Background: High need patients are characterized by medical complexity, high amounts of health acute care utilization and disproportionate costs[1]. Recent studies have characterized worsening of loneliness in the general population, however, it has not been characterized in the high need population. We hypothesized that increases in loneliness would be associated with increasing symptoms of depression; [...]

Background: Despite having the highest health care spending, the US continues to have rates of maternal mortality over three times greater than similarly high-income countries. Generally, deaths occur in the days immediately following birth, and typically occur in hospital intensive care units (ICUs). As ICU utilization is often employed to identify indication of severe maternal [...]

Background: The use of physical restraints (PR) in the hospitals among patients is associated with increased delirium, pressure ulcers, prolonged ventilator use, post traumatic stress disorder and disruption of therapeutic relationship with the healthcare team. The current scientific research suggests their ineffectiveness for patient safety like preventing falls or dislodging medical devices. There has been [...]

Background: There is a population of patients who visit Emergency Department (ED) frequently and this has become a challenge for the health-care system. A small proportion, four percent of ED patients, could constitute up to 20% of ED visits (1-3).Interdisciplinary approach of care management is the most widely evaluated and single-point-of contact (4).We conducted a [...]

Background: Excessive laboratory use has been associated with increased hospital costs, increased incidence of anemia, and unnecessary additional testing and procedures. Previous studies have focused on resident interventions within teaching hospitals amongst other residents, but few studies have had residents intervene on non-teaching faculty. A quality improvement initiative was implemented at our institution to reduce [...]

Background: Indwelling urinary catheters (IDUCs) are commonplace in hospital medicine wards, facilitating patient care but introducing risks such as catheter-associated urinary tract infections (CAUTIs). The urgency to minimize these complications has spurred initiatives to refine catheter utilization protocols. This study examines the efficacy of the Foley Removal Countdown Strategy, a novel, proactive approach in the [...]

Background: Post-discharge phone calls to hospitalized patients have been associated with reduced 30-day readmissions.[1,2] But their impact during the COVID-19 pandemic is unknown. Further, whether the 30-day readmission metric is an accurate surrogate for care utilization remains a concern.[3-5] Since 2012, national all-cause readmissions have decreased while emergency department (ED) visits and observation status have [...]

Background: Hospital at Home programs originated as pilot initiatives on a national scale, gaining momentum during the COVID-19 pandemic. The need for reevaluating healthcare delivery systems became pronounced during this period. Kent Hospital in Rhode Island collaborated with key stakeholders, including Blue Cross Blue Shield of Rhode Island, United Health Care, and CMS, to bring [...]

Background: Cardiac arrhythmias pose a significant risk to hospitalized patients, with the potential for increased morbidity and mortality. Rapid recognition of clinically significant arrhythmias is crucial for timely intervention. Cardiac telemetry monitoring offers a means of remote heart rhythm surveillance in the hospital setting. However, limited availability of telemetry beds in many hospitals and the [...]

Background: Cost associated with diagnostic testing contributes greatly to the rising cost of health care in the United States (Bindraban et al, 2018). There is evidence to suggest that up to 20% of lab testing is unnecessary (Bindraban et al, 2018).Main Line Health (MLH) is a health system in suburban Philadelphia made up of four [...]