Background: Academic health systems face growing challenges from medical necessity denials and the administrative burden on frontline providers. In 2024, Emory Healthcare implemented a centralized, all-hospitalist Physician Advisor (PA) program to standardize denial management, optimize admission status decisions, and support clinicians across six hospitals. Purpose: To assess the impact of a centralized PA team on [...]

Background: Undercoding during billing is a widespread and costly problem among hospitalists. Undercoding is often driven by insufficient training and overreliance on complex medical decision-making (MDM) criteria. At our institution, internal benchmarking and comparison to national evaluation and management coding distributions revealed substantial undercoding across our hospitalist group. The 2023 Center for Medicare and Medicaid [...]

Background: Current daily clinical demands significantly limit a hospitalist’s ability to proactively escalate process delays or maintain a comprehensive grasp of the entire hospital medicine census. This fragmented, non-structured communication, particularly at the inter-departmental level, fails to address timely, system-wide resolution of bottlenecks. While traditional throughput models (e.g., Discharge Hospitalist, Nurse-Led Flow Coordination) have shown [...]

Background: Dalbavancin, a long-acting lipoglycopeptide, offers vancomycin-like coverage with potent activity against MRSA, MSSA, Enterococcus, and Streptococcus. Although FDA-approved for skin and soft tissue infections, emerging data support its use in deep-seated MRSA infections such as osteomyelitis, endocarditis, and bacteremia requiring prolonged courses of 4-6 weeks of IV antibiotics. This creates discharge barriers (PICC-related complications, [...]

Background: Hospitalists spend an estimated 30–40% of the workday documenting patient care encounters, yet this workload is not always captured through accurate billing and coding [1-2]. Billing guidelines revised in 2021 and 2023 simplified coding by focusing on medical decision making and expanding billing by time to include total encounter time instead of just face-to-face [...]

Background: Large-scale sustained medical surges (like the COVID-19 pandemic) can exceed existing hospital capacity and can result in activation of Alternate Care Facilities (ACFs). Traditional ACFs have repeatedly demonstrated limitations including inadequate privacy, HVAC control, infection prevention challenges, lack of integrated clinical systems, and poor patient and staff experience. With grant funding from the Defense [...]

Background: Recruitment is a major cost for hospital medicine groups (HMGs) with some sources citing $400-600k as the cost to hire a new hospitalist (Frenz 2016). The culture of a practice is often the leading factor considered by applicants when deciding to take a position, as well as a major factor when deciding to remain [...]

Background: Hospitalists and hospitals face unprecedented challenges with growing demand for acute care. Academic medical centers must also provide a superior learning experience for the future healthcare workforce. With executive sponsorship from our health system and school of medicine, we undertook a major initiative (Project ELEVATE) to completely re-imagine and transform how hospital medicine care [...]

Background: High-quality patient–provider communication improves comprehension, trust, satisfaction, and outcomes (1,2). Yet the quality of care and patient safety can be compromised by challenges such as frequent handoffs, complex teams, time pressure, and fragmented systems (3). Although many hospitals have implemented communication-related initiatives, best practices for hospital-based implementation remain uncertain. This study aimed to characterize [...]

Background: Rapid and accurate diagnosis is essential in hospital care, yet diagnostic uncertainty is often high, and many hospitalists work without team-based support. Informal diagnostic second opinions from hospitalist colleagues may provide diagnostic value, but it remains unclear how frequently hospitalists seek such opinions and what barriers they encounter. Methods: A cross-sectional survey was conducted [...]