Background: In order to most efficiently improve transition of care, hospitals need to target intensive discharge interventions at those patients at high risk of unplanned readmission. The “HOSPITAL” score, derived previously in the US, is an easy to use prediction model that accurately identifies medical patients at high risk of readmission. It includes the following [...]

Background: Multiple tools have been developed to improve the quality of signout from daytime clinicians to night covering clinicians. However, despite the frequency of holdover signout (new overnight admissions whose care is transferred to a new primary team), there are no studies or generally accepted best practices to ensure a high quality new admission handoff. [...]

Background: Our employed Hospitalist practice in a large academic medical center has been asked to assist with Emergency Department throughput by increasing the number of discharges by noon. Retrospective data analysis of our group showed that less than 20% of our physician discharges are before noon. To further analyze, we looked at discharge data from [...]

Background: Kaiser Permanente Roseville Medical Center is a 340 bed facility in Northern California.  Reducing readmissions has been a focus, and the current observed over expected rate is 0.77.  Starting from this relatively low readmission rate, our focus has been optimizing care for patients at high risk of readmission. A retrospective review of all patients [...]

Background: Observation services continue are a growing part of U.S. healthcare, with over 90% of surveyed hospitalist groups providing observation care. Despite observation services growing at teaching hospitals, few residents receive structured training in this area. Purpose: To create a structured clinical experience for internal medicine residents that gives an initial introduction to observation medicine [...]

Background: The role of a hospitalist in treating nicotine withdrawal using counseling and medications during hospitalization can improve cessation rates of tobacco users. Clinical decision support and drug-condition alerts within the electronic medical record prompt the prescribing of medications for tobacco treatment and ease documentation of reimbursable counseling by physicians. Additionally, several hospitals have implemented [...]

Background: Discharge education initiated early and performed with teach-back has been shown to improve transition outcomes. However, little is known about parental discharge education preferences.  Our objective was to understand parental preferences regarding discharge education learning styles and timing. Methods: Parents of non-technology dependent children less than 2 years of age or children with asthma age [...]

Background: Accumulating literature promotes early discharge education and transparency about hospitalization goals and discharge criteria as a key element of effective care transitions. However, little is known about the prevalence or nature of parental concerns about discharge during their child’s hospitalization.  Our objective was to understand the prevalence and nature of parental concerns about discharge [...]

Background: 　 There is increasing recognition that high quality transitions of care are essential to ensuring patient safety.　While no universal standard has been identified, using available literature and data from provider surveys, Project Impact identified key elements for acute care discharge education.  However, no studies have focused on the parent perspective.　 Objective: To determine parental [...]

Background: Handoffs are a part of inpatient medical care and can lead to patient care errors and threats to their safety.  Incomplete care transitions during service changes are associated with uncertainty of patient care plans. Current literature on handoffs focuses on day-night handoffs. Our project is intended to assess and improve handoffs at service change [...]