Background: The use of transthoracic echocardiograms (TTEs) has increased dramatically, particularly over the last ten years. There is a perceived lack of harm in performing a non‐invasive TTE, though high cost and overdiagnosis are important downsides. Appropriate use guidelines for echocardiograms have been developed but have not changed the pace at which echocardiogram use is [...]

Background: Federal meaningful use programs continue to accelerate the adoption of electronic health records (EHRs) by U.S. hospitals. With increasing use of EHRs, it is likely that more hospitals will transition from paper to electronic provider notes over the next several years. Electronic provider documentation (ePD) can enable hospitals to capture, analyze, and leverage patient [...]

Background: Hospital throughput and discharge coordination are strategic priorities for the hospital to ensure patients are safely transitioned across episodes of care and to predict bed availability for patients being admitted. Coordinating bed flow and discharge requires anticipation of when discharges are likely to occur. Physicians make these determinations to help care teams plan for [...]

Background: Cancer patients are particularly at risk for being readmitted within 30 days after discharge. However, many of these readmissions are either related to elective chemotherapy or are not avoidable. In order to identify the cancer patients who might benefit from more intensive discharge interventions, we aim to identify the risk factors associated with 30‐day [...]

Background: Despite the high prevalence of functional limitations in community‐dwelling Medicare patients and Medicare penalties for “excessive” readmission rates, there is limited information on effects of these functional limitations on readmission for hospitalized Medicare patients. Methods: Our cohort included 6,695 Health and Retirement Study (HRS) subjects enrolled who were hospitalized at least once from 2000‐2008 [...]

Background: Compliance with the 2011 Accreditation Council for Graduate Medical Education work hour restrictions has led to increased numbers of hand‐overs. As a result, there is a renewed focus to maximize patient safety in this era of increased hand‐overs. Several elements have been identified as necessary for safe hand‐overs including, 1) face‐to‐face communication, 2) opportunities [...]

Background: Several care transition interventions have proposed that post‐discharge phone calls reduce adverse events, and decrease costly return visits to the hospital. However, given the multi‐faceted nature of most care transitions interventions, the true relationship between post‐discharge phone calls and readmissions in a real world setting is uncertain. Methods: From June of 2010 to May [...]

Background: Transition of care from the weekday hospitalist to the weekend hospitalist is typically not performed at the bedside, a model which leads to provider reluctance to discharge on the weekend and poor patient satisfaction scores. Creating a sign out model which occurs at the bedside on Fridays with both the weekday and weekend hospitalist [...]

Background: Information exchange is critical to high‐quality care transitions, yet little is known about the quality of information transfer from hospitals to post‐acute care facilities. To evaluate the quality of information transfer from a tertiary care University Hospital to post‐acute care facilities, we performed a cross‐sectional survey of post‐acute care clinicians and staff. Methods: During [...]

Background: Literature supports the positive impact of timely outpatient primary care follow‐up on reducing hospital readmissions. A post‐acute care clinic, staffed by hospitalists, housestaff or mid‐level providers, has emerged as a model for augmenting community PCP availability. The University of New Mexico Hospital (UNMH), an academic medical center and safety net hospital, established a Post‐Acute [...]