Background: A key factor contributing to physician burnout is what is known as “pajama time”—the time spent on clinical tasks outside of regular working hours. For inpatient physicians, responding to after hours texting may contribute significantly to pajama time. Purpose: At our large, urban academic medical center, 163 medicine residents rotate through the general medicine [...]

Background: As surgical and anesthetic practices have advanced, an increasing population of older adults with increased medical complexity are undergoing surgery. A significant portion of these patients may present to the hospital requiring urgent surgical intervention and there is an evolving and expanding role for hospitalists in preoperative risk assessment. However, there remains variable exposure [...]

Background: Advance care planning (ACP) conversations are essential for aligning care with patients’ values, particularly for high-risk hospitalized patients. However, there are limited tools in hospital medicine to identify and prompt clinicians to engage in ACP conversations effectively. Best Practice Alerts (BPAs) are commonly used in electronic medical records (EMRs) to streamline clinical workflows but [...]

Background: The Mount Sinai at Home (MSaH) program is a continuum of care that includes Hospitalization at Home (HaH), Palliative Care at Home and Subacute Rehab at Home (RaH). With these care delivery models, we can meet a wide and expanding spectrum of patient care needs. At MSaH, hospitalists, nurses, physical and occupational therapists, social [...]

Background: Critical to any health system’s mission is ensuring patients receive timely access to care. Continuity of care has been shown to decrease rates of ED utilization and hospitalizations and to improve patient satisfaction [1]. Providing patients with quick access to care following a hospital stay is a tenet of high-quality health care. A growing [...]

Background: Effective discharge communication is critical to ensuring safe patient transitions from the hospital and can improve outcomes. We have observed declining HCAHPS communication performance across our Section of Hospital Medicine and the transition out of the hospital was identified as a significant contributor. HCAHPS data was too slow to inform real-time improvement, so we [...]

Background: The transition period from hospital to home is a critical phase in patient care. Inadequate transitions can lead to adverse events, readmissions, delays in care, increased healthcare expenses and increased morbidity and mortality. Individuals with diabetes are particularly susceptible to readmission, facing a significantly higher risk compared to those without the condition. Furthermore, diabetic [...]

Background: Within 3 weeks of hospital discharge, about 19% of patients experience an adverse event, with 66% of these being an adverse drug event. During a patient’s transition from hospital to home, pharmacists have identified and resolved medication discrepancies. Inappropriate continuation or discontinuation of medications post-hospital discharge often stems from medication list complexity, inconsistent or [...]

Background: Outside-hospital (OSH) transfers are crucial to providing patients with a higher level or more specialized care. Despite the intent to improve care, OSH transfers are associated with negative outcomes due to miscommunication, lack of information, and other factors affecting patient care. Currently, there is no widely standardized process for OSH transfers. Studies show that [...]

Background: Transition of care, particularly at the point of discharge, is a pivotal part of the patient’s healthcare journey, carrying substantial risks to safety and quality of care. Whether a patient is discharged to home, an outpatient rehabilitation center, or a skilled nursing facility, each transition introduces opportunities for errors. Errors may include inaccurate medication [...]