Background: Centers for Medicare & Medicaid Services (CMS) recommends against the use of Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) for determining patient satisfaction with physicians, however, hospital administrators often use HCAHPS scores as one metric for determining physician incentives. Such use of HCAHPS likely results from its easy availability and lack of [...]

Background: Our institution is a Level 1 regional trauma center with a large inpatient volume. A large percentage of these patients are elderly, with the traumatic events occurring as sequelae of their age, debility or medical complications. Last year, we developed a Trauma/Acute Care Surgery Hospitalist Co-Management program, due to, in large part, the increasing [...]

Background: In most hospitals, physicians provide care to patients across multiple units while nurses are often unit-based, resulting in team dispersion, and potentially impairing teamwork. Geographically localized care teams may demonstrate improved communication between team members and with patients, potentially enhancing coordination of care. However, the impact of geographically localized teams on patient experience scores [...]

Background: Hospitalized patients placed on contact, droplet, or respiratory isolation due to a carrier state or infection with resistant or highly communicable organisms report higher rates of anxiety and loneliness and have fewer physician encounters, room entries, vital sign records, physician and nursing notes in the chart. For these reasons, it has been hypothesized that [...]

Background: The hospital discharge is one of the most important aspects of a patient’s hospitalization, yet in residency training, this process often goes overlooked. Most residents are never properly taught how to effectively discharge a hospitalized patient. As a sequelae, patients often lack understanding about their hospitalization, treatment(s), and follow up plans. This uncertainty can [...]

Background: Hospitals are compelled by a variety of factors to optimize patient satisfaction. Pain management has been identified as an important determinant of overall inpatient satisfaction. However, effective pain management may be more challenging in the current climate of more cautious opioid use. Purpose: The 32-item Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) [...]

Background: Opiates, frequently used to provide analgesia, are associated with post-analgesia related tolerance effects such as hyperalgesia and hyperkatifeia, which lead to worsening of the pain experience. Patients can subsequently experience dissatisfaction with their care and seek further opiate use as a solution, worsening their experience further. Due to pharmacologic and healthcare-associated operational factors, the [...]

Background: The 2001 Institute of Medicine Report Crossing the Quality Chasm cited a lack of care coordination as a contributing factor to the “chasm” between evidence-based and delivered care and suggests team-based models of care delivery. Hospitalists are tasked with increasing efficiency in inpatient care. LOS is designated as a measure of care coordination and [...]