement project is [...]

Background: Inpatient utilization of Magnetic Resonance Imaging (MRI) is rapidly expanding, with potential effects on length of stay (LOS). At the same time, current hospital occupancy remains about 10 percentage points higher than before the pandemic and hospitalizations are projected to increase 11% by 2034. Hospital systems are striving to optimize processes to improve bed [...]

Background: Among bedside procedures, factors such as body mass index (BMI), prior spinal procedures, and complex spinal anatomy are known to affect the success of lumbar punctures (LP) [2, 3]. However, the phenomenon of a “dry tap,” where cerebrospinal fluid (CSF) cannot be obtained despite the needle tip being correctly positioned in the thecal sac, [...]

Background: While predictive analytics can help anticipate trends, the specific consequences of a national disaster on the healthcare system are often unpredictable. Recently, the East Coast suffered supply chain disruptions due to hurricane damage, leading to dramatic shortages of saline, intravenous (IV) fluids, and dialysate. The damage to Baxter’s North Carolina facility, which represents 60% [...]

Background: In July 2021, our institution launched the Better Flow Program, aimed at streamlining patient flow by documenting the Medically Ready for Discharge Date (MRDD) and the Discharge Delays (DDs) in the electronic medical record (EMR). The MRDD is the date at which a patient is deemed clinically stable for discharge by their medical team. [...]

Background: Multi-visit patients (MVP) tend to represent a small portion (< 5%) of all admitted patients, yet account for more than 40% of 30-day readmissions based on prior literature (1-2). Among our institution’s MVPs, Heart failure (HF) exacerbations are one of the top disease presentations accounting for 40% of 30-day readmissions in 2022. These patients [...]

Background: Palliative care (PC) is a multidisciplinary consult service aimed at ensuring goal-concordant medical care while optimizing patient/family support. Prior studies have illustrated that palliative care consultation can be associated with a significantly shorter length of stay but without significant change in mortality or disposition. Utilization of standard high-risk descriptive criteria or “triggers” that uniformly [...]