Background: New hospitalists can often feel overwhelmed by learning system practices, navigating difficult dispositions, and managing difficult patient and family relationships. This can lead to increased length of stay1, increased burn out, and a feeling of lack of mentorship. Purpose: We hypothesized that weekly meetings between a hospitalist director and a junior faculty hospitalist to [...]

Background: New hospitalists can often feel overwhelmed by learning system practices, navigating difficult dispositions, and managing difficult patient and family relationships. This can lead to increased length of stay1, increased burn out, and a feeling of lack of mentorship. Purpose: We hypothesized that weekly meetings between a hospitalist director and a junior faculty hospitalist to [...]

Background: To date, there are limited reports around the use of well-designed information technology tools to enhance throughput communication during interdisciplinary rounds (IDRs). In collaboration with our technology innovations center, we developed a Microsoft Teams IDR tool known as “NORA.” NORA is an automated process-oriented tool designed to extract patient summary information from electronic health [...]

Background: With the transition to diagnosis related group (DRG)-based hospital reimbursement, length of stay has become a significant financial driver of every health system and hospital medicine group. To understand how one health system compares to national peers, length-of-stay index (LOSi) has become the standard method of reporting. LOSi is defined as the ratio of [...]

Background: Communication between Hospital Medicine physician teams and interdisciplinary care providers (e.g. nurses, physical and occupational therapists, case managers) regarding disposition planning is often inconsistent, potentially delaying care and resulting in poor patient and provider experience. Prior studies demonstrate that sharing the estimated discharge date (EDD) early in a patient’s hospitalization can improve communication and [...]

Background: Project Caring for Patients with Opioid Misuse through Evidence-Based Treatment (COMET) launched in 2019 to provide patients with opioid use disorders (OUD) individualized and evidence-based care at Duke University Hospital (DUH). Patients with OUD have higher rates of self-directed discharge (SDD) which is associated with higher healthcare utilization costs, hospital readmissions, and adverse health [...]

Background: Facing challenges of capacity strain, many hospitals have implemented programs to prioritize discharges in the morning as a strategy to improve patient throughput, decrease emergency room boarding, and improve patient satisfaction/experience. (1) However, evaluations of these practices have had mixed results. (2) Like many other complex health interventions, priority discharge interventions may fail to [...]

Background: The leadership of our academic hospital medicine group designed a geographic rounding intervention with the goal of improving patient-nursing communication, decreasing hurdles in discharging patients and eventually leading to reducing patient length of stay and increasing discharge rate. Our quantitative analysis compared the pre-intervention and post-intervention time periods with regard to observed to expected [...]

Background: Hospital discharge requires coordination among multiple disciplines and may feel chaotic as discharge approaches. The 48-Hour Discharge Prediction Tool (48DPT) is an AI-based system developed to predict clinical readiness for discharge 48 hours beforehand, with the aim of alerting the interdisciplinary team and prompting earlier completion of preparatory procedures. This study assessed 48DPT’s impact [...]

Background: The after-visit-summary (AVS) is an essential tool used by providers to explain discharge instructions and ensure appropriate post discharge follow up. Studies have shown that post discharge follow up within 7 days is associated with substantially lower risk of readmission, an organizational priority for us (1). However, many patients were not following up within [...]