Background: Hospitalized patients with COVID-19 who improve clinically but have ongoing oxygen requirements are often discharged with home oxygen. There are important considerations for home monitoring, follow-up and education at the time of discharge for these patients who must manage new equipment at home. This project aimed to describe discharge planning for COVID-19 patients with [...]

Background: Hospitals increasingly face capacity strain and challenges with patient flow, leading to emergency department (ED) crowding, ED boarding, and threats to patient safety and quality of care. ED boarding occurs from the time of the decision to admit until the patient arrives in an inpatient bed and is affected by many factors including discharge [...]

Background: Breastfeeding and human milk are the normative standards for infant feeding and nutrition. Studies have shown that newborns who were exclusively breastfed had lower risk of otitis media, upper respiratory tract infections, lower respiratory tract infections, asthma, atopic dermatitis, gastroenteritis, RSV bronchiolitis, obesity, celiac disease, type I and type II diabetes, and leukemia.1,2The American [...]

Background: Direct admissions (DA), wherein patients are non-emergently admitted to the hospital, bypassing the emergency room (ER), makeup 15% of non-elective adult hospitalizations (1). DAs can reduce ER volumes (2), but may lead to delays in initial evaluation of patients and inappropriate admissions (2,3). DAs carry risks involved with transitions of care and handoffs, yet [...]

Background: Efficient discharge planning for hospital medicine patients requires alignment across multiple disciplines. Understanding how clinicians communicate information about discharge readiness can identify opportunities to improve discharge coordination and impact length of stay, hospital capacity, and patient satisfaction. The objective of this study was to outline the existing information gathering and communication pathways around discharge [...]

Background: National guidelines recommend that pediatric health systems have written policies or guidelines addressing their approach to the pediatric to adult healthcare transition (HCT). It is unclear how inpatient care should be communicated in these policies, if at all. This is especially relevant as there are an increasing number of adults with childhood-onset conditions being [...]

Background: To address bed capacity concerns related to the COVID-19 pandemic, the Centers for Medicare and Medicaid Services (CMS) waived the certificate of medical necessity for oxygen claims, allowing for reimbursement for oxygen prescribed for patients upon hospital discharge with COVID-19 respiratory illness. This reimbursement allows providers to discharge patients with COVID-19 respiratory illness still [...]

Background: The 30-day readmission rate is a key performance indicator for hospitals and hospitalist groups alike. Studies have reported a correlation between scheduling follow-up appointments and reduced readmission rates in specific patient populations (e.g. Heart Failure, COPD). However, evidence regarding the effectiveness of scheduling post-discharge appointments in general medicine patients has been mixed. Methods: We [...]

Background: The transfer of patients between hospitals, known as inter-hospital transfer (IHT), is associated with higher rates of mortality, longer lengths of stay, and higher hospitalization costs compared to admissions from the emergency department. Despite these poor patient outcomes, best practices to guide IHTs are lacking. To characterize the IHT process and identify key challenges [...]

Background: Troponin is a big molecule, with its fragments not readily cleared by impaired renal function or during dialysis [1]. Oftentimes diagnosing myocardial injury/infarction (MI) is challenging in patients with ESRD due to atypical clinical features coupled with indeterminate ECG changes [2], and elevation of troponin levels with lower PPV [3]. In this study, we [...]