REVIEWS Striving for Optimal Care: Updates in Quality, Value, and Patient Experience Christopher Moriates, MD 1,2 *, Michelle Mourad, MD 1 1 Division of Hospital Medicine, University of California, San Francisco, San Francisco, California; 2 Center for Healthcare Value, University of California, San Francisco, San Francisco, California. BACKGROUND: Hospitalists are playing a growing role in quality improvement efforts, and they are increasingly spearheading programs to improve patient experience and healthcare value. We aimed to summarize and critique recent research related to quality, value, and patient experi- ence in the clinical practice of hospital medicine. METHODS: We reviewed articles published between January 2014 and February 2015, identified through a hand search of leading journals, continuing medical education collaborative journal reviews, Agency for Healthcare Research and Qual- ity’s Patient Safety network, and PubMed. The authors collec- tively selected 9 articles based on their relevance to hospital practice. We review their findings, strengths, and limitations and make recommendations for practice. This is a summary of an update we presented at the 2015 Hospital Medicine national meeting. RESULTS: Key findings include: a comprehensive hand-off program was associated with improved patient safety; suc- cessful readmissions interventions were resource-intensive, multifaceted and increased patient capacity to handle illness; patient activation was correlated with lower resource use post-hospitalization; positive associations exist between patient experience and understanding of their hospitalization; hospitals and practitioners can adopt simple low-cost strat- egies to reduce the trauma of hospitalization; hospitalists fre- quently order low-value tests, most often to reassure themselves or their patients; broad-spectrum antibiotics are grossly overused in hospitalized patients leading to prevent- able harms including clostridium difficile colitis, and programs that support “self-stewardship” may help moderate this risk. CONCLUSIONS: Recent research provides important insights into readmissions prevention, patient experience and low-value test ordering, as well as introduces interven- tions that may mitigate the risks of handoffs and the overuse of broad-spectrum antibiotics. Journal of Hospital Medicine 2016;11:145–150. V C 2015 Society of Hospital Medicine Hospitalists have a professional obligation to provide the highest quality care for patients and increasingly, hospitalists lead programs to improve quality, value, and patient experience. 1–3 The federal government introduced the hospital Value- Based Purchasing (VBP) program in 2012, initially with 1% of Medicare hospital payments tied to quality indica- tors. This percentage will continue to grow and the VBP program has expanded to include metrics related to qual- ity, safety, cost-effectiveness, and patient satisfaction. 4 Hospitals now face significant financial penalties if they do not achieve these benchmarks; thus, remaining up-to- date with the literature and the most promising interven- tions in these arenas is vital for hospitalists. The goal of this update is to summarize and critique recently published research that has the greatest potential to impact clinical practice in quality, value, and patient experience in hospital medicine. We reviewed articles pub- lished between January 2014 and February 2015. To iden- tify articles, we hand-searched leading journals, continuing medical education collaborative journal reviews (including New England Journal of Medicine Journal Watch and the American College of Physicians Journal Club), the Agency for Healthcare Research and Quality’s Patient Safety network, and PubMed. We eval- uated articles based on their scientific rigor (peer review, study methodology, site number, and sample size) and applicability to hospital medicine. In this review, we sum- marize 9 articles that were felt by the authors to have the highest potential for impact on the clinical practice of hos- pital medicine, as directly related to quality, value, or patient experience. We present each topic with a current quality question that the accompanying article(s) will help address. We summarize each article and its findings and note cautions and implications for practice. The selected articles cover aspects related to patient safety, readmis- sions, patient satisfaction, and resource utilization, with each of these topics related to specific metrics included in VBP. We presented this update at the 2015 Society of Hospital Medicine national meeting. IS THERE ANYTHING WE CAN DO TO MAKE HANDOFFS SAFER? Starmer AJ, Spector ND, Srivastava R, et al. Changes in medical errors after implementation of a handoff program. N Engl J Med. 2014;371(19):1803–1812. *Address for correspondence and reprint requests: Christopher Moriates, MD, Assistant Clinical Professor of Medicine, Division of Hospital Medicine, University of California, San Francisco, 505 Parnassus Ave, M1287, San Francisco, CA 94143-0131; Telephone: 415-476-9852; Fax: 415-502-1963; E-mail: cmoriates@medicine.ucsf.edu Additional Supporting Information may be found in the online version of this article. Received: June 17, 2015; Revised: August 28, 2015; Accepted: September 3, 2015 2015 Society of Hospital Medicine DOI 10.1002/jhm.2488 Published online in Wiley Online Library (Wileyonlinelibrary.com). An Official Publication of the Society of Hospital Medicine Journal of Hospital Medicine Vol 11 | No 2 | February 2016 145