Medical appointment no shows cause a delay in a patient receiving the care that they need and cause a burden for the health care provider organization. The purpose of this project was to explore whether the use of empathic language in preappointment text message communications with a patient would affect appointment attendance rates. This project was conducted within a mental health treatment organization and included 419 patients scheduled for a virtual intake appointment during a 30-day period. The results indicated that adjusting the language used in preappointment text message communication with patients did not generate a statistically significant change in attendance rates. Additional findings point to possible gender differences, although sample size limitations affected the strength of these findings. The days of the scheduled appointments also seemed to affect attendance rates.

Length of stay (LOS) is a critical metric for the efficient utilization of limited resources. A multidisciplinary task force in an academic hospital was created to optimize discharge planning with expanded resources to support a structured discharge process.

Limited qualitative research has explored clinician behaviors that enhance communication with patients who have limited health literacy (HL). Teach-back is a patient-centered strategy used to confirm understanding and close HL gaps.

Surgical instrument inventory optimization leads to sizable cost savings through tray reduction. Yet, a commonly overlooked benefit is the increase in efficiency stemming from reduced task variety for health care workers resulting from this reduction in inventory variety. We hypothesized that reducing the variety of surgical instrument trays would lead to significant improvement in reprocessing time, labor cost savings, and staff satisfaction.

Human papillomavirus (HPV) vaccination rates lag behind other recommended adolescent vaccines. Practice- and clinician-based interventions to improve HPV vaccination rates are known to be effective in improving completion rates.

Individuals with severe mental illness (SMI), including schizophrenia, schizoaffective disorder, and bipolar disorder, face twice the risk of cardiovascular disease compared with the general population. However, disparities in cardiovascular care access persist. We established a cardiopsychiatry clinic to assess cardiovascular risk and initiate evidence-based treatment in this population.

To evaluate whether acquisition of independent dialysis facilities by large chains is associated with changes in clinical quality metrics and patient-reported experiences of care.

Emergency department (ED) crowding is a crisis of an overstrained health care system that is associated with poor patient outcomes and dissatisfaction. We aimed to assess the effect of an interdisciplinary, provider-led triage team, "the Dugout," on ED length of stay (LOS), door-to-provider (DTP), and left without being seen (LWBS) rates.

Less than 1/5th of eligible patients are prescribed statins for primary prevention in the United States.

Percutaneous ultrasound-guided core needle biopsies (CNB) and fine needle aspirations (FNA) provide high yield and minimal risk for neck pathology diagnosis. Organizational shifts led to the planned closing of a long-standing pathology FNA clinic and a potential doubling in biopsy volume for our neuroradiology neck biopsy service.

Early identification and management of sepsis improves patient outcomes, yet hospitals struggle to consistently screen patients on arrival and during hospitalization. The Centers for Disease Control published Hospital Sepsis Program Core Elements to guide hospital sepsis management and outcomes improvement efforts and will measure the sepsis core elements with the National Healthcare Safety Network Annual Hospital Survey.

Heart failure (HF) is one of the most common diagnoses in the United States during hospitalization. The incidence of HF is expected to increase in the future, coinciding with the expected increase in the utilization of post-acute care facilities. Recent studies have demonstrated that the implementation of an original Heart Failure Disease Management Program (HFDMP) has a significant potential to decrease readmissions. The Department of Internal Medicine at two acute care hospitals coordinated with a post-acute facility for the implementation of an HFDMP quality improvement project.

Effective management of patient care delivery within the Veterans Affairs (VA) and Department of Defense (DOD) healthcare systems requires innovative strategies to implement clinical practice guidelines (CPGs). The authors explore the expansion of these strategies by leveraging the Strategic Analytics for Improvement and Learning data, the Electronic Quality Measures dashboard, and Patient Aligned Care Teams across the Veterans Health Administration enterprise. A multidisciplinary, national, virtual Community of Practice (CoP) using subject matter expert presentations that utilize the VA/DOD CPGs and strategic methods for implementation to enhance patient outcomes was developed and implemented. This work aims to detail the development and implementation of a virtual CoP that integrates multidisciplinary expertise and data analytics to enhance CPG adoption and implementation. The implications of CPG CoP discussed reflect the ongoing success and growth of the program's CPG CoP.

