… in the MARQUIS2 study found that patient receipt of a best possible medication history (BPMH) in the emergency …

… research on this relationship is warranted. … Casalino LP, Li J, Peterson LE, et al. Relationship between physician …

… pragmatic quality improvement study (MARQUIS2) implemented a refined toolkit including system-level and patient-level … 17 hospital sites, the intervention was associated with a significant decrease in unintentional mediation … Schnipper JL, Reyes Nieva H, Mallouk M, et al. Effects of a refined evidence-based toolkit and mentored implementation …

Teamwork is essential to providing high quality, safe healthcare. This survey of general medicine nurses, nurse assistants, and physicians at four hospitals identified significant differences in perceptions of teamwork climate and collaboration across professional categories. While a majority of physicians reported the quality of collaboration with nurses as high, less than half of nurses gave high ratings to the quality of collaboration with physicians. Future teamwork training efforts should target the discrepancy in perceived teamwork across professional categories.

Artificial intelligence may have the potential to improve patient safety by enhancing diagnostic capability. In this study, researchers applied machine learning techniques to a large amount of pediatric electronic health record data and found that their model was able to achieve diagnostic accuracy analogous to that of skilled pediatricians.

Engaging trainees in quality improvement efforts has been an important area of focus within graduate medical education, but less is known about how health system resources are aligned with these activities. Researchers used survey data to better understand the perceptions of internal medicine residency program directors regarding health system support for and alignment with graduate medical education quality improvement efforts.

Previous studies have investigated the benefits of unit-based interventions as a potential safety strategy. This survey study sought to examine implementation of several unit-based initiatives to improve care quality in inpatient settings: localization of physicians to specific designated units, nurse–physician joint leadership, periodic review of local performance data, and interdisciplinary rounds. Investigators invited residency program directors and hospital medicine leaders to participate in the study. The response rate was low and thus the findings may not reflect academic hospitals in general. Overall, among respondents' institutions, the interventions were not widely or consistently implemented. These findings underscore the challenge of translating interventions shown to be effective for enhancing safety in research settings into clinical practice.

Fragmented care transitions may lead to adverse events due to poor provider communication, disjointed continuation of care, and incomplete patient follow-up. In this study, site visits were conducted at 22 healthcare organization across the United State to determine facilitators and barriers to implementing transitional care services. Identified facilitators included collaborating within and beyond the organization, tailoring care to patients and caregivers, and generating buy-in among staff. Barriers included poor integration of transitional care services, unmet patient or caregiver needs, underutilized services, and lack of physician buy-in. Results suggest how institutions may wish to prioritize strategies to facility effective care transitions.

This retrospective cohort study demonstrated that a readmission risk score could prospectively identify patients at risk for readmissions for the four target conditions for nonpayment: acute myocardial infarction, chronic obstructive pulmonary disease, pneumonia, and heart failure. These results suggest that this algorithm can identify a high-risk patient group who may benefit from interventions to prevent readmission.

… study, researchers described lessons learned from creating a leadership role that bridges quality and safety activities …

Hospitals with high readmission rates face reductions in Medicare reimbursements. Understanding the patient perspective at the time of readmission may better inform future readmission reduction efforts. Researchers surveyed patients readmitted to the general medicine services within 30 days of discharge across 12 hospitals on multiple aspects of self-care. Although 91% of patients reported understanding of their discharge plan, more than 52% reported difficulty with at least one aspect of self-care after discharge.

… the negative effects associated with sleep disruption. A PSNet perspective described how fatigue can affect …

Preventing readmissions is a cornerstone of patient safety efforts. However, one concern about nonpayment for readmissions is that many may not be preventable. To determine whether they were preventable, this observational study investigated readmissions through patient and physician surveys along with chart review. Researchers determined that only one quarter of readmissions were preventable. Factors associated with potential preventability were premature hospital discharge, insufficient communication with outpatient providers, failure to discuss care goals, and emergency department decisions to readmit a patient who did not require a second inpatient stay. These results suggest that multiple interventions will be needed to avert readmissions, and such efforts will have limited impact since most readmissions are not preventable.

… of hospital medicine … J Hosp Med … Medication errors are a common cause of adverse events after hospital discharge . …

Interprofessional bedside rounds have been promoted as a way to enhance patient-centeredness, but their benefits remain unclear. This randomized trial of patient-centered bedside rounding found no differences in patient satisfaction outcomes. Nurses perceived bedside rounds to improve communication, but physicians did not. This raises questions about the benefits of patient-centered bedside rounds as a way to improve patient satisfaction and suggests further research is needed to identity methods to augment patient-centered care.

… This study reports on the development and validation of a novel survey instrument that measures family and …

… root causes. This study describes the development of a new rapid approach to RCAs, colloquially called "SWARMing," … intelligence. SWARMs are conducted without delays after a reported event. The process begins with a preliminary investigation into what happened and who was …

Forming clinical communities that commit to shared goals can augment quality improvement efforts. This commentary describes the development of 14 clinical communities as a way to support institutional quality improvement goals in a large health care system. The authors report the benefits of the program, which enhanced access to expertise and collective knowledge. The article highlights the use of a unit-level engagement model and physician champions as key elements for the success of clinical communities.