Background: Hospital Medicine groups are often called upon to lead initiatives that require access to high-quality data from their local health system. These include quality and value improvement (QI) efforts as well as health services and outcomes research. Although these efforts can be important for clinical operations as well as academic advancement, clear mechanisms to [...]

Background: Despite years of intense focus, inpatient and observation readmission rates remain high and largely unchanged. Little robust evidence exists to guide hospitals in the selection of interventions effective at reducing 30 day readmissions in real-world settings. Our local healthcare system incorporated the most recent recommendations for preventing readmissions into a comprehensive program called Transition [...]

Background: Septic arthritis (SA) of native joints has an incidence rate of 4-12 per 100,000 person-years. In 2012, there were 36, 539 hospitalizations for SA in US non-VA hospitals and costed the US healthcare system $2.85 billion. Such data has not been reported for US VA-healthcare System. SA has a mortality of 4-13%. Among survivors [...]

Background: Patients with diabetic foot ulcers (DFUs) experience large burdens of morbidity, mortality, and hospital costs. Over a third of patients with diabetes will develop DFUs in their lifetime; and almost half of these patients subsequently develop diabetic foot infections (DFIs). Although it has been reported that obese patients with diabetes do not have higher [...]

Background: Chronic Obstructive Pulmonary Disease (COPD) is a lung disease characterized by chronic, irreversible airway obstruction that can precipitate into acute exacerbations (AECOPD) of cough, dyspnea and sputum production, often requiring hospitalization. Hospital systems aiming to improve outcomes for patients with AECOPD are testing innovative approaches to care in the acute care setting. To enroll [...]

Background: Sepsis research is limited by heterogeneity and inaccuracy of patient identification. An ideal identification algorithm would broadly define a population with suspected infection to optimize discrimination and provide real-time identification of high-risk populations for potential interventions. We combined clinical and administrative to identify a population of adults hospitalized with suspected infection and examined characteristics [...]

Background: The US healthcare system is under increasing pressure to improve value and affordability. Acute care is responsible for a large proportion of overall health costs, but the complexities and pace in this environment have left an evidence gap in value-based care transformation. Novel improvement and evaluation strategies are thus needed more than ever to [...]

Background: Patients with increasing age and medical complexity are undergoing colorectal surgery. Medical complications are not uncommon, and may contribute to higher mortality. We implemented a unique surgical co-management (SCM) model in July 2014 at our institution where two SCM hospitalists were dedicated to Colorectal surgery year round. Each patient was screened daily by a [...]

Background: Currently, once-daily nebulized bronchodilator therapy is unavailable for patients with chronic obstructive pulmonary disease (COPD). Prior studies demonstrated that once-daily revefenacin (REV) doses of 88 and 175 µg produced significant bronchodilation in COPD patients. We report the pooled results of two replicate phase 3 efficacy trials. Methods: In these double-blind, placebo-controlled, parallel-group, 12-week trials [...]

Background: The American healthcare system is focused on promoting value; providing high quality care while paying close attention to associated costs. Studies have shown that admission to a teaching hospital is associated with better outcomes, reduced mortality, compared to nonteaching hospitals. It is not known whether the value proposition at academic hospitals is worthwhile for [...]