Background: The Atlanta Medical Center (AMC) closure in fall 2022 resulted in diversion of its patients to Grady Memorial Hospital, Emory University Hospital-Midtown (EUHM), Emory Decatur Hospital, and Emory Hillandale Hospital. The impact on Emory has not been examined; this reflects a gap in the literature. There are many studies of negative impacts of rural [...]

Background: This umbrella meta-analysis assesses the safety of left atrial appendage (LAA) closure by minimal invasive procedures compared to oral anticoagulants (OACs) in patients with atrial fibrillation (AF), concentrating on adverse events and overall clinical outcomes. The results seek to elucidate the most effective treatment. This umbrella meta-analysis intends to evaluate the safety and efficacy [...]

Background: Identifying discharge barriers, reducing length of stay (LOS) and optimizing the observed over expected (O/E) ratio for LOS are crucial in healthcare management. Addressing obstacles—DME needs, medical issues, diagnostic/procedure delays, administrative hurdles—can streamline discharge, enhancing outcomes, optimizing resources, cutting costs, and improving hospital efficiency. Effective discharge planning, interdisciplinary collaboration, and patient education are vital [...]

Background: Kidney injury significantly reduces renal clearance, posing unique challenges for patients with type II diabetes, particularly those on insulin. This reduced clearance can lead to elevated insulin levels, increasing the risk of hypoglycemia and subsequent complications, which often extend the patient’s length of stay (LOS). Chronic kidney disease (CKD) itself is an independent risk [...]

Background: A process problem with our MDR process was identified which had exhausted conventional unit-based approaches to improvement. We researched new processes and brainstormed on an “outside the box” approach to the Case Management model and MDR Daily Meetings. The new approach involved a dramatic Hospital-wide change of structure, associated with integration of multiple service [...]

Background: Medical errors are the third leading cause of death in the United States yet physicians report minimal education on how to disclose errors and adverse events. To Err is Human shed light on the severity of errors. As a result, communication and resolution programs were developed over the past two decades to attempt to [...]

Background: Prior studies have described the negative collateral effects of a hospital’s closure on the efficiency, access, and quality of care delivered at nearby hospitals that bear the brunt of care transfers and patient dispersion. However, few studies have addressed quality at the institution that is closing, as it is closing, and when the closure [...]

Background: Accurate clinical documentation is essential for capturing patient severity of illness (SOI) and risk of mortality (ROM). These metrics directly influence hospital quality reporting, including rankings like Vizient and metrics such as Observed-to-Expected Mortality (O:E) ratios. Traditional documentation methods rely heavily on manual input, which in busy clinical practices, results in underrepresented patient risk [...]

Background: Patients undergoing induction chemotherapy for acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL) often experience prolonged hospital stays due to the length of induction therapy, follow-up bone marrow biopsies, and count recovery. While the average length of stay (LOS) for these patients may exceed 30 days, most diagnosis-related groups (DRGs) assign a LOS [...]

Background: Traditional Length of Stay (tLOS) is commonly used in Hospital Medicine to assess hospital resource utilization and to incentivize reductions in patient stays. However, tLOS is often attributed to the discharging physician, which can lead to attribution errors and fairness concerns. These limitations can reduce the metric’s utility. In response, Pierce, Harrison, and Patel [...]