Background: During the COVID 19 pandemic, our organization used a novel virtual care approach, an adult hospital at home (AH@H), to address the demand for bed capacity. Our pediatric hospital faces a similar capacity issue, being over 90% bed occupancy in 2024. While some pediatric acute hospital at home (PAH@H) models are used in Europe [...]

Background: Patients with chronic and serious illness frequently experience fragmented outpatient follow-up, poorly controlled symptoms, and repeated emergency department (ED) visits. These preventable episodes often reflect missed opportunities for earlier intervention, care coordination, and proactive goals-of-care discussions. Chronic Care Management (CCM) and outpatient palliative care can support these patients, yet many internal medicine practices struggle [...]

Background: Interdisciplinary rounds (IDR) have been used in hospitals to improve throughput, reduce readmission rates and improve patient satisfaction.They have been shown to improve teamwork and communication.The composition and structure of IDR vary widely from institution to institution and within the same institution. Purpose: In our institution, traditional IDR involved a care team of physicians, [...]

Background: Hospitalists frequently encounter patients wishing to leave the hospital before the medical team has recommended discharge (sometimes referred to as “discharges against medical advice” or “patient-directed discharges”). The ethically appropriate response by hospitalists to patients in these scenarios depends on several factors, including the presence of decision-making capacity, the availability of surrogates, the severity [...]

Background: Chronic Obstructive Pulmonary Disease (COPD) is a major contributor to morbidity, mortality, and healthcare costs globally. Acute exacerbations frequently result in hospital admissions, and 30-day readmission rates remain persistently high. Digital health interventions, including mobile apps and remote monitoring, show potential to improve quality of life and reduce exacerbations, though findings are heterogeneous and [...]

Background: Safe transitions of care and effective communication remain persistent challenges in acute care settings, often impacting patient outcomes and satisfaction. Traditional rounding models lack structured interdisciplinary engagement, leaving gaps in patient understanding, discharge planning, and medication reconciliation. These gaps contribute to increased risk for readmissions and lowered HCAHPS scores. Purpose: BOOST Rounds were developed [...]

Background: Medication reconciliation errors remain a major driver of preventable harm, particularly during hospital admission when incomplete medication histories lead to missed therapy, duplicate treatment, or incorrect dosing. National data show that medication discrepancies occur in up to seventy percent of patients and contribute to adverse drug events and readmissions. At our institution, baseline audits [...]

Background: Within the medicine service line (MSL) at Memorial Hermann Hospital TMC, the average length of stay (LOS) is 6.53 days. Despite this duration, discharge education is frequently deferred until the day preceding discharge or the day of discharge. Furthermore, there is no standardized protocol to evaluate patient readiness to receive educational content, ensure the [...]

Background: Iron deficiency anemia (IDA) is one of the most prevalent causes of anemia encountered across both inpatient and outpatient settings, contributing to fatigue, prolonged recovery, and hospital readmissions. Although daily oral ferrous sulfate is the standard treatment, emerging evidence shows that consecutive-day dosing can increase hepcidin release, paradoxically reducing iron absorption. Moreover, daily dosing [...]

Background: Patients with complex health and behavioral needs often face barriers to securing long-term care (LTC) placements. A busy acute care hospital within a large public healthcare system frequently experienced capacity strain due to the high volume of such patients requiring LTC. To address these challenges, the hospital formed a partnership with a skilled nursing [...]