Background: Emergency Department (ED) boarding has increased nationwide since the COVID-19 pandemic and poses additional risks to patients, including increased length of stay, worsened health outcomes, and overall mortality (1,2). Oregon Health & Science University (OHSU), a 562-bed academic health center and tertiary/quaternary referral center for the region, has faced increasing capacity constraints causing prolonged [...]

Background: Hospital medicine is a high-volume, high-demand specialty where frontline clinicians frequently identify system challenges but lack structured opportunities to influence solutions. Leadership is often occupied with urgent operational needs, leaving hospitalists’ concerns under-addressed. This gap contributes to inefficiency, disengagement, and burnout. An innovative forum—the “Think Tank”—was created to empower hospitalists to generate, prioritize, and [...]

Background: Surgical co-management (SCM), a care model in which hospitalists jointly manage medically complex perioperative patients with surgical teams, has demonstrated decreases in surgical complications, decreases in length of stay, and cost savings (1-6). At Stanford Health Care (SHC), SCM physicians manually screen elective surgeries to identify patients requiring co-management services. However, this process contributes [...]

Background: Common hospitalist workflow includes hospitalists balancing inpatient care and discharges with new Emergency Department (ED) admissions. This model can strain hospitalist efficiency. We hence introduced a Double ED Admitter (DEDA) Model, where we designated two hospitalist physicians exclusively for ED admissions during peak hours, allowing rounding hospitalists to focus on inpatient care and timely [...]

Background: Medical emergencies present a major challenge to outpatient clinics. The University of Colorado Hospital (UCHA), a quaternary referral hospital with more than 1.4 million outpatient visits per year, previously relied on Emergency Medical Services (EMS) for patient evaluation and transport to the Emergency Department (ED), leading to prolonged response times, poor utilization of community [...]

Background: The rigid architecture of electronic health records (EHRs) is inherently at odds with the dynamic environment of clinical practice, creating a widening gap between EHR workflows and frontline needs.(1) Although digital health solutions are available from external vendors, their implementation is often prolonged by legal and governance requirements, as well as architectural integration challenges, [...]

Background: Health systems are rapidly piloting Large Language Model (LLM)-enabled tools within the Electronic Health Record (EHR) [1–4], but there is limited guidance on how to evaluate these tools during early deployment [5]. Qualitative clinician feedback is essential for understanding real-world usability, identifying safety concerns, and guiding iterative improvement of novel technologies [6]. Traditional qualitative [...]

Background: Our health care system includes two academic medical centers (AMC) and community hospital locations. Occupancy at our AMC often exceeds 100%. Identifying patients while in the Emergency Department (ED) whose care needs can be safely and appropriately managed in a community hospital setting is a key priority. This approach helps preserved AMC capacity for [...]

Background: Prolonged hospitalizations for patients medically ready for discharge can increase healthcare costs, risk of complications, and strain on hospital capacity. Therefore, identifying and mitigating modifiable barriers to discharge that extend length of stay (LOS) is critical for improving quality of care. Purpose: To address this challenge, the UNC Health Care Management Physician Advisor team [...]

Background: Code status discussions (CSDs) are essential but often inadequate in routine clinical practice. Simulation with standardized patients (SPs) can address CSD skills, but is resource-intensive and not widely available. As a result, many learners lack sufficient training in these difficult conversations. This study examined how artificial intelligence (AI)-driven simulation might enhance CSD training. Methods: [...]