Background: Diagnostic errors (DE), defined as missed opportunities to make a correct or timely diagnosis based on the available evidence, are a critical but understudied cause of patient harm. While previous efforts have focused on examining the incidence and factors contributing to DEs in ambulatory and emergency room settings, fewer studies have examined incidence of […]

Background: Prior studies have tested interventions to redesign aspects of the care delivery system for hospitalized medical patients, but the majority have evaluated the effect of single interventions. We sought to implement a set of complementary interventions and evaluate the effect on interprofessional teamwork and patient safety. Methods: The REdesigning SystEms to Improve Teamwork and […]

Background: Patient portal use has been associated with improved patient experience, safety, and health outcomes.1,2 To keep patients better connected to their providers, our institution aimed to expand MyChart utilization. We piloted a standard operating procedure (SOP) to enhance MyChart education and uptake among those admitted to an inpatient general medicine unit. Purpose: Our intervention […]

Background: Communication with consultant teams is critical to the hospitalist workflow, especially in hospitals with multiple levels of hierarchy due to varying training backgrounds and experiences. We aimed to increase knowledge of the communication dynamic between hospitalists and consultant attendings in medical and surgical specialties. Methods: We surveyed Emory Division of Hospital Medicine physicians and Advanced Practice Providers to assess interactions with consultant attendings. Surveys […]

Background: The advent of internal medicine procedure services within academic medical centers has had a profoundly positive impact on patient care, patient safety, and resident training (1-4). In general, these teams focus on performing invasive bedside procedures, including paracenteses, lumbar punctures, central venous catheter placements, thoracenteses, and ultrasound-guided peripheral intravenous catheter placements. Recently, the procedure service at […]

Background: Every year, as many as 98,000 people die from medical errors within the hospital, making medical errors one of the top 10 leading causes of death in the United States(1). While the Accreditation Council for Graduate Medical Education (ACGME) has incorporated healthcare quality and patient safety into the Clinical Learning Environment Review (CLER) program […]

Background: Bone marrow biopsies (BMB) are a relatively frequent procedure needed in the inpatient setting, especially in a tertiary care center. BMB are a straightforward procedure with a generally low complication rate. In lieu of using specialists (eg, oncologists) or computed tomography (CT) guidance with radiology, procedure-focused hospitalists can provide an excellent option for doing […]

Background: Central venous catheters (CVC), including temporary dialysis catheters, are a relatively frequent procedure needed in the inpatient setting. Historically in our institution, CVC have been placed in the intensive care unit (ICU) by critical care staff or in the radiology suite by interventional radiology staff. The reasons for this placement preference have included the […]

Background: Central line associated bloodstream infection (CLABSI) is the 8th leading cause of death in the United States, causing 100,000 deaths annually. Each CLABSI costs about $56,000 per patient and increases length of hospital stay by an average of 3 weeks. Femoral lines have been shown to have the highest risk of infection compared to […]

Background: Communication related to medications is an important metric on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey to measure patient experience after discharge from the hospital. There are many factors which can lead to poor communication about medications (Figure 1). Over 20% of readmissions can be related to medications, and of […]