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: Mortality rates are a critical quality metric for hospitals, influencing both clinical outcomes and institutional reputation. The Centers for Medicare and Medicaid Services (CMS) incorporates 30-day mortality rates into its Value-Based Purchasing (VBP) program and Star Ratings, directly impacting hospital reimbursement and public perception. Similarly, U.S. News & World Report factors 30-day mortality into [...]

Case Presentation: A 71-year-old man with history of coronary artery disease, aortic stenosis status post transcatheter aortic valve replacement (TAVR) two years ago, and ankylosing spondylitis presented to the emergency department for evaluation of 3 days of subjective fevers, worsening generalized weakness requiring one-person assist for ambulation, and tachycardia on his smart watch in the [...]

Case Presentation: A 39-year-old active MMA fighter with hypertension and type 2 diabetes mellitus, both diagnosed in early adulthood, presented with 1 day of crampy, left-sided abdominal pain associated with multiple episodes of vomiting. He also reported episodic dizziness, flushing, headache, and rises in blood pressure (BP) over the two years prior. He denied recent [...]

Case Presentation: A 14-year-old female with a one-month history of iron-deficiency anemia due to menorrhagia presented to the emergency room for weakness and dizziness. She was found to have a hemoglobin of 3.7 g/dL in the setting of her menstrual cycle. Menarche began at age 13 and has gradually become longer and heavier. Most recent [...]

Background: Recent research highlights that in-hospital communication increasingly is relying on secure electronic messaging with notable unintended consequences, including increasing task switching and the overall burden of communications. This study sought to quantify non-actionable, non-urgent messages to better understand their prevalence and to develop interventions aimed at optimizing communication workflows. Methods: A qualitative content analysis [...]

Background: Secure text messaging systems that allow for bidirectional communication between a sender and recipient, instead of relying on unidirectional alphanumeric text or numeric-only messages, have fundamentally changed inpatient communications. At our institution, all clinical team members utilize the same secure messaging platform (Voalte). We aimed to explore physician and nurse overall satisfaction with our [...]

Background: UC Davis Medical Center is a 646-bed tertiary care center and level 1 pediatric and adult trauma center, serving over 33 counties. Most inpatient internal medicine consultations originate from orthopedic and trauma services, with a significant subset of fragility fractures and geriatric patients. We established a co-management service to provide additional assistance for the [...]

Background: Oropharyngeal dysphagia (OD) is a common syndrome in hospitalized patients with Alzheimer’s disease and related dementias (ADRD). Although modified barium swallow study (MBSS) is considered the reference standard test for OD diagnosis and classifying OD severity, it is not routinely used in clinical practice. The objective of our study was to determine whether the [...]