Background: Background: Essentia Health St Mary’s Medical Center, a tertiary referral center serving the rural areas of Northeastern Minnesota and Northwestern Wisconsin, identified disparities in hospice utilization of Medical Shared Savings Programs (MSSP) decedents in 2021 – 2022 (40% vs 53% Medicare national, 2nd quarter 2022). Health system metrics on hospital readmission and length of [...]

Background: Bedside procedures are safe, cost effective, and efficient when performed by trained hospitalist physicians, unfortunately it is a skill that has been lost over the years when not practiced after residency. Interventional radiologists (IR) perform the bulk of these procedures in many different hospitals, but this can lead to delay in patient care, increased [...]

Background: SIBR originated from a multi-pronged initiative to improve value and outcomes for our patients. On the Oncology floor where the complexity of care is high and patients have several consultants involved in their care, it is very easy to have fragmentation of care and lose the patient’s trust. Our objective was to engage the [...]

Background: Cost associated with diagnostic testing contributes greatly to the rising cost of health care in the United States (Bindraban et al, 2018). There is evidence to suggest that up to 20% of lab testing is unnecessary (Bindraban et al, 2018).Main Line Health (MLH) is a health system in suburban Philadelphia made up of four [...]

Background: Delays in medical care are frustrating for all stakeholders involved, including patients, their families, and the clinical teams responsible for moving their care forward. These delays, particularly in inpatient care, not only extend hospital stays but also have a cascading effect on patient throughput and inpatient bed availability. Hospitalists regularly navigate these challenges and [...]

Background: Increasing mobility in the hospital leads to better patient outcomes. However, published efforts to improve inpatient mobility report resulted increases in unnecessary physical/occupational therapy (PT/OT) consults. In our hospital we noted that physicians were ordering PT/OT on all patients in an effort to increase mobility. This meant very functional patients who did not need [...]

Background: As hospital systems look to a future of accelerated movement toward value, hospitalist engagement will be necessary for identifying opportunities and executing improvement in the inpatient space. Improvement in efficiency of clinical care, and related decrease in length of stay (LoS), has been identified as a way hospitalist teams can contribute to value-based care. [...]

Background: Lung transplant recipients are a unique cohort of patients who require a multidisciplinary approach to management when hospitalized due to their higher rate of comorbidities, use of immunosuppression medications, and increased risk of complications. As of April 2023, over 12,000 total transplants have been performed in our institution, of which, 538 (4.5%) have been [...]

Background: At our multi-hospital system, our utilization management (UM) program found that the length of stay (LOS) for observation patients in one hospital was, on average, 10 hours longer than the rest of the hospital system. There was a challenge of having better observation management, but there was no space or staffing to create a [...]

Background: Observations units commonly serve as an intermediate stage between the emergency department and inpatient hospitalization where patients of appropriate acuity are managed, however many observation units exist serving diverse patient populations ranging from peripartum or post-op surgical. Patients in observation units typically have lower-acuity health concerns and have an average length of stay of [...]