Background: Each year 45 million procedures are performed in the United States. For elective procedures, the preoperative evaluation is an opportunity to identify and manage risk factors that may contribute to post -operative morbidity and mortality. Increasingly thispre-operative visit has come under the purview of hospital medicine. While studies have demonstrated that pre-operative evaluations reduce [...]

Background: Our goal was to evaluate the group of patients that are admitted to the Medicine service under the care of our hospitalist team and then transferred to the medical intensive care unit (MICU) within 12 hours of admission, to see if this was a result of incorrect triage or progression of the underlying disease [...]

Background: The Intermediate Care Unit (IMU) was developed in the 1960s – 1970s as a level of care between general medicine (GMU) and intensive care units (ICU) [1]. The Society of Critical Care Medicine has established guidelines for admitting patients to an IMU based on severity of illness or need for frequent or complex