Background: Accurate attribution of quality metrics to individual hospitalists is crucial for quality improvement and value-based care initiatives. However, the collaborative nature of inpatient care with frequent patient handoffs makes fair attribution challenging. The current understanding of variation in hospitalist quality metrics comes primarily from studies using attribution methods based on who oversaw the majority [...]

Background: The benefits of palliative care for hospitalized cancer patients are well known and have become a hallmark of high-quality oncologic care. This evolution in cancer treatment has led to a growing demand for palliative care services, and to questions about how to most effectively integrate this specialty into patient care. Furthermore, the field of [...]

Background: Hospital length of stay (LOS) is an important metric for evaluating a healthcare system’s quality of patient care, patient experience and outcomes, efficiency of practice, and resource management. The COVID-19 pandemic led to a significant increase in the average hospital LOS in the United States. Hospital LOS has continued to remain high due to [...]

Background: Patients admitted for nonsurgical management of small bowel obstruction (SBO) often receive intravenous (IV) opioids for pain relief. However, given the opioid crisis and the potential for opioids to hinder recovery and contribute to ileus, exploring alternative analgesics is crucial. This randomized controlled trial (RCT) evaluates the efficacy of IV acetaminophen for pain management [...]

Background: There are approximately 500,000 episodes of alcohol withdrawal that require pharmacologic treatment yearly. Lorazepam is commonly used due to its high therapeutic to-toxic effect index and its status as historically being the usual treatment. Phenobarbital is another common drug used to treat alcohol withdrawal. Patients with heavy alcohol use may become resistant to some [...]

Background: In 2019, the US Food & Drug Administration issued a warning regarding safety of gabapentin use in patients with respiratory conditions, including chronic obstructive pulmonary disease (COPD). Gabapentin is widely prescribed, often for off-label indications, however limited data exist regarding safety and outcomes among patients with COPD. Methods: We analyzed data from 29 US [...]

Background: Geographic localization is the practice of assigning physician and advanced practice provider teams to patients located in the same inpatient unit. Poor localization of hospital medicine teams at our institution was identified as a top cause of increased Emergency Department boarding and Length Of Stay (LOS). The purpose of our process improvement project is [...]

Background: Length of Stay (LOS) can provide important information regarding the efficiency and quality of patient care. Often, LOS is used as a proxy of efficient hospital management because reducing LOS can allow capacity for emergent admissions and interhospital transfers.2 Increased LOS is associated with negative patient outcomes including increased risk for mortality, hospital acquired [...]

Background: Discharge planning plays a critical role in managing hospital length of stay (1). We report on the implementation of a program in a large hospital system where health care providers were requested to estimate and record the Medically Ready for Discharge Date (MRDD) in the electronic health record (EHR) for hospitalized patients to facilitate [...]

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 [...]