Background: It is challenging for patients to navigate through complex healthcare systems after-hours. This leads to delays in patient care, patient/provider dissatisfaction, inappropriate resource utilization, readmissions, and higher healthcare costs. Prior to August 2015, non-medical staff at external call centers with invalidated standard work, poor work cell co-location, and inadequate active daily management addressed the [...]

Background: Discharge from the hospital can be overwhelming for patients. Prior to May 2016, discharge phone calls were made by inpatient bedside nurses who seldom had the resources or time to resolve patient’s unmet needs. Patients/families were often referred to the outpatient clinics for assistance. Purpose: To provide seamless connectivity to patients after discharge from [...]

Background: Currently, Physical and Occupational Therapy (PT/OT) documentation dictates next site of care. PT/OT recommends how much therapy is needed upon discharge and where the therapist believes these services should be provided, which is often a Skilled Nursing Facility (SNF). This practice eliminates meaningful conversations between provider and patient regarding the patient’s wishes on next [...]

Background: Risk factors for hospital-acquired venous thromboembolism (HA-VTE) have been well-studied in adults, with validated risk assessment tools available. Adults admitted to children’s hospitals are younger but with comorbidities stemming from childhood conditions. There is a paucity of data on HA-VTE characteristics and risk factors in this population. Our objective was to evaluate HA-VTE in [...]

Background: Rifaximin, a nonsystemic antibiotic, may be used alone or in combination with lactulose for reducing the risk of overt hepatic encephalopathy (OHE) recurrence in adults. This analysis evaluated rifaximin alone and rifaximin + lactulose (combination) on health-related quality of life (QOL) and caregiver burden in patients with a history of OHE. Methods: In a [...]

Background: Adverse drug events are common during transitions of care and often due to patient misunderstanding of the medication regimen or non-adherence. Challenges exist that may influence the ability of new interventions to address this issue. As part of the Smart Pillbox study, a randomized controlled trial of an electronic pillbox, we explored barriers and [...]

Background: Preventing readmissions of patients with chronic illness can improve healthcare outcomes and decrease costs. Previously reported Medicare claims data from 2003 to 2004 showed that 19.6% of Medicare beneficiaries discharged from the hospital were readmitted within 30 days at a cost of $17.4 billion. Our 232-bed community hospital has set a goal to reduce [...]

Background: Due to the complexity of patient discharge needs leading to increased length of stay within a large academic medical center, a specialized inpatient unit became a priority. Purpose: The University of Kentucky Healthcare created the Complex Discharge team to identify and manage patients who may have a long length of stay, a challenging placement [...]

Background: Recurrent hospitalizations are responsible for considerable health care costs. This retrospective observational study was undertaken to determine whether timely communication of care (COC), such as direct phone call or voicemail notice, following a hospitalization is effective at increasing clinic follow-up rates and reducing readmissions within 30 days after discharge. Methods: We analyzed 237 patients [...]

Background: Medical housestaff must participate in a handoff process when transitioning between rotations on hospital services. During this time, a new team of residents assumes care for multiple patients. A prior study demonstrated that this critical period of transition is associated with increased mortality among hospitalized patients. Methods of improving daily patient handoffs to overnight [...]