Background: Effective communication among physicians during the hospital discharge process is critical to patient care. Since 2004 the Joint Commission has provided a set of necessary information to be included in all discharge documentation. Beyond this minimum data set, other data elements are likely necessary as well (e.g., information about medication reconciliation). As a consequence, […]

Background: The number of hospitalists in academic medical centers has grown rapidly. We evaluated the rates of satisfaction and burnout and the predictors and consequences of each in academic hospitalists. Methods: We performed a cross‐sectional survey of hospitalists at 17 U.S. medical centers using simple statistics to describe responses and multivariable models to determine factors […]

Background: Care by hospitalists has, in general, been associated with improved or similar cfinical outcomes and improved efficiency. However, less is known about the affect of hospitalists on conditions that may be dependent on consultants for procedures and/or treatment plans. Our objective was to compare clinical outcomes and efficiency for patients with acute upper gastrointestinal […]

Background: Increasing hospital efficiency has resulted in lower hospital length of stay (LOS); however, the impact of reduced LOS and hospital readmission rates has not been well described. Our objective was to determine trends in hospital LOS and 15‐day read‐mission rates for all medical diagnoses and 4 common diagnoses over 10 years in the Veterans […]

Background: Few studies have investigated how to optimally educate physicians on the cognitive skills required for effective clinical handoffs. Methods: A single‐institution, prospective, randomized, controlled trial was conducted to explore the effectiveness of different educational modalities to teach handoff skills. Thirty‐nine internal medicine interns were assigned to an interactive didactic workshop, an interactive didactic workshop […]

Background: Although substantial effort has been made to understand uptake of evidence‐based practice among participants in national quality campaigns, little attention has been directed toward hospitals that elect not to join these efforts. Methods: We conducted a prospective cohort study using a sample of 365 hospitals first surveyed in 2005 before the existence of a […]

Background: The Joint Commission's National Patient Safety Goals for 2008 and 2009 include numerous anticoagulation elements requiring hospitals to use approved protocols for the initiation and maintenance of anticoagulant therapy. Additionally, at our hospital, patients receiving warfarin on the Cardiac Surgery Service were noted to have an average length of stay (LOS) that was 2 […]

Background: Although comanagement models of care are proliferating, the management structures of comanaging providers have not been characterized. Methods: Between April and October 2008, all eligible providers on a novel medical comanagement service (described elsewhere) were asked to complete a preliminary survey soliciting respondents' expectations about their role on an ideally comanaged service. Subsequently, each […]

Background: Coordination is a critical aspect of care involving multiple interdependent providers. The characteristics of care coordination among providers in a comanagement model have never been examined. Methods: Between April and October 2008, hospitalists, midlevels, hepatologists, and Gl fellows on a novel comanagement service (described elsewhere) were surveyed at the completion of every rotation in […]

Background: In 2005, the Infectious Diseases Society of America and the American Thoracic Society published guidelines regarding treatment of health care–associated pneumonia (HCAP). These guidelines recommend MRSA coverage as well as 2 antipseudo‐monal antibiotics for patients with HCAP. In December 2007, an electronic survey with hypothetical HCAP cases was sent to 228 UCSD physicians most […]