Background: Accurate and timely documentation is essential for patient care, as well as the appropriate reflection of patient complexity and severity of illness. Most hospitals utilize a traditional retrospective or contemporaneous physician-query strategy to ensure documentation accurately impacts performance data, reputation/ranking, and reimbursement.  Purpose: Here, we highlight three unique, hospitalist-driven interventions to support accurate documentation [...]

Background: Unplanned readmissions among cancer patients are common and gastrointestinal (GI) cancer has some of the highest readmission volumes. Under the Affordable Care Act, hospitals have been getting penalized for excessive readmission rates. For now, the medical treatment of cancer is exempt from this measure. This is because the readmission profile of the cancer patient [...]

Background: Studies have identified that CDI incidence has increased or even doubled between 2001 and 2010. While the 2013 National Standardized Incidence Ratio (SIR) showed a decrease of hospital onset CDI (CDI-HO) from the 2011 baseline, there were significant differences at the state level. As costs, rates of infections, and risk of readmission for CDI [...]

Background: Functional decline during hospitalization of older adults is well-recognized and potentially preventable.  Recent studies have suggested that clinically significant functional decline also affects hospitalized adults under 65 years of age, and that physical function is an important predictor of hospital readmissions. Despite the importance of function, we lack simple, efficient, and standardized measures to [...]

Background: Chronic Obstructive Pulmonary Disease (COPD) is the third most common cause of hospital readmission within 30 days of discharge. These readmissions increase the overall healthcare cost burden. We examined the effect of early follow-up visit with patient’s primary care physician (PCP) or pulmonologist on 30-day and 1-year readmission risk. Methods: We constructed an electronic [...]

Background: Recent evidence supports a restrictive transfusion strategy in the majority of hospitalized patients, though transfusion practices for oncology patients remain highly variable.  We evaluated whether use of a best practice alert for solid tumor oncology inpatients would result in more restrictive transfusion practices and impact patient outcomes. Methods: We conducted a retrospective, historical control [...]

Background: Recently, the role of non-physician extenders such as nurse practitioners has expanded in the hospital setting. However, there are few data examining the consequences of adding these providers to the care provision team.  The primary aim of this study was to determine the effect on quality of care and hospital efficiency of adding nurse [...]

Background: Despite recent advancements in the medical management of acute and chronic Heart Failure (HF), smooth transitions of care for patients hospitalized with HF remain elusive for most health care systems. Use of home health services and other ancillary services have been promoted in recent years as a means of reducing readmission rates among HF [...]

Background: Multiple professional societies recommend red blood cell transfusions for hospitalized patients based on the presence of symptoms of anemia, like fatigue. These recommendations endorse the idea that the severity of anemia symptoms are due to a patient’s nadir or reduced hemoglobin (Hb) concentration, and that correcting the Hb concentration with a transfusion will improve [...]

Background: Peripherally inserted central catheters (PICCs) are increasingly used in the care of hospitalized patients. While major complications such as venous thromboembolism and central line-associated bloodstream infection related to PICCs have been well reported, comparatively less attention has been given to minor complications such as occlusion associated with PICCs. This knowledge gap is important because [...]