Background: Ten to twenty percent of U.S. hospitalizations are avoidable, driven by clinical uncertainty, social factors, or lack of access to ambulatory care [1-3]. These unnecessary admissions result in significant human and financial costs, including in-hospital errors, wasteful spending, and medical debt [4-7]. With hospital occupancy reaching critical levels, we designed and launched the Olive [...]

Background: Ten to twenty percent of U.S. hospitalizations are avoidable, driven by clinical uncertainty, social factors, or lack of access to ambulatory care [1-3]. These unnecessary admissions result in significant human and financial costs, including in-hospital errors, wasteful spending, and medical debt [4-7]. With hospital occupancy reaching critical levels, we designed and launched the Olive [...]

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: Inpatient telemetry monitoring is a limited resource. The value of telemetry monitoring in hospitalized patients with high risk for cardiac arrhythmia is high. However, telemetry monitoring is often ordered for inpatients at low risk for cardiac arrhythmia. The SHM’s Choosing Wisely campaign recommended avoiding continuous telemetry monitoring in non-ICU patients without a protocol. Ordering [...]

Background: Nearly one-third of laboratory tests in hospitalized patients and up to 60% of routine, repeat lab tests are unnecessary. Unnecessary testing results in excess venipuncture, iatrogenic anemia, patient discomfort, excess costs, wasted lab resources, and a potential cascade of additional tests and interventions. Few academic medical centers, including our institution, have systematic lab stewardship [...]