Background: Interhospital transfers (IHT) for additional care are a necessary, if high-risk, part of the healthcare system. Return transfers, in which the patient is returned to the referring hospital once higher-level care is no longer needed, are also a part of the healthcare system but are even more varied and less systematized and studied within [...]

Background: In our NIH funded multi-site cluster randomized clinical trial (RCT), we used implementation science methods to develop and implement quality improvement programs consisting of evidenced-based interventions to improve care transitions for patients hospitalized with chronic obstructive pulmonary disease (COPD). Since the hospitals were the ‘subject’ of study, typical patient-level RCT enrollment practices were not [...]

Background: The Healthcare Improvement and iNnovation in Quality (THINQ) Collaborative, launched by UCLA Health’s Department of Medicine (DoM) Quality Program in 2014, aims to fill gaps in quality improvement (QI) education at the undergraduate level. As QI and patient safety (PS) have become core aspects of health professions education, interdisciplinary, team-based care models are increasingly [...]

Background: Addiction medicine services are a critical component of care for patients suffering from opioid use disorder. Previous research has indicated that opioid use disorder patients have higher lengths of stay (LOS) and higher hospital readmission rates than patients admitted for a different medical condition. Even though the presence of a specialized team of addiction [...]

Background: Communication failure during patient handoffs is a common cause of harmful medical errors. Therefore, the Joint Commission recommends that healthcare facilities standardize communication during this process. Intrahospital patient transport represents an instance in which it is crucial to have a standardized handoff approach – as patients are monitored less closely, may experience interruptions in [...]

Background: Patients with limited English proficiency (LEP) have a primary language other than English. During the hospital discharge process, patients with LEP may experience challenges communicating with members of the healthcare team and in our division, they have increased readmission rates and reported increased difficulty understanding discharge instructions compared to English proficient patients. Purpose: To [...]

Background: In 2023, UVA Health’s Catheter-Associated Urinary Tract Infection (CAUTI) Coalition identified diagnostic stewardship as a contributing factor in 57% of all CAUTI events. An independent review of all CAUTIs involving hospitalist physicians from 2022-2023 found that diagnostic stewardship was a key driver. Inappropriate urine testing can lead to treating asymptomatic bacteriuria with antibiotics, which [...]

Background: Physician/Bedside Nurse (RN) communication is at the center of care delivery and patient experience for patients admitted to any Hospital Medicine service. While efficient communication within the healthcare team is the hallmark of high quality care, it is highly variable in terms of timing and quality. Inadequate communication between physicians and nurses, as perceived [...]

Background: Stepdown units were introduced to provide an alternative for patients with needs not met by a general ward unit but did not require an intensive care unit. Current research indicates that these beds promote greater flexibility in patient triage, increase accessibility to limited intensive care resources, and provide a cost-effective alternative for patients. The [...]

Background: With increasing subspecialization in the field of Internal Medicine, the role of the hospitalist has metamorphosed, and the expectation for certification in specialized procedures, such as paracentesis, has diminished. Many hospitalist groups have traditionally relied on procedure services to manage specialized procedures. As a result, the majority of hospitalist faculty, and to a greater [...]