Background: Reducing preventable hospital readmissions is a complex and challenging goal without a clear roadmap for successful attainment. The problem is compounded by the lack of consensus on the defining criteria for preventable readmissions. We sought to define a comprehensive conceptual model that classified the etiologic subtypes of readmissions by incorporating the perspectives of patients, […]

Background: There has been considerable interest in development of strategies to reduce avoidable readmissions after hospital discharges. Studies have shown that home visits after discharge can result in readmission prevention, improved patient satisfaction, understanding and compliance. However, this intervention can be resource intensive. By coupling postdischarge home visits to a readmission prediction tool, we can […]

Background: Effective hospital work rounds require attention to multiple components: physicians should be able to review patients’ course, test results, and treatment plan while attending to their comfort and answering questions. In general, it also provides the opportunity to enhance patient satisfaction. Poor execution of these tasks can lead to adverse patient outcomes and decreased […]

Background: Handoffs are a core competency of hospitalists. While the Society of Hospital Medicine and others recommend improving handoffs, there is a lack of validated tools for teaching and assessing handoff quality. The specific aims of this project were to create video–based examples of varying levels of handoff performance for education and to validate an […]

Background: While well studied in the pediatric setting, little is known about the application of patient– and family–centered rounds (PFCR) to the adult population, but the potential for care improvement is great. PFCR is a model for empowering patients and families and improving communication and care in an academic, inpatient setting. In contrast to traditional […]

Background: Failures in communication among healthcare personnel during intrahospital handoffs in care are known threats to patient safety. In August, 2009, our healthcare system held a multistakeholder summit on handoffs, developed consensus around the need for a system–wide electronic handoff tool, and recommended a pilot study to develop and evaluate this technology. Methods: We adapted […]

Background: Nurse–physician communication is essential to ensure consistent and complete discharge instructions to patients. Though comprehensive discharge education can improve patient understanding and may reduce unnecessary rehospitalization, little is known about nurse and physician communication practices around patient discharge education. Methods: Nurses, interns, and hospitalists caring for medicine patients in a 600–bed academic medical center […]

Background: To improve patient safety, The Joint Commission has called for standardization of physician–to–physician handoffs of patient information. The handoff from Emergency Medicine (EM) to Internal Medicine (IM) providers at the time of patient admission is high–risk, may pose unique challenges to standardization, and has never been characterized on a national level. We aimed to […]

Background: Communication between primary care physicians (PCPs) and hospitalists occurs only 3–20% of the time. The aim of this study is to assess the PCPs’ response to information requests at the time of their patients’ hospital admission. Methods: Seventy–six patients admitted to the internal medicine service of an academic medical center whose PCP’s were outside […]

Background: Hospitalists are charged with addressing the gaps in transitional care, which manifest as adverse events (AEs) and readmissions after discharge. The Centers for Medicare & Medicaid Services plan to lower reimbursement to hospitals with excessive 30–day readmission rates. However, there is a lack of evidence–based strategies for improving transitional care. We conducted a systematic […]