Background: In the acute care environment, healthcare workers interface with patients who have limited access to medical care and a high prevalence of social determinants of health (SDoH) barriers.1 The inpatient setting presents a key intervention point where the social needs of vulnerable populations might be addressed. Standard inpatient medicine care teams, however, lack the […]

Background: Many patients continue their post-acute care in settings such as skilled nursing facilities (SNFs). One in four hospitalized Medicare patients are discharged to SNFs. These patients are generally the elderly or require more care than patients discharged home, placing them at greater risk of clinical decline and rehospitalization. Moreover, 25% of patients discharged to […]

Background: Patients experiencing unsheltered homelessness are at extreme risk for worse outcomes, including increased mortality 10 times that of the general population and an average life expectancy of 53 (over 20 yrs less than general population). Transitions of care pose unique difficulties for this vulnerable population, with numerous barriers to ongoing care and resulting readmission […]

Background: Hospital readmission reduction has gained greater awareness since the passage of the Affordable Care Act and within it the Hospital Readmission Reduction Program (HRRP). Policy makers sought to improve quality of care by increasing reporting transparency and imposing financial penalties on facilities for excessive readmission rates. Baylor Scott & White Health (BSWH) remains committed to reducing hospital readmissions and in doing […]

Background: “Hospital at Home” (HaH) models of care have existed for over 20 years in the U.S. Demand for healthcare value, advances in relevant technologies, and the ongoing global pandemic have driven renewed attention to HaH models, by way of policy-based and academic pilot programs – and even commercialization attempts. Where studied, these models have […]

Background: Alcohol use disorder (AUD) is the most prevalent substance use disorder, but most patients with AUD do not receive evidence-based medications for AUD (MAUD), including naltrexone or acamprosate. Inpatient addiction consult services (ACS) may offer an opportunity to start medical treatment for hospitalized patients with AUD, but it is unknown if ACS are associated […]

Background: Backup systems (jeopardy) are utilized by hospital medicine programs to staff clinical services in the cases of illness, leave and unexpected increases in clinical volumes. In the context of increasing hospitalist burnout and increased staffing needs during and after the COVID pandemic, a focus on how jeopardy contributes to clinician experience has emerged as […]

Background: Anemia is a risk factor for cognitive impairment as a result of the reduced delivery of oxygen to the brain from low hemoglobin (Hb) levels. In ambulatory patients even mild anemia (Hb < 12g/dL) has been associated with reductions in patients’ cognitive function. However, in hospitalized patients it is standard of care to maintain […]

Background: Alcohol withdrawal is a common issue in hospitalized patients and is associated with significant morbidity and mortality. Alcohol withdrawal occurs when the gamma aminobutyric acid (GABA) stimulating effect of alcohol is removed, resulting in an excess of the excitatory neurotransmitter glutamate. Treatment typically consists of as needed benzodiazepines, which activate GABA. However, this reactive […]

Background: Intimate partner violence (IPV) is a serious and prevalent public health issue associated with increased healthcare utilization and worse healthcare outcomes. The majority of IPV outcomes research is conducted in emergency and outpatient populations. Our study aims to investigate how IPV exposure affects hospitalization rates and outcomes in adult patients. Methods: We performed a […]