Background: Functional status plays a major role in determining discharge disposition in hospitalized adults such as need for nursing care facility vs home. (1-4) No specific diagnosis codes exist to capture functional status, limiting our ability to study its impact further. Some clinicians document functional status components in their clinical notes. Large language models (LLMs) [...]

Background: Documentation burden has been on the rise since the introduction of electronic health records (EHRs). Artificial Intelligence (AI) scribes use ambient documentation technology with the potential to mitigate documentation burden. Few studies have investigated the implications of AI scribes on hospital medicine providers’ workflow and patient interactions. Methods: We conducted a stepped-wedge trial at [...]

Background: Hospitals across the nation are gripped with capacity constraints, and some hospitals have indicated they are operating at “Capacity Disaster” status. It is critical to identify solutions that are beneficial to both hospitals and patients. Destino (2019) indicated that early discharges help decrease emergency department and post-anesthesia care unit hospital bed times. The Reverse [...]

Background: Handoffs are critical for conveying essential information about the patient’s care, yet they often lack structure and completeness, which increases the risk of adverse events and medical errors. Patients with LEP are especially vulnerable due to communication barriers, which can exacerbate disparities in care quality and outcomes. Despite the rising number of patients with [...]

Background: Automated bidirectional text messaging has emerged as a compelling strategy to facilitate communication between patients and the health system after hospital discharge. Understanding the unique ways in which patients interact with these messaging programs can inform future efforts to tailor their design to individual patient styles and needs. The aim of this study was [...]

Background: Hospital readmission is detrimental and is often a consequence of patient vulnerabilities, social factors and inadequate health system safeguards. The current 30-day readmission rate for Internal Medicine patients at the University Hospital is 13.43%. Historically, little has been known about patients’ perspective on factors that contributed to their readmission. Previous studies have shown that [...]

Background: Discharge planning is an important component of safe and efficient hospital care. While standardization of these practices can be useful, adopting general approaches may overlook important nuance for unique patient populations. In particular, we are interested in how patients who live in a baseline unsafe situation conceptualize a “safe” discharge plan. Thus, our study [...]

Background: Inter-hospital transfer (IHT) refers to the movement of patients between acute care hospitals and is a routine practice within healthcare systems. The process, however, remains unstandardized, resulting in variability in how patients are identified, managed, and transferred, as well as in patient outcomes, safety, and associated costs. While IHT typically provides specialized care unavailable [...]

Background: Michigan Medicine’s Hospital Care at Home (HCAH) Program was designed to provide eligible patients living in Southeast Michigan hospital level care from their own homes. Since the advent of the CMS Hospital at Home Waiver in Nov 2020, 93% of HCAH programs have been in urban locations, with prominent programs in cities such as [...]

Background: Interhospital transfers (IHT) for additional care are a necessary, if high-risk, part of the healthcare system. Return transfers, in which the patient is returned to the referring hospital once higher-level care is no longer needed, are also a part of the healthcare system but are even more varied and less systematized and studied within [...]