Background: Inter-hospital transfer (IHT), defined as the transfer of patients between acute care facilities, is a common practice. Despite assumptions that IHT is done to provide patients with necessary specialized care, the factors which drive patient transfer are highly variable in ways that are not fully explained by differences in patients or hospitals. As such, [...]

Background: Hospital bed capacity is limited across the nation due to increased demand and staffing shortages. Capacity shortages result in hospital diversion and therefore impact Emergency Department (ED) length of stay and ED medical boarding. A large tertiary hospital typically serves as the referral hub for many smaller hospitals in the region, and optimizing bed [...]

Background: In 2006, the Institute of Medicine issued a report on the state of emergency care, which identified overcrowding and patient boarding as major concerns. Subsequent research has confirmed that boarding in the emergency department (ED) leads to adverse events including medication errors, higher mortality, and lower patient satisfaction. In answer to this, hospitalist groups [...]

Background: Hospitals globally have been facing unprecedented challenges with patient throughput and capacity, especially in the aftermath of the COVID-19 pandemic. Efficient discharge processes are integral to improving bed availability and mitigating the negative outcomes associated with patient boarding in emergency departments Purpose: This study evaluates the efficacy of an early morning huddle approach in [...]

Background: Shifting dynamics present unique opportunities for inpatient providers to enhance outcomes during transitions of care (TOC) as hospital medicine rises as a specialized field. It is well established that gaps in TOC can lead to unfavorable outcomes for patients and healthcare systems alike including increased morbidity, complications, readmissions, and costs. While TOC visits are [...]

Background: A hospitalist “triagist” physician assesses patients for admission and supports the transition of patients from the outpatient to inpatient setting [1]. Active bed management and triaging by hospitalists have been reported to improve emergency room (ER) patient flow and ER to ICU throughput, while hospitalist-directed transfer and admission of stable ER patients may shorten [...]

Background: The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a post-discharge survey which captures patient experience during and after hospitalization (1). Previous studies have demonstrated that high quality discharge communication is vital for patient safety, with poor communication leading to decreased medication adherence, unplanned readmissions, and poorer health outcomes—important implications for both [...]

Background: • Northwell Health Hospital Medicine, based on published national guidelines and expert opinion developed an internal guideline for the inpatient management of the medical patient with acute pain combined with a corresponding order set to implement the recommendations. • Given spotty utilization of multi-modal analgesia and the risks of opioid use and misuse, we [...]

Background: Like many institutions nationwide, our health system, an urban tertiary care academic medical center, has experienced challenges due strained hospital capacity. Hospitalists frequently face feedback to place discharge orders as early as possible in the day, for reasons as diverse as assisting patients with obtaining a ride home to expediting bed turnover for the [...]

Background: Hospitals continue to experience pressures to optimize efficiency and quality outcomes and to reduce practice variation. In surgical patient populations, the Enhanced Recovery After Surgery (ERAS) pathways have been shown to reduce length of stay, postoperative complications, hospital readmissions, and cost by integrating multidisciplinary, evidence-based interventions throughout the perioperative period (1). A similar model [...]