Background: Prolonged length of stay (LOS) is associated with worse quality outcomes, poor patient satisfaction, and negative financial performance for hospitals. Geographic cohorting of provider teams and their patients could improve LOS, readmissions, and other quality metrics. Many prior studies of geographic cohorting have shown no beneficial effect on these metrics. In 2021, we implemented […]

Background: 22% of the hospitals overall STAR rating is based on readmission reduction for the following disease specific groups: pneumonia, chronic obstructive pulmonary disease, acute myocardial infarction and congestive heart failure. Creating strategies surrounding prevention of readmissions that create workload balance leads to improved ability to manage these patients. The hospitalist medicine, emergency medicine, pulmonary, […]

Background: Case Managers (CM) are now a standard presence in emergency departments (ED) of large hospitals, partnering with ED and Hospital Medicine providers to improve care. They are integral in improving hospital throughput and reducing unnecessary hospital admissions and readmissions. Case Managers generally identify high-risk patients using a manual chart review process or by provider […]

Background: Timely, effective follow-up after hospital discharge can improve the efficiency and outcomes of care by increasing hospital throughput and decreasing readmissions and other adverse events after discharge. The University of Chicago Medical Center (UCMC) has chronic bed shortages and a medically and socially complex patient population that makes optimal management of post-discharge care especially […]

Background: Avoiding preventable readmissions is a major goal of health care systems nationwide1. The Cardiorespiratory cohort consists of Veterans admitted with a diagnosis of CHF, COPD and non-COVID-19 Pneumonia, and is a high-risk group for readmissions. As part of a larger National VA High Reliability Organization (HRO) Collaborative2, an interdisciplinary team was launched to achieve […]