Background: The transfer of patients between hospitals (interhospital transfer, IHT), exposes patients to risks of discontinuity of care. In this study, we aim to better understand which patients may (or may not) benefit from IHT by evaluating the impact of IHT on clinically important patient outcomes among a variety of patient diagnoses. Methods: We performed [...]

Background: In a previous randomized trial we found that shorter ward rotations reduced attending physician burnout at rotation-end. This improvement was offset, however, by negative education outcomes among trainees. Therefore solutions to burnout other than simply shortening rotations are needed to preserve the educational mission. We examined additional data collected (but not yet presented) to [...]

Background: The transfer of patients between hospitals (interhospital transfer, IHT), exposes patients to risks of discontinuity of care. In this study, we aim to better understand which patients may (or may not) benefit from IHT by evaluating the impact of IHT on clinically important patient outcomes among a variety of patient diagnoses. Methods: We performed [...]

Background: In a previous randomized trial we found that shorter ward rotations reduced attending physician burnout at rotation-end. This improvement was offset, however, by negative education outcomes among trainees. Therefore solutions to burnout other than simply shortening rotations are needed to preserve the educational mission. We examined additional data collected (but not yet presented) to [...]

Background: Many end stage renal disease (ESRD) patients present with complaints related to missed or incomplete hemodialysis (HD). Inpatient HD units often are not credentialed for outpatient use which results in extra cost and consumes additional resources for a standard outpatient procedure. Delays in patient throughput in emergency departments (ED) can cause boarding in the [...]

Background: Hospital-acquired delirium is serious, leading to increased falls, pressure ulcers, length of stay (LOS), cost, patient institutionalization, and patient and caregiver distress. In addition, it is associated with mortality rates as high as 35-40% within one year in older patients who develop delirium. Because hospital-acquired delirium is often under-recognized and prevention and treatment involves [...]

Background: Dedicated hospitalists are associated with improvements in healthcare quality and patient outcomes, but are not feasible for small-volume critical access hospitals (CAHs). A telemedicine “virtual hospitalist” model may expand the capabilities of a CAH at a fraction of the cost of an on-site provider. Purpose: Our purpose was to provide hospitalist coverage to remote [...]

Background: Inter-hospital transfer (IHT, the transfer of patients between hospitals) exposes patients to risks of discontinuity of care. To identify aspects of the transfer process that increase risk, we examined the impact of select transfer process factors on clinical outcomes among patients undergoing IHT. Methods: We performed a retrospective analysis of patients ≥ age 18 [...]

Background: Communication between patients, nurses and physicians is vital to patient care. Prior studies have shown that a substantial number of hospitalized patients do not understand their care plan and that physician-nurse co-location or time spent communicating have little impact on physician-nurse concordance of plan of care. To our knowledge, there have been no prior [...]

Background: For several years, patient evaluations of their physician has been utilized as a metric to evaluate physician performance and now it has been included as a parameter utilized to calculate reimbursement. Despite the routine use of these evaluations by most hospitals and agencies, little research has been done to evaluate the accuracy and characteristics [...]