Background: The STAT priority in imaging is universally understood as a signal for medical emergencies; however, its misuse is widespread. At our institution, prior to intervention, 45% of all imaging exams were ordered STAT, with many of these orders not indicating medical emergencies. Our previous initiative in 2023 aimed to redefine imaging priority categories, reserving [...]

Background: Medicine procedure services (MPSs) have been shown to increase procedure volume, procedure completion rate, adherence to best practice safety measures, resident involvement, and resident satisfaction, and decrease length of stay within Internal Medicine (IM) [Ref 1-4]. However, the frequency with which MPSs rely on other services, particularly Interventional Radiology (IR), for assistance to complete [...]

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: Blood gas analysis should be performed within 30 minutes of collection to ensure accurate results. Venous blood gas (VBG) data can help evaluate critically ill patients, but it has little role in routine use in non-critically ill hospitalized patients. Nonetheless, we noted that at our urban safety-net hospital, many general medicine patients had VBGs [...]

Background: Transthoracic echocardiography (TTE) is a valuable diagnostic tool widely used for cardiac patients, but its accessibility and convenience have contributed to overuse. Although Appropriate Use Criteria (AUC) were developed to address this, inpatient TTE use continues to rise, with 5–8% annual increases. Studies reveal that while most TTEs meet AUC standards, fewer than one-third [...]

Background: High hospital readmission rates have both clinical and financial consequences which are associated with worse healthcare outcomes for our patients and costly financial penalties for the hospital. The average cost of a readmission estimated to be at $15,200 and adds burden on hospital systems, resources, and cause further harm to our patients, leading to [...]

Background: Diagnostic errors (DE) are common in hospitalized patients, especially those with an unintended escalation of care, and cause substantial harm. However, individual hospitals currently lack methods to analyze local diagnostic process failure patterns to identify targets for quality improvement efforts. Purpose: The AHRQ funded UPSIDE study identified key diagnostic process failures across a national [...]

Background: Prior studies have described the negative collateral effects of a hospital’s closure on the efficiency, access, and quality of care delivered at nearby hospitals that bear the brunt of care transfers and patient dispersion. However, few studies have addressed quality at the institution that is closing, as it is closing, and when the closure [...]

Background: Accurate clinical documentation is essential for capturing patient severity of illness (SOI) and risk of mortality (ROM). These metrics directly influence hospital quality reporting, including rankings like Vizient and metrics such as Observed-to-Expected Mortality (O:E) ratios. Traditional documentation methods rely heavily on manual input, which in busy clinical practices, results in underrepresented patient risk [...]

Background: The Joint Commission (TJC) defines a sentinel event as one related to patient safety resulting in death, permanent, or severe harm.(1) In TJC Sentinel Event Data Annual Review for 2022, communication breakdowns were identified as the root cause for these events. With stricter duty hour restrictions in hospitals nationally, the number of patient caregivers [...]