Background: At our Level 1 trauma center, geriatric trauma (GT) patients are primarily managed by hospitalists with surgical consultation. This care model offloads the trauma surgical services, improving time to surgery and hospital throughput. As the number of injured GT patients rose, so did the need to address a higher complication risk, longer hospital stays, [...]

Background: The underlying burden of medical co-morbidity is often the main driver of ICU transfer of patients initially admitted to the medical wards (1). The role of non-patient related factors is unclear, as are the mortality and economic data associated with ICU transfer from the medical ward. The purpose of this analysis was to identify [...]

Background: In 2012, as part of Value based purchasing program, CMS instituted the Hospital Readmission Reduction program (HRRP). This aimed to decrease the number of unplanned readmission to the hospital for six conditions: Acute myocardial infarction(AMI),chronic obstructive pulmonary disease( COPD), Heart Failure (HF), Pneumonia ( PNA) , Coronary bypass graft(CABG), Elective total hip arthroplasty (THA) [...]

Background: Geographic localization (GL) has been shown to improve perceptions of physician-nurse, physician-physician, and physician-Case Management communication. However, data on other benefits of GL are mixed. While some studies show that GL improves time allocated by physicians for direct patient care, others report an increased frequency of workday interruptions and greater time spent on indirect [...]

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: Accountable Care Units (ACUs) with Structured Interdisciplinary Bedside Rounds (SIBR® rounds) have shown significant improvements in throughput, clinical outcomes, and satisfaction. Yet, prior studies have noted difficulties achieving such improvements or sustaining them. Interdisciplinary rounds are a predominantly physician-led teamwork process with efficacy vulnerable to inconsistent physician leadership and engagement. Our hospital had previously [...]

Background: Heart Failure (HF) is among the top 10 causes of hospitalization and almost a fifth are readmitted within 30 days. Clinical assessment of lung congestion is subjective and patients may be discharged prior to good resolution. Lung ultrasound (LUS) is helpful in evaluating lung congestion. The presence of B-lines on LUS can reliably indicate [...]

Background: To address bed capacity concerns related to the COVID-19 pandemic, the Centers for Medicare and Medicaid Services (CMS) waived the certificate of medical necessity for oxygen claims, allowing for reimbursement for oxygen prescribed for patients upon hospital discharge with COVID-19 respiratory illness. This reimbursement allows providers to discharge patients with COVID-19 respiratory illness still [...]

Background: The 30-day readmission rate is a key performance indicator for hospitals and hospitalist groups alike. Studies have reported a correlation between scheduling follow-up appointments and reduced readmission rates in specific patient populations (e.g. Heart Failure, COPD). However, evidence regarding the effectiveness of scheduling post-discharge appointments in general medicine patients has been mixed. Methods: We [...]