Background: To relieve hospital capacity strain, hospitals often encourage clinicians to prioritize early morning discharges which may have unintended consequences. We aimed to test the effects of hospitalist physicians rounding on discharging patients first. Methods: Prospective, multi-center randomized controlled trial at three large academic hospitals. Participants were Hospital Medicine attending-level physicians and patients the physicians […]

Background: To relieve hospital capacity strain, hospitals often encourage clinicians to prioritize early morning discharges which may have unintended consequences. We aimed to test the effects of hospitalist physicians rounding on discharging patients first. Methods: Prospective, multi-center randomized controlled trial at three large academic hospitals. Participants were Hospital Medicine attending-level physicians and patients the physicians […]

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: Nearly 6 million pediatric patients are discharged from the hospital yearly in the United States (AHRQ 2012), and social determinants of health (SDoH) impact discharge outcomes (Nacht 2022). Effective discharge planning prevents patient readmissions (Shapiro 2021), but the literature on how best to educate pediatric trainees is limited (Key-Solle 2010, Widmer 2015). We assessed […]

Background: Written discharge instructions frequently lack guidance on how patients should address problems and questions that arise at home, and this represents an opportunity to enhance discharge safety and prevent readmissions. This study aimed to increase the number of discharge instructions that included anticipatory guidance and self-management among patients discharged from internal medicine teaching services […]

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 pediatric discharge education process currently struggles with a lack of standardization, miscommunication between care team members, and non-patient-centered discharge communication. These issues contribute to medical errors, increased readmissions, patient dissatisfaction, and unnecessary healthcare costs. The purpose of this study is to understand the current level of caregiver comprehension in our hospital, streamline the […]

Background: Using average length of stay (LOS) as a quality indicator for individual hospitalists is problematic because it is a metric typically attributed to the discharging attending, who may not have cared for the patient for the majority of the hospitalization. In addition, a hospitalist may have a long average LOS if they are skilled […]

Background: Oncology comanagement of hospitalized cancer patients is increasingly common. We (1) and others (2-4) have previously demonstrated that when compared with traditional oncologist-only staffing, hospitalist co-management can improve on well-recognized quality outcomes including length of stay, early discharge rates and 30-day readmission rates. Yet, the composition of an oncology hospitalist practice is incompletely understood […]

Background: Overuse of daily labs (DL), especially CBC and BMPs in hospitalized patients leads to increased costs and utilization of resources, iatrogenic anemia, and patient discomfort. Prior quality improvement (QI) efforts in hospital medicine have worked to reduce excessive lab utilization, but few have focused on labs ordered on the day of discharge (LOD) . […]