Success Story

'Fall-Free Fridays'

Weekly rounds with a catchy name helped one hospital reduce patient falls.

May 22, 2024 | FREE
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A plan for paracentesis

A hospitalist launched a clinic to provide paracentesis to patients who repeatedly presented to the ED with ascites.

A quick heart failure stay

Heart failure patients who would typically be admitted were treated instead on a short-stay unit in a recent project.

February 14, 2024 | FREE
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Intermediate care unit helped surgical, COVID-19 patients

An intermediate care unit with a maximum census of six created over 1,000 available ICU bed-days over 12 months.

Clinicians team up to combat burnout

Online group coaching for women trainees decreased burnout symptoms.

December 6, 2023 | FREE
Most ACP Hospitalist content is available exclusively to ACP Members. This article is free to the public.

Handling HCV in the hospital

A program led by infectious disease specialists began treating inpatients with hepatitis C virus (HCV) during hospitalization.

Nudging physicians not to test

A high-value care project reduced unnecessary testing without adding a single click.

Community paramedics treating heart failure

Cardiologists and paramedics collaborated to keep some patients out of the hospital.

August 16, 2023 | FREE
Most ACP Hospitalist content is available exclusively to ACP Members. This article is free to the public.

Chief residents run a procedure service

A chief resident-led procedure service celebrates 10 years and reports positive results.

July 19, 2023 | FREE
Most ACP Hospitalist content is available exclusively to ACP Members. This article is free to the public.

Hiking hospitalists

A hiking competition brought hospitalists together outside of work.

Reducing returns to the ED

A transition clinic smoothed care for patients, the ED, and hospitalists, a study found.

Computer points out patients who need a visit

Nurses check with a machine learning program every six hours to identify ward patients at risk of death or ICU admission.

Simple steps for sounder sleep

New protocols for blood pressure checks and clot prophylaxis allowed patients to get better sleep at one hospital.

Fixing hip fracture outcomes

Orthos, geriatricians, and hospitalists at one hospital collaborated to apply age-friendly strategies in their hip fracture care.

Video visits for hospital medicine

A pandemic-driven innovation to optimize care after discharge has carried on, with positive reports from patients.

November 23, 2022 | FREE
Most ACP Hospitalist content is available exclusively to ACP Members. This article is free to the public.

Bringing meditation to the hospital

Meditation may be an effective stress-reduction tool for hospital clinicians, a recent project showed.

October 19, 2022 | FREE
Most ACP Hospitalist content is available exclusively to ACP Members. This article is free to the public.

Lessons from patients help clinicians handle stress

Researchers created a program to promote resilience in seriously ill children and their families and adapted it for hospital staff during the pandemic.

September 21, 2022 | FREE
Most ACP Hospitalist content is available exclusively to ACP Members. This article is free to the public.

A community hospital preps for critical events

Simulations with mannequins and actors helped hospitalists at one community hospital improve their readiness to treat critical inpatient events.

A different kind of business card

Hospitalist information cards increased patient satisfaction, one program found.

July 20, 2022 | FREE
Most ACP Hospitalist content is available exclusively to ACP Members. This article is free to the public.

Familiar faces reduce readmissions

A hospitalist explains how his facility focused a consistent multidisciplinary team on patients who were likely to return to the hospital.

June 22, 2022 | FREE
Most ACP Hospitalist content is available exclusively to ACP Members. This article is free to the public.

A text a day keeps the doctor informed

Inpatients, their caregivers, and their interns shared daily care plans and goals by texting in a med-peds pilot program.

June 1, 2022 | FREE
Most ACP Hospitalist content is available exclusively to ACP Members. This article is free to the public.

A click to improve cirrhosis care

An electronic alert increased use of rifaximin in patients with cirrhosis who were taking lactulose and were admitted with hepatic encephalopathy.

An app for delirium

An app, which is now available for free download, enabled nursing assistants, nurses, and hospitalists to screen elderly inpatients for delirium in about a minute.

There will be (less) blood

A new patient blood management program reduced transfusions, length of stay, and cost at one hospital.

January 19, 2022 | FREE
Most ACP Hospitalist content is available exclusively to ACP Members. This article is free to the public.

Writing (and working) at night

One hospital's nocturnist service teamed up to develop projects, posters, and papers for publication.

Relief from a pager

Nonphysicians took over responsibility for an admissions pager.

The inpatient vs. observation dilemma

A bundle of interventions decreased use of observation status.

