Background: Length of stay (LOS) is an important metric to monitor the efficiency of a hospital and is the focus of many operational and quality projects. Decreasing LOS is often made the responsibility of hospitalists and in order to identify improvement opportunities, LOS at the individual is examined. There are multiple strategies to attribute LOS [...]

Background: Asymptomatic bacteriuria (ASB), the presence of bacteria in urine without signs or symptoms of a urinary tract infection, is a common finding. The current recommendation by the Infectious Diseases Society of America is against screening for and treating ASB in patients undergoing non-urologic surgeries, due to the lack of demonstrable benefit in reducing the [...]

Background: In November 2020, CMS issued the Acute Hospital Care in the Home waiver which allows hospitals to care for appropriate Medicare inpatients in a patient’s home. UNC Health launched its home hospital program Advanced Care at Home in August 2021. Hospitals issued the CMS waiver are required to subject patients to both clinical and [...]

Background: Hospitalization at Home (HaH) has demonstrated clinical quality and patient experience superiority in general inpatient medical patients. Expansion of this service to sub-specialized inpatient populations would be highly beneficial to patients and health systems. Mount Sinai Health System (MSHS) HaH enrolls oncology patients with active disease admitted for acute general medical conditions and for [...]

Background: Lack of mobilization of hospitalized non-ICU medical patients has known negative consequences, including worse health and psychological outcomes, functional decline and increased hospital length of stay (1). Known challenges to increasing mobilization amongst inpatients include patient- and institutional-related limitations such as patient symptoms and lack of available assistance (2). At our urban, quaternary care, [...]

Background: Guidelines by the Society of Critical Care Medicine and the Infectious Disease Society of America recommend empiric antibiotics active against Methicillin-resistant Staphylococcus aureus (MRSA) for certain patient groups but do not base their recommendations on systematic review or attempt to quantify the benefit on mortality. Methods: A systematic literature search was conducted using Embase, [...]

Background: Clostridioides difficile infection (CDI) is the most common health care–associated infection in the United States and has serious clinical consequences with limited data on economic impact on US hospitals. The objective of this study was to quantify the cost of hospitalizations, readmissions, and expected reimbursement for each all-cause and CDI-related hospitalization during 12 months [...]

Background: As members of the patient experience committee, we aimed to identify areas of opportunity to improve the HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) scores. By analyzing the data through the utilization of our analytics tool provided by the patient and customer experience department, we noticed trends in the regional demographics in [...]

Background: Prolonged length of stay (LOS) is associated with worse quality outcomes, poor patient satisfaction, and negative financial performance for hospitals. Geographic cohorting of provider teams and their patients could improve LOS, readmissions, and other quality metrics. Many prior studies of geographic cohorting have shown no beneficial effect on these metrics. In 2021, we implemented [...]

Background: Cross-covering patients overnight is part of standard Hospitalist practice, however there is little understanding of the workload contribution. Much of the current literature for hospitalist productivity focuses on wRVU, day census, or number of admits per shift. These metrics are not applicable to cross cover since it is largely non-billable work. A cross sectional, [...]