Search results for "High-Value Care"
Rapid diagnostics, antimicrobial stewardship both needed for optimal BSI management
Mortality, length of stay, and time to optimal therapy improved when rapid diagnostic tests were used together with conventional blood cultures in antimicrobial stewardship programs for patients with bloodstream infection (BSI), a review found.
https://acphospitalist.acponline.org/archives/2024/05/08/rapid-diagnostics-antimicrobial-stewardship-both-needed-for-optimal-bsi-management.htm
8 May 2024
Decision support tool reduced unnecessary use of telemetry
A tool in one hospital system's electronic health record pushed physicians to choose an indication for telemetry and advised them on the recommended duration based on American Heart Association practice standards.
https://acphospitalist.acponline.org/archives/2024/05/08/decision-support-tool-reduced-unnecessary-use-of-telemetry.htm
8 May 2024
EHR-based intervention reduced repetition of blood typing and screening
The weekly average rate of duplicate blood type-and-screen tests decreased by 48.7% after a best practice advisory was added to the electronic health record (EHR) in a large health system.
https://acphospitalist.acponline.org/archives/2023/07/19/ehr-based-intervention-reduced-repetition-of-blood-typing-and-screening.htm
19 Jul 2023
Intervention successful in decreasing routine vitamin D testing
A decision support tool that prompted clinicians about appropriate testing criteria and included a best practice advisory was associated with a 44% drop in orders for vitamin D levels and a 61% reduction in repeat testing among inpatients.
https://acphospitalist.acponline.org/archives/2023/05/10/intervention-successful-in-decreasing-routine-vitamin-d-testing.htm
10 May 2023
Intervention in safety-net system failed to reduce overuse of VTE prophylaxis
An order set and best practice advisory in the electronic health record did not significantly affect use of prophylaxis against venous thromboembolism (VTE), but did provide some useful lessons, a study of 11 New York City hospitals found.
https://acphospitalist.acponline.org/archives/2023/04/19/intervention-in-safety-net-system-failed-to-reduce-overuse-of-vte-prophylaxis.htm
19 Apr 2023
Mindful ordering project changed residents' lab testing practices
A five-phase intervention that included education, reminders, and changes to electronic heath record options to encourage internal medicine residents to think more carefully before ordering lab tests reduced overall use of labs.
https://acphospitalist.acponline.org/archives/2023/04/05/mindful-ordering-project-changed-residents-lab-testing-practices.htm
5 Apr 2023
Most daily blood draws were collected during traditional sleep hours
At one U.S. teaching hospital, about 39% of blood draws for adult patients were collected between 4 and 6:59 a.m. from November 2016 through October 2019, although the timing shifted to slightly later during that period.
https://acphospitalist.acponline.org/archives/2023/01/25/free/most-daily-blood-draws-were-collected-during-traditional-sleep-hours.htm
25 Jan 2023
Procalcitonin algorithm reduced antibiotic use in patients with acute pancreatitis
A randomized trial assigned some patients to a treatment strategy of starting, stopping, or continuing antibiotics based on whether their procalcitonin test value was more or less than 1.0 ng/mL.
https://acphospitalist.acponline.org/archives/2022/07/27/procalcitonin-algorithm-reduced-antibiotic-use-in-patients-with-acute-pancreatitis.htm
27 Jul 2022
Alert decreased coagulation test orders during lab tube shortage, single-center study finds
A best practice advisory delivered through the electronic medical record during a national shortage of laboratory tubes was associated with an immediate decrease in orders for prothrombin time, international normalized ratio, and partial thromboplastin time.
https://acphospitalist.acponline.org/archives/2022/07/27/free/alert-decreased-coagulation-test-orders-during-lab-tube-shortage-single-center-study-finds.htm
27 Jul 2022
Study finds no diagnostic benefit from head CT in common psychiatric presentations
In 369 patients in ED and inpatient settings, the diagnostic yield of head CT examinations was 0.00% for indications of suicidal ideation, homicidal ideation, hallucinations, delusions, paranoia, catatonia, and/or psychosis.
https://acphospitalist.acponline.org/archives/2022/06/29/study-finds-no-diagnostic-benefit-from-head-ct-in-common-psychiatric-presentations.htm
29 Jun 2022
Having more hospitalists linked to better care value
Hospitals that employed more hospitalists had better scores in the CMS Hospital Inpatient Value-Based Purchasing Program overall and in the Patient Experience and Efficiency domains, a cross-sectional study found.
https://acphospitalist.acponline.org/archives/2022/06/29/having-more-hospitalists-linked-to-better-care-value.htm
29 Jun 2022
SHM selected new Choosing Wisely recommendations with patient input
The latest advice from the Society of Hospital Medicine (SHM) on avoiding low-value care includes recommendations against waking patients at night for routine care and against routinely prescribing venous thromboembolism prophylaxis to all inpatients.
https://acphospitalist.acponline.org/archives/2022/06/15/free/shm-selected-new-choosing-wisely-recommendations-with-patient-input.htm
15 Jun 2022
Nearly 40% of inpatient physical therapy consults at one hospital may have been unnecessary
Of nearly 3,600 physical therapy consults requested on hospital medicine services at a large academic medical center, 38% were deemed potential overutilization based on patients' high mobility score at admission and discharge to home.
https://acphospitalist.acponline.org/weekly/archives/2021/08/25/2.htm
25 Aug 2021
Residents may misjudge faculty, patient attitudes toward high-value, cost-conscious care
A survey in the Netherlands found that residents underestimated faculty's attitudes about the duty to incorporate costs into practice and overestimated their attitudes toward potential drawbacks while underestimating patients' concerns about drawbacks.
https://acphospitalist.acponline.org/weekly/archives/2020/11/11/4.htm
11 Nov 2020
Low-value procedures associated with hospital-acquired complications, study finds
The authors said that future research should expand the focus to the consequences of low-value care to the health care system as well as the potential financial, psychological, and psychosocial harm to patients.
https://acphospitalist.acponline.org/weekly/archives/2019/03/06/1.htm
6 Mar 2019
Intervention reduced routine chest X-rays in cardiovascular ICU, but not in medical ICU
Barriers in the medical ICU included insufficient visibility of the intervention and low investment among medical residents due to frequent rotation and competing priorities, researchers found.
https://acphospitalist.acponline.org/weekly/archives/2019/02/13/3.htm
13 Feb 2019
EHR alert reduced unnecessary telemetry outside the ICU at one hospital
The reduction in telemetry use was smaller than that achieved with multicomponent interventions, but simply adding an electronic health record (EHR) alert is less costly and more scalable, the study authors said.
https://acphospitalist.acponline.org/weekly/archives/2018/12/19/2.htm
19 Dec 2018
Productivity bonuses for hospitalists may decrease high-value care culture
Researchers surveyed hospitalists from 12 California hospitals about their institutions' culture of value-based decision making and found an association between high-value culture scores and how hospitalists were paid.
https://acphospitalist.acponline.org/weekly/archives/2018/11/07/2.htm
7 Nov 2018
Most patients on mechanical ventilation received daily chest X-rays, despite guideline changes
The hospital in which patients received mechanical ventilation was the strongest predictor of whether they received daily X-rays, even after adjusting for patient variables.
https://acphospitalist.acponline.org/weekly/archives/2018/08/15/1.htm
15 Aug 2018
List offers opportunities to improve value in hospital medicine
Recommendations from the Right Care Alliance Hospital Medicine Council include checking orthostatic vital signs in patients with syncope before considering testing beyond an electrocardiogram.
https://acphospitalist.acponline.org/weekly/archives/2018/03/14/4.htm
14 Mar 2018