Background: Inpatient margins and hospital reimbursement have become increasingly dependent upon improving key metrics, such as length of stay and 30-day readmissions. Hospitalists typically lack access to credible, timely, and insightful metrics that inform their practice. In addition, individualized metrics, when available, struggle to properly normalize for patient complexity, warranted variations in care, shared decision-making, [...]

Background: Inpatient margins and hospital reimbursement have become increasingly dependent upon improving key metrics, such as length of stay and 30-day readmissions. Hospitalists typically lack access to credible, timely, and insightful metrics that inform their practice. In addition, individualized metrics, when available, struggle to properly normalize for patient complexity, warranted variations in care, shared decision-making, [...]

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: Higher rates of 30-day readmissions are associated with lower quality hospital care, and readmissions may put patients at risk for worse health outcomes including death. Historically, 20% of hospitalized Medicare beneficiaries were readmitted within 30 days, and many readmissions appeared avoidable. Accordingly, the Centers for Medicare and Medicaid Services (CMS) implemented the Hospital Readmissions [...]

Background: Hospital readmissions continue to remain prevalent despite their negative impact on patient outcomes and economic cost. One in five Medicare beneficiaries is expected to be readmitted within 30 days. As a result, strategies to reduce readmissions is a point of emphasis for all healthcare systems. Guidance regarding reducing readmissions differs and is not abundant. [...]

Background: Multidisciplinary team-based care is a novel concept in hospital medicine where, healthcare team members representing multiple disciplines collaborate to develop patient care plans. Multiple published studies have shown that team-based care is associated with improved length of stay (LOS) and increased staff satisfaction but the data on patient safety and patient satisfaction is conflicting. [...]

Background: Initial management of acute upper gastrointestinal bleeding (UGIB) aims towards aggressive fluid resuscitation to maintain hemodynamic stability. Existing evidence regarding benefit of early endoscopy is unclear with some studies suggesting mortality benefits and some suggesting otherwise. The purpose of this study is to evaluate if there is any mortality benefit of doing early endoscopy [...]

Background: Hospital readmission rates may be influenced by the level of healthcare literacy. Patients who lack an understanding of their diagnosis and warning signs have the potential to not seek medical care in a timely manner. The information patients tend to receive upon discharge is lengthy and unclear. In addition, instructions are not standardized across [...]

Background: Disruptions in normal life routines (such as sleep, function, nutrition, etc.) that commonly occur as part of routine hospital care may be traumatic for acutely ill patients and lead to a generalized condition of high risk after discharge that has been described as “post-hospitalization syndrome.” We created the ARCHES cohort study to measure these [...]

Background: Procalcitonin (PCT) is a precursor peptide to calcitonin produced by the thyroid parafollicular cells, and the intestinal and lung neuroendocrine cells. PCT is a proinflammatoy marker specific to bacterial infections, and was initially used clinically to guide antibiotic therapy in lower respiratory tract infections. PCT has seen its role expanded to aid with initiation, [...]