The Joint Commission's Ongoing Professional Practice Evaluation Process: Costly, Ineffective, and Potentially Harmful to Safety Culture.

Objective: To evaluate the estimated labor costs and effectiveness of Ongoing Professional Practice Evaluation (OPPE) processes at identifying outlier performers in a large sample of providers across multiple health care systems and to extrapolate costs and effectiveness nationally.

Methods: Six hospital systems partnered to evaluate their labor expenses related to conducting OPPE. Estimates for mean labor hours and wages were created for the following: data analysts, medical staff office professionals, department physician leaders, and administrative assistants.

Improving the reliability of verbal communication between primary care physicians and pediatric hospitalists at hospital discharge.

Introduction: Timely and reliable verbal communication between hospitalists and primary care physicians (PCPs) is critical for prevention of medical adverse events but difficult in practice. Our aim was to increase the proportion of completed verbal handoffs from on-call residents or attendings to PCPs within 24 hours of patient discharge from a hospital medicine service to ≥90% within 18 months.

Methods: A multidisciplinary team collaborated to redesign the process by which PCPs were contacted following patient discharge.

Oral antibiotics at discharge for children with acute osteomyelitis: a rapid cycle improvement project.

Background: Substantial evidence demonstrates comparable cure rates for oral versus intravenous therapy for routine osteomyelitis. Evidence adoption is often slow and in our centre virtually all patients with osteomyelitis were discharged on intravenous therapy.

Objective: For patients with acute osteomyelitis admitted to the hospital medicine service, we aimed to increase the proportion of cases discharged on oral antibiotics to at least 70%.

Prospective evaluation of a pediatric inpatient early warning scoring system.

Purpose: The present study evaluated the use of the Pediatric Early Warning Score (PEWS) for detecting clinical deterioration among hospitalized children.

Design/methods: A prospective, descriptive study design was used. The tool was used to score 2,979 patients admitted to a single medical unit of a pediatric hospital over a 12-month period.