Background: Hypertension and diabetes are common comorbidities frequently managed by primary care physicians. Poorly controlled cases of these conditions can lead to increased healthcare resource utilization. We conducted a prospective pilot study involving high-risk patients with hypertension and diabetes to evaluate whether a multidisciplinary team approach could lead to improved clinical outcomes and reduced healthcare [...]

Background: Palliative care (PC) is a multidisciplinary consult service aimed at ensuring goal-concordant medical care while optimizing patient/family support. Prior studies have illustrated that palliative care consultation can be associated with a significantly shorter length of stay but without significant change in mortality or disposition. Utilization of standard high-risk descriptive criteria or “triggers” that uniformly [...]

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: Length of stay is an important marker for quality of care in the hospital. Increased length of stay can affect patient flow through the hospital and can lead to overcrowding, increased boarding in the emergency department, delays in inter-hospital transfer, and cancellation of elective procedures due to bed availability (1). In addition, longer hospitalizations [...]

Background: Efficient discharge planning is crucial for improving hospital capacity strain and patient care. Multidisciplinary rounds (MDRs) have demonstrated effectiveness in enhancing communication and care coordination, but their impact on resident teaching teams has been less studied. The expected discharge date (EDD), among other key metrics in discharge efficiency, helps predict bed capacity, optimize patient [...]

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 [...]

Background: Length of stay is an ongoing challenge for hospitals across USA. Large number of medically stable patients continue to remain in the hospital. There are multiple barriers including social, financial, and poor communication between team members. This delays discharge leading to poor patient care, burnout of team members, reduced bed capacity and access. Purpose: [...]

Background: A recent uptick in hospital readmissions, prolonged lengths of stay that was above national benchmarks, and declining patient satisfaction scores threatened the institution’s reputation within the community and risked CMS reimbursement penalties. In response, an interdisciplinary physician-led huddle followed by a structured nurse-physician bedside rounding protocol was developed. This approach was designed to strengthen [...]

Background: The patient population at tertiary hospitals is increasingly complex due to advancements in healthcare and more aggressive management of comorbidities. This complexity is particularly evident in the patients on medicine services that have a tracheostomy. Patients with tracheostomies on general medical floors often experience prolonged lengths of stay and multiple inpatient complications, such as [...]

Case Presentation: Patient is a 53-year-old female with a medical history of hypertension, hyperlipidemia, diabetes, and tobacco use, presented with a right middle cerebral artery (MCA) stroke and left-sided weakness. She initially delayed seeking care, attributing her symptoms to chronic back pain, but was eventually brought to the hospital by her family. MRI revealed a [...]