Background: Under the Hospital Value-Based Purchasing (VBP) program, we are evaluated based on 30-day readmission rates. This metric prompted our project after identifying that many patients were being discharged without a timely follow-up appointment.Communication between inpatient care teams and outpatient scheduling was inconsistent and often fragmented.Internal audits revealed:A high rate of missed or delayed follow-up [...]

Background: Discharge delays in adult medical-surgical units prolong length of stay and contribute to reduced hospital capacity. Baseline review (Feb 2024–Jan 2025) demonstrated 1,857 total delays with a median delay of 26.5 hours. The largest contributors were insurance authorization (31.45%), post-acute rehab (15.35%), other (10.99%), patient/family delays (9.42%), and transportation (6.24%). Physical therapy (PT)-related delays [...]

Background: Beginning in 2023, our urban community teaching hospital identified improving efficiency as a key strategic priority. One specific goal was to improve our average inpatient length of stay (LOS) which was reported as higher than both local and national peer institutions, based on observed-to-expected LOS (O/E) and case mix index (CMI) adjusted. Executive leadership [...]

Background: The use of cellular therapy and cancer immunotherapy (including chimeric antigen receptor (CAR) T-Cell therapy and bispecific antibodies) in malignant hematology and solid tumor oncology has greatly increased over the last few years. These novel treatments have a unique set of toxicities such as Cytokine Release Syndrome (CRS) and Immune Effector Cell-Associated Neurotoxicity Syndrome [...]

Background: Prolonged hospitalization is associated with increased risk of complications. Patients with intellectual and developmental delay (IDD) are overall more likely to seek hospital care for chronic conditions, more likely to be admitted and more likely to have extended hospitalizations. While inpatient length of stay (LOS) and readmission rates among patients with IDD have been [...]

Background: MRIs are a valuable inpatient diagnostic tool but the requirement to remain calm and still can be difficult to achieve due to clinical factors, such as claustrophobia, anxiety, and agitation (1). For most hospitalist patients in non-ICU settings, benzodiazepines (BZDs) are used to achieve minimal sedation for MRI, wherein patients are calm but do [...]

Background: Since 2012, hospitals have been penalized for 30-day readmissions via the Hospital Readmissions Reduction Program. For fiscal year 2023, over 2000 hospitals were penalized for excessive 30-day readmissions, losing up to 3% of Medicare payments. Previous work has demonstrated that over 25% of hospital readmissions to general medicine were considered to be preventable when [...]

Background: Hospital readmissions have potent implications on patients and healthcare systems as they are frequently used as a surrogate for the quality of patient care. The Hospital Readmission Reduction Program was created to reduce Medicare reimbursement for hospitals with above expected 30-day readmission rates. As a result, many studies have evaluated themes among preventable readmissions [...]

Background: The Veterans Health Administration (VHA) is the nation’s largest integrated health system and serves more than one million hospitalized Veterans annually at a cost of approximately $19 billion/year. Given the scope and complexity of this care, a centralized team was needed to provide data-centric support, access, and knowledge to hospital medicine leadership and front-line [...]

Background: In-hospital hypoglycemic events can lead to several adverse outcomes including, but not limited to, seizure, coma, or death. Vizient’s “Hypoglycemia in Insulin Use” metric, defined by the percentage of discharges with any blood glucose (BG) ≤ 50 mg/dL while on insulin, serves as a tool to improve patient care quality and delivery. An internal [...]