Background: Poor coordination between hospital and outpatient care worsens health outcomes, and increases preventable hospitalization and health care expenditures, especially for socioeconomically disadvantaged populations. Evidence of the effects of current programs to improve care coordination is mixed, and there is little data on how their impact may differ for hospitalizations for ambulatory care-sensitive conditions (ACSCs) [...]

Background: Poor coordination between hospital and outpatient care worsens health outcomes, and increases preventable hospitalization and health care expenditures, especially for socioeconomically disadvantaged populations. Evidence of the effects of current programs to improve care coordination is mixed, and there is little data on how their impact may differ for hospitalizations for ambulatory care-sensitive conditions (ACSCs) [...]

Background: Discharging complex patients at an academic tertiary care center requires comprehensive evaluation, interprofessional coordination, and meticulous planning to address what is needed to ensure safe and timely discharges. Misalignment across care team members on discharge needs and barriers can lead to a delayed discharge which may result in poor patient satisfaction, increased task burden [...]

Background: As a strategy to improve throughput and efficiency, Vanderbilt University Hospital implemented geographic localization across several Hospital Medicine (HM) teams and units. This large-scale structural change presents an opportunity to not only improve efficiency and quality metrics, but to improve other patient-centered outcomes including patient experience. Purpose: To assess the impact of a hospital [...]

Case Presentation: A 54-year-old tracheostomy and gastric tube dependent, non-verbal male with chronic spastic quadriplegia, autonomic dysautonomia, and recent ICU admissions for MDR pneumonia presented to the emergency department from his skilled nursing facility with acute hypertension. His home medications were notable for hydralazine, isosorbide mononitrate, clonidine, midodrine, and an intrathecal baclofen pump. He was [...]