Background: Like many institutions nationwide, our health system, an urban tertiary care academic medical center, has experienced challenges due strained hospital capacity. Hospitalists frequently face feedback to place discharge orders as early as possible in the day, for reasons as diverse as assisting patients with obtaining a ride home to expediting bed turnover for the [...]

Case Presentation: A 70 year old female with metastatic cholangiocarcinoma, heart failure with reduced ejection fraction, stage 4 chronic kidney disease and pulmonary embolism on anticoagulation presented to a NYC safety net hospital with bilateral lower extremity edema, dyspnea at rest and a recent unwitnessed fall. Her malignancy was diagnosed 7 months prior and her [...]