Background: Delays in the discharge process of hospitalized patients impact patient flow and lead to increased costs and slower progression of care. As hospitalist work becomes increasingly shift based, there are concerns for proper patient handoffs and hesitancy with clinical progression of care overnight. This leads to daytime patient flow congestion and is a significant [...]

Background: Delays in the discharge process of hospitalized patients impact patient flow and lead to increased costs and slower progression of care. As hospitalist work becomes increasingly shift based, there are concerns for proper patient handoffs and hesitancy with clinical progression of care overnight. This leads to daytime patient flow congestion and is a significant [...]

Background:   Academic medical centers are complex healthcare delivery systems that are quickly adopting electronic health records (EHR) nationwide while still using alpha-numeric paging for physicians-in-training raised with cell phones, texting, messaging, and newer technologies.  Understanding workflow processes for these providers of patient care are key to finding solutions to improve healthcare quality and safety.   [...]

Background: The need to improve patient satisfaction (or patient experience) is increasing dramatically. Patient satisfaction is not only a direct indicator of quality of care but it is also an important component of pay for performance metrics. We started a standardized process of admitting patients by developing dedicated admission teams called Patient Centered Admission Teams [...]

Case Presentation: A 81 year old Asian woman with past medical history of diabetes, hypertension, coronary artery disease, and arthritis presented with fever and five days of worsening neck stiffness and pain, worsened by neck movement. Laboratory examination revealed mild leukocytosis, CRP 28 and ESR 114. Broad spectrum antibiotics were started for possible meningitis. Lumbar [...]