Background: Prolonged hospitalizations of patients who are medically ready for discharge are highly prevalent in the current acute care environment.1 Patients who remain in the hospital beyond resolution of their acute medical needs often have high medical, social and psychiatric complexity and are poorly served remaining in an environment that is not designed for their [...]

Background: The Institute for Healthcare Improvement’s Age-Friendly Health Systems (AFHS) initiative calls for providers to ensure that older adults move safely to maintain daily function. However, studies show that about a third of hospitalized older adults have bed rest orders, most of which are not medically indicated. Therefore, at our 537-bed community teaching hospital, we [...]

Background: Hospitalist groups must be able to respond to unexpected staff absences due to sick calls, personal emergencies, and unanticipated leave, all of which have substantially increased since the 2020 coronavirus pandemic. They also need to be able to respond to ongoing fluctuations in census related to seasonal respiratory viral surges, as well as institutional [...]

Background: Our Academic Medical Center, (AMC), located near the US-Mexico border, began receiving and treating patients with COVID-19 beginning in February of 2020. After activating incident command to increase surge capacity and developing protocols for treatment of patients with COVID-19, we developed adequate capacity for the most likely scenarios of pandemic progression. By April of [...]

Background: Providers have a variety of situations arise on shift that challenge or inhibit their ability to provide care to patients, sometimes with advanced notice but often without. Most programs have coverage systems in place for emergent needs, but these are less than ideal for immediate and short-term situations (Table 1). Without a set policy, [...]

Background: Although hospitals and hospitalists often engage in work to improve patient care and quality, rarely does such work directly seek engagement from patients and communities. Even when direct to patient surveys are distributed, historically marginalized populations are often underrepresented. Understanding how to authentically engage with communities is integral to improving patient experience and ensuring [...]

Background: Microaggressions and bias events in the clinical environment are widespread and have both individual and structural consequences. Microaggressions are brief and mundane verbal, environmental, or behavioral slights that communicate bias, hostility, or prejudice toward any group. Microaggressions can occur in a variety of interactions between the physician and patients, learners, colleagues, and staff. Studies [...]

Background: Hospital at Home programs originated as pilot initiatives on a national scale, gaining momentum during the COVID-19 pandemic. The need for reevaluating healthcare delivery systems became pronounced during this period. Kent Hospital in Rhode Island collaborated with key stakeholders, including Blue Cross Blue Shield of Rhode Island, United Health Care, and CMS, to bring [...]

Background: Patient experience (PEX) is not only a metric guiding a hospital’s performance-based compensation-system and STAR rating, but also a very important indicator of personalized care and hospital staff’s relationship with patients. Challenges in the post- COVID healthcare climate (increased staff burnout, disengagement, financial strains on patients and health systems) have been affecting overall PEX. [...]

Background: The growth of academic hospitalists has lagged behind the expansion of hospital medicine as a specialty, and leaders within the field have called the lack of academic hospitalists a challenge to the academic credibility of the field.1 Previous publications have cited challenges to developing academic hospitalists including lack of access to resources, an absence [...]