Background: Hospital readmissions are frequent and can represent low-quality, high-cost care. Timely post-hospital follow-up has been described as an important element of high-quality transitions of care and readmissions prevention (1-3), yet exactly what type of follow-up is most successful is unclear. We sought to understand the relationship between timing, hospital follow-up visit provider specialty and [...]

Background: The traditional role of hospitalists is to provide care to patients hospitalized with acute medical conditions. Over the past few years, this has evolved to improve care transitions and stewardship of hospital resources. Many hospitals may embed hospitalists in the Emergency Department (ED) to improve patient flow into the hospital; however, there are sparse [...]

Background: Hospital readmissions are frequent and can represent low-quality, high-cost care. Timely post-hospital follow-up has been described as an important element of high-quality transitions of care and readmissions prevention (1-3), yet exactly what type of follow-up is most successful is unclear. We sought to understand the relationship between timing, hospital follow-up visit provider specialty and [...]

Background: The traditional role of hospitalists is to provide care to patients hospitalized with acute medical conditions. Over the past few years, this has evolved to improve care transitions and stewardship of hospital resources. Many hospitals may embed hospitalists in the Emergency Department (ED) to improve patient flow into the hospital; however, there are sparse [...]

Background: High hospital occupancy is a ubiquitous problem worldwide. Singapore General Hospital (SGH) being the largest tertiary hospital in Singapore, sees a large number of attendees come through its Emergency Department (ED) daily 1,2. With silver tsunami on the horizon and rising life expectancies around the world, we are facing higher healthcare complexities and stress [...]

Background: Diabetic ketoacidosis (DKA) is a life-threatening complication of diabetes mellitus that is increasing in frequency, and yet is preventable with adequate outpatient management. Studies have shown that children with diabetes in minority populations experience more frequent DKA admissions, possibly due to inequities in healthcare access. We examined whether disparities by race/ethnicity exist in DKA [...]

Background: Social needs are associated with poor medical outcomes, including increased readmissions. Several studies compare demographic or ICD-10 code indices of social risk and readmissions, or social needs in disease-specific readmissions. Others found that addressing needs is associated with decreased readmissions. However, little is known about how needs differ between patients who are readmitted to [...]

Background: Heart failure (HF) hospital readmissions are a leading cause of US 30-day hospital readmissions. Factors related to clinical complexity and unmet social needs are among the key drivers associated with HF negative clinical outcomes. Digital platforms have shown promise in improving HF outcomes but limitations like patient lack of familiarity with technology and unmet [...]

Background: The process by which patients are admitted to the inpatient setting after evaluation in the emergency department (ED) is a critical component of their care transition. Striking the proper balance between the speed of the process and the quality of the communication is paramount to optimizing workflows and ensuring patient safety. At our institution, [...]

Background: Shifting dynamics present unique opportunities for inpatient providers to enhance outcomes during transitions of care (TOC) as hospital medicine rises as a specialized field. It is well established that gaps in TOC can lead to unfavorable outcomes for patients and healthcare systems alike including increased morbidity, complications, readmissions, and costs. While TOC visits are [...]