Background: Early discharges from inpatient units improve throughput from the Emergency Department (ED) and reduce ED boarding. ED boarding increases patient safety events, provider burnout, and decreases patient satisfaction. Multidisciplinary communication between hospitalists, nursing staff and case management is essential for facilitating early discharges from inpatient medicine units. Such communication frequently requires in-person care coordination […]

Background: The transfer of patients between hospitals, known as inter-hospital transfer (IHT), is associated with higher rates of mortality, longer lengths of stay, and higher hospitalization costs compared to admissions from the emergency department. Despite these poor patient outcomes, best practices to guide IHTs are lacking. To characterize the IHT process and identify key challenges […]

Background: The division of the hospital medicine at the University of Florida has 52 attending hospitalist physicians with an average daily census of 200 patients. On any given day, one physician carries 16 patients and practices direct care services. This includes chart review, placing orders, answering pages, coordinating with case managers, requesting consultations, rounding on […]

Background: Mass General Brigham’s Faulkner hospital (BWFH) is a 171 bed community hospital closely affiliated with Brigham and Women’s hospital (BWH), which is located 2.5 miles away. Patient care at BWFH is supported by robust access to consultation and advanced testing from subspecialists located at BWH. To access some advanced diagnostic testing and procedures, patients […]

Case Presentation: Planning a safe discharge from the hospital is a collaboration that includes the care team and the patient. At our VA hospital, a geriatric 4M’s (Mobility, Medications, Mentation, What Matters Most) assessment helps to determine “What Matters Most” to older Veterans as well as to connect them with the right community services (such […]