To improve access to care, the Veterans Administration (VA) offers eligible veterans the choice to receive Community Care (CC). Local changes to CC scheduling coincided with a decrease in expected surgical volumes. This project aimed to increase the retention of CC eligible veterans from 66% to 76% by September 2024, while prioritizing veteran autonomy.

Low-value laboratories lead to healthcare inefficiencies, unnecessary interventions, and environmental waste. Maternal complete blood count (CBC) testing is routine after cesarean birth, but does not change clinical management in most cases. We aimed to decrease routine postpartum CBC testing at a tertiary-care hospital and replace it with targeted ordering for patients at increased risk of severe anemia.

Patient-centered care is paramount for optimal outcomes. To address this, at Meritus Health, we asked a simple, yet profound question: "What matters most to you? (WMM)" This question, integrated into the patients' electronic health records (EHRs), facilitates meaningful conversations and helps tailor care to align with patient goals. This initiative, grounded in the principles of Age-Friendly Healthcare from the John A. Hartford Foundation, underscores the power of information by enabling clinicians to gain a comprehensive understanding of their patients. Our implementation required significant teamwork and provider engagement. Over 3 years, we have recorded more than 65,000 responses, creating a strategic priority for the health system to personalize care, guide clinical decision making, and drive continuous improvement. This strategic priority is health system wide. Patient-facing units and departments all across the health system track and report monthly metrics on the number of WMM responses captured. In addition, many departments across the system lead quality-improvement projects to improve and refine the process of asking this question.

Miscommunication is the leading cause of hospital medical error, most occurring during patient care handoffs. Even with successful implementation of a standardized handoff methodology, our hospital experienced continued handoff problems in the perioperative space. No studies have yet examined barriers to effective perioperative handoff communication.

The Centers for Medicare and Medicaid Services (CMS) reimburse hospitals through the Hospital Value-Based Purchasing Program (HVBP) based on clinical outcomes, safety, efficiency, and patient satisfaction, currently weighted equally. The aim is to explore whether adjusting these weights could address reimbursement inequities for safety net hospitals (SNH).

Discharge to home is an increasingly used hospital metric unlikely to be met by all patients after hip fracture surgery. There has never been a study using a badge buddy system in patients with hip fracture to improve rates of discharge to home.

Laboratory test utilization initiatives are well-studied in academic centers but less so in rural and community hospitals. We applied the EPIDEM model ( e xploration, p romotion, i mplementation, d ocumentation, e valuation, m odification) across a nine-hospital, predominantly rural health system to reduce unnecessary daily laboratory tests.

Unplanned return emergency department (ED) visits (RV) and return ED visits leading to admission (RVA) are common. A comprehensive assessment of prognostic factors associated with RVs and RVAs is required to guide further inquiry into how they might be mitigated. We conducted a prognostic indicator systematic review of factors associated with an emergency department (ED) return visit (RV) and RV with admission (RVA) within 30 days of the index ED visit using PRIMSA guidelines (PROSPERO #CRD42023483802). After searching Medline, EMBASE, CINAHL, and Cochrane Library, two investigators independently screened titles/abstracts, extracted data, and assessed risks of bias using the QUIPS template. In total, six studies were included. Most studies were hampered by risks of bias from study participation and study attrition. We found wide variation in the inclusion or exclusion of patient phenotypes associated with frequent ED utilization in the denominator of patients at risk for RV and RVA. Ultimately, heterogeneity and risk of bias precluded meta-analyses. We tabulated ranges of odds ratios for multiple subject-level, ED-level, and hospital-level prognostic factors. Male patient sex, Medicaid or Medicare insurance, and lower acuity emergency severity index scores were most consistently associated with higher risks of RV and RVA within 30 days.