What to fix?

Clinicians tackle workflow problems.

Connecting hospitalists and postacute care teams

A version of Project ECHO targeted postdischarge care.

Monitoring vitals at home may reduce readmissions

A team of skeptics convinced themselves that home monitoring helped patients.

Helping sepsis survivors thrive after discharge

The Sepsis Transition and Recovery program uses virtual care to implement best practices after sepsis.

Nurses key to antibiotic stewardship intervention

Algorithms helped them know when urine cultures were appropriate.

Using old cultures to choose new antibiotics

Results from previous hospitalizations were used to guide empiric therapy.

Less administrative burden, less burnout on ED boarder service

Pharmacy students helped hospitalists with medication histories.

Tap water avoidance reduced infections

A hospital found nontuberculous Mycobacteria in some of its water sources.

Telemonitoring after COVID-19 care

Patients who had been tested for SARS-CoV-2 were called by clinicians after discharge.

A path for patients returning after joint replacement

The orthopedics service worked with hospital medicine and took more readmitted patients.

Engaging families to detect ICU delirium

Fair diagnostic accuracy was achieved when family members used delirium tools for daily assessments.

Another way to detect breakdowns in care

A program encouraged patients to report problems that arose during hospitalization.

Another way to detect breakdowns in care

A program encouraged patients to report problems that arose during hospitalization.

Med students used donuts to improve opioid prescribing

Students led the way in an effort to reduce opioid overuse.

Empowering patients to prevent falls

A color-coded poster highlighted the importance of fall precautions.

An extra step to reduce urine cultures

New containers allowed clinicians time to think before culturing.

Making early discharge a priority for residents

A new form of rounds got more patients out of the hospital by 11 a.m.

Bringing hospital medicine to the ED

A hospitalist-led boarder service reduced length of stay.

Conference room becomes medical unit

One hospital found an unusual solution to an influenza season surge.

Automatic antibiotic stewardship

One health system added a best practice alert to the electronic health record and notified clinicians when specific criteria suggesting a viral illness were met.

Automatic antibiotic stewardship

One health system added a best practice alert to the electronic health record and notified clinicians when specific criteria suggesting a viral illness were met.

Calls with coaches eased burnout symptoms

A self-directed coaching intervention helped mid-career physicians.

Taking steps with mobility techs

Patient care nursing assistants were trained to get patients moving.

Silencing text-message interruptions

A system change allowed more concentration on medical education.

Time's up for respiratory rate mistakes

A team effort increased the accuracy of respiratory rate measurements and saved time.

Granting patients' dying wishes

The 3 Wishes Project fulfills small, joyful requests.

Partnering up to increase patient capacity

An academic medical center joined forces with a nearby community hospital.

Advice worth repeating: Avoid duplicate labs

An electronic best practice alert reduced unnecessary repetition of labs.

A citywide pledge to reduce readmissions

Camden, N.J., focused on removing barriers to postdischarge primary care visits.

The IMPACT of treating addiction

One hospital launched a consult service focused on inpatients with substance use disorders.

A real-time reminder to stop telemetry

Physicians are automatically alerted when telemetry exceeds a recommended duration and asked to take action.

Getting patients on board with VTE prophylaxis

A bundle to educate patients about venous thromboembolism (VTE) included a 10-minute video of patients' stories and in-person support from a nurse educator.

Virtual hospitalists bring expertise to rural hospital

A telemedicine program connected hospitalists with advanced practitioners and nurses at a rural facility.

Brushing up on pneumonia prevention

One facility reduced rates of hospital-acquired pneumonia with simple oral hygiene.

Coaching program builds resilient residents

Trainees are matched with volunteer coaches outside of their discipline to help them navigate the highs and lows of residency.

Screening for C. diff on admission

A surgical service found screening for carriers reduced hospital-acquired Clostridium difficile.

Shifting opioids from IV to subcu

One hospital unit found a simple strategy to help combat the opioid epidemic.

Readmission prevention starting at admission

Patients were screened up front to determine their likely readmission risk.

Just say no to lengthy NPOs

A system change shortened patients' fasting before bronchoscopy or cardiac catheterization.

Helping patients follow their heart (failure meds)

Partnership between clinicians and pharmacy improved medication adherence after discharge.

EHR-based trigger detects preventable adverse events

A trigger flagged admissions, leading reviewers to detect preventable adverse events including diagnostic errors and care management-related events.

Creating a universal suicide screening program

One hospital built an algorithm for suicide screening into its electronic health record.

‘Skip the Drips' reduced PPI overuse

Residents and fellows at one hospital corrected overuse of proton-pump inhibitor infusions for upper gastrointestinal bleeding.

Schedule tweaks boost admission capacity

A hospital with long ED wait times had its hospitalists study staffing models to find a solution.

A video to explain code status

The six-minute video describes and demonstrates patients' code status choices: full code (CPR and intubation if required), do not resuscitate (DNR), and do not resuscitate/do not intubate (DNR/DNI).

Meditation, not medication, for acute pain

A randomized controlled trial tested the effects of three 15-minute interventions on pain.

Peer support after stressful events

A program at Johns Hopkins provides a team of 39 peer responders who take turns volunteering to support clinicians affected by stressful cases.

An individual effort to smooth transitions

A primary care nurse practitioner visited her patients during and after hospital admissions to improve transitions of care.

Automating antimicrobial stewardship

EHR integration of a patient scoring tool improved care quality.

A new app to PICC up

A project to improve use of peripherally inserted central catheters (PICCs) in Michigan becomes app available anywhere.

Virtual rounds bring families to bedside

One hospital is using videoconferencing software to communicate with patients' families.

Breaking language barriers with a phone call

An intervention used telephone access to expand translation services.

Take a chronology instead of a history

A chronology of present illness, an alternative history-taking strategy, can help medical student organize the more traditional history of present illness.

Improving access, education reduces readmissions after PCI

Physicians developed an initiative spanning all phases of PCI care.

Reducing HIT by removing the culprit

An “avoid heparin” policy yields benefit.

The frontiers of sepsis care

Physicians in Kansas improve sepsis care at critical access hospitals.

Hospitalists enter SNFs to snuff out readmissions

Outreach program helps improve outcomes after an acute hospitalization.

Senior hospitalists get new hires up to speed

Peer mentorship program helps communicate expectations.

Get patients moving in, and out of, the hospital

Two 24-bed general medicine units at the Johns Hopkins Hospital tackled inpatient mobility.

Stretching the end of hospitalization past discharge

A new clinic in an outpatient care center focuses on recently discharged patients at high risk for readmission.

An ear-ly intervention to reduce delirium

Providing earplugs in the ICU may be a low-cost way to reduce hospital noise and prevent arousal during sleep.

Debriefs help make sense of adverse events

Two teaching hospitals enabled clinicians and staff to discuss serious adverse clinical events soon after they happen.

A money-back guarantee for hospital care

A goal of the program is to identify flaws in the health care system's processes.

Fixing folate testing for high-value care

Adding a message to the physician order entry system led to a decrease of 80% in tests ordered.

Web-based therapy helps prevent suicidal ideation among interns

Those in the intervention group were 60% less likely than controls to report suicidal ideation during their internship year.

App takes a hack at streamlining review of symptoms

Patients report their symptoms while waiting to be seen, and clinicians review, confirm, and edit the information.

Postdischarge case management, clinic combat readmissions

A 5-hospital health system improved patients' access to postdischarge care.

Patient navigator program reduces length of stay

A 442-bed acute care urban academic health center in Toronto decreased length of stay by improving patient-physician communication and handoffs.

Engaging a team to stop C. diff

A 528-bed acute care hospital reduced C. diff rates by 53% over 2 years.

Patient surveys give hospitalists real-time feedback

A teaching hospital uses patient satisfaction data to improve care.

A simple solution for hospital patients with poor vision: Glasses!

An academic medical center implements a method to test and correct patients' vision.

Technology connects geriatricians and hospitalists to nursing home staff

Program improves quality of clinical care for older patients in long-term care facilities.

Treating 1 patient at a time

Increased intern efficiency improves discharge rates, decreases duty-hour violations.

A phone call puts patients in the right place

Collaboration includes hospitalists, ED, and patient placement manager.

Consistent consults improve cirrhosis care

A tertiary care center used mandatory GI consults to help meet quality indicators.

Speedy stroke treatment and feedback

An academic medical center reduces door-to-needle time dramatically.

Searching for swift, secure communication

Pilot project shows use of the app is contagious among general medicine team members.

Improving care by targeting ‘superutilizers'

Health care costs and readmissions are reduced by focusing on patients with frequent ED visits and hospitalizations.

A traffic signal for discharge planning

Color-coded system helps clinicians prepare for likely discharges.

Turning talk about value into action

One hospital targets unnecessary treatment and tests.

A tasty solution to recurrent Clostridium difficile

Curing recurrent C. diff infections without fecal transplantation.

Let the computer do the math

Clinicians and information technology experts worked together to create a heparin dosing calculator for their electronic health record.

Tackling tPA through telemedicine

Researchers analyzed telemedicine stroke network involving 13 "spoke" hospitals.

Put a dermatologist in your pocket

Remote triage and in-person consults yielded similar diagnoses and care plans.

Getting with the C. difficile guidelines

Cleveland Veterans Affairs Medical Center in Ohio improved C. diff treatment by instituting a formal stewardship initiative.

Tablets aren't just for doctors anymore

As part of a pilot, St. Rita's Medical Center in Lima, Ohio, distributed tablets with patient-centric software to patients on a cardiac step-down unit.

Yogurt: A tasty tool against C. difficile

Program has been expanded to 2 long-term care facilities in the same health system.

Take note

Patients at University of Michigan's University Hospital are given bedside notepads to encourage discussions about care.

A new place between the hospital and the office

Effort by Holston Medical Group in Virginia and Tennessee aims to provide inpatient-level care without the negative effects of hospitalization.

Play it again

Effort at Cullman Regional Medical Center in Cullman, Ala. led to better patient satisfaction scores and lower 30-day readmissions rates.

Music soothes ventilated patients

Patients listened to preferred music at least twice a day.

A different kind of bundle

St. Joseph Health Services of Rhode Island program has achieved high compliance with isolation attire and hand hygiene.

From zero to 100 in six months

Cincinnati Children's Hospital Medical Center initiative targeted pneumonia treatment.

One hospital gets smart about discharge paperwork

Anne Arundel Medical Center in Maryland uses whiteboards, worksheets to instruct patients.

The early referral gets the rehab

Henry Ford Hospital in Detroit boosted rehab rates to over 70%.

Catheter caps cut CLABSIs

NorthShore University HealthSystem in Illinois reduced its infection rate by 52%.

Facing the problem of patient ID errors

Children's Hospital Colorado used photos to reduce errors in computerized physician order entry.

Shifting views on shiftwork

The University of Pittsburgh Medical Center developed a new system to maintain night coverage in the ICU under resident work-hour limits.

Doctoring at a lower decibel

Rochester General Hospital in New York used a team approach to reduce noise throughout the facility.

Be your own rapid response

Beth Israel Deaconess Medical Center developed rapid response teams composed of patients' main clinicians and tested the outcomes.

A new home for hospitalists

Denver Health Medical Center helped reduce boarding of patients in the emergency department.

Appreciating a good signout

University of Virginia Medical Center in Charlottesville, Va., improved the signout of patients from one resident to another.

From a warm welcome to a follow-up appointment

DePaul Hospital in St. Louis, Mo., improved patient satisfaction scores by improving communication.

But why should I take it?

Brigham and Women's Hospital set up a program that involved individual counseling from a research pharmacist.

Hospitalists and intermediate care prove to be a good fit

A Spanish intermediate care unit is staffed entirely by hospitalists.

Four-day blocks match hospitalists' and patients' schedules

Johns Hopkins Bayview Medical Center in Baltimore changed hospitalists' schedules to improve physician satisfaction and quality of care.

Paging Dr. Right

Sunnybrook Health Sciences Centre in Toronto developed a program to help ensure pages were sent to the correct physician.

Competitors collaborate on cardiac care

Schneck Medical Center in Seymour, Ind., worked with another nearby facility to help get door-to-balloon times for cardiac catheterization below 90 minutes.

Discharge coordinator pleases patients, eases residents' burden

Massachusetts General Hospital smoothed the discharge process by having a nurse practitioner work with residents.

Hospitalist-resident teams find happiness and efficiency

Strong Memorial Hospital in New York developed a new rotation system to help ease pressure on residents.

Put a number on it: Rating patient acuity

The University of Chicago Medical Center found a reliable way to transmit vital information about patient status.

Improving outcomes with new roles

A medical center in Vero Beach, Fla., reduced code blues and implemented multi-disciplinary rounds through a patient safety and quality initiative.A medical center in Vero Beach, Fla., reduced code blues and implemented multi-disciplinary rounds through a patient safety and quality initiative.

Nurses turn evidence into action

A care management department at Mercy Medical Center in Cedar Rapids, Iowa, helps incorporate new evidence and guidelines into daily practice.

Yet another use for duct tape

Trinity Medical Center in Illinois saved over $110,000 in personal protective equipment costs.

It takes a hospital to reduce pressure ulcers

Fairview Southdale Hospital, a 352-bed acute care hospital in Edina, Minn., reduced pressure ulcer rates from 0.35 to 0.16 per 1,000 patient-days.

Technology helps to monitor hand hygiene

A new system at Princeton Baptist Medical Center in Birmingham, Ala., reduced health care-associated infections by about 20%.

Observation moves faster with dedicated hospitalists

Clinicians at University Hospital in San Antonio, Texas, opened a Clinical Decision Unit to improve care efficiency for observation patients.

Creative solutions to difficult discharges

Denver Health Medical Center's complex discharge committee helps find creative dispositions for patients who are medically ready for discharge but, for many reasons, unable to leave the hospital.

Getting patients on the move in the ICU

Two academic tertiary care medical centers begin mobilization early in mechanically ventilated ICU patients.

Smart software and simple posters keep patients on their feet

Standardizing interventions at Partners HealthCare facilities in and around Boston helped reduce patient falls.

Handoff strategy cuts chitchat and confusion

The Mayo Clinic formed a team to address its main handoff problems: unpredictable schedules, inefficiency, poor communication and poor physical environment.

Spreading the word about glucose control

SSM St. Mary's Health Center, a 525-bed teaching hospital in St. Louis, Mo., implements a comprehensive program to improve glucose control.

Collaboration and experimentation reduce C. difficile infections

Rates drop by 73% on pilot wards at English hospital Salford Royal.

Hospitalists cost-effective even with per diem payments

Olive View-UCLA Medical Center improved census coverage and reduced payment denials.

Individual schedules maximize autonomy, efficiency

At Munson Medical Center in Michigan, hospitalists' workload and compensation are determined by personal preference.

Reducing readmissions by empowering patients

St. Joseph Hospital in Whatcom County, Wash., reduced unnecessary readmissions by improving patient self-management after hospital discharge.

Residency redesign helps patients and pleases doctors

Brigham and Women's Hospital redesigned its residency program to focus on integrated teaching.

Stickers, candy help reduce drug errors

Auckland City Hospital in New Zealand reduced medication errors due to inaccurate recording of patients' medications.

PA training gives hospitalists helping hands and new teaching opportunities

The Mayo Clinic in Phoenix, Ariz., has developed a fellowship program for physician assistants.

Fewer catheters…fewer infections

The Michigan Health and Hospital Association reduced unnecessary use of catheters and thereby catheter-associated UTIs.

Telemetry unit initiative reduces ED crowding, smooths patient flow

Grady Memorial Hospital in Atlanta standardized admission and transfer criteria for its telemetry unit.

System catches codes before they're called

Mercy Hospital Anderson in Cincinnati used a scoring system to reduce the number of code blues called outside the ICU.

Watchful eyes make for clean hands

Greater Baltimore Medical Center used signed pledges and volunteer auditors to dramatically improve hand hygiene rates.

A bundle of care that keeps elderly patients out of the hospital

Baylor University Medical Center in Dallas instituted a pilot project providing a "care bundle" to elderly patients at particularly high risk for returning to the hospital.

Homemade computer program improves glucose control

The Medical University of South Carolina Medical Center in Charleston, S.C., developed a nurse-driven Web-based insulin infusion protocol to manage blood glucose in the intensive care unit, as well as in the rest of the hospital

Hospitalist Web site streamlines signouts, helps communication

At St. John's Mercy Medical Center in St. Louis, Mo., a hospitalist-developed Web site makes it easy to identify and contact each patient's attending physician.

Hospitalist-led initiative reduces ambulance diversion, improves ED throughput

Johns Hopkins Bayview Medical Center in Baltimore recently introduced a hospitalist-led bed management program in a successful attempt to improve emergency department wait times and decrease ambulance diversion hours. Find out how they did it.

Improvements in emergency department create ripple effect in hospital

Kennan Hospital & University Health Center, Sioux Falls, S.D. used a manufacturing concept called Lean to identify wasted steps in the delivery of care. The result: decreased wait times and more efficiency in a new emergency department.

Risk-assessment tool makes sure clots are prevented whenever possible

A hospitalist creates a program to teach VTE prophylaxis, and then teaches others to spread the word.

Hospitalist-only unit frees time, improves care

St. Mary's Hospital in St. Louis, Mo. saves an hour a day of hospitalists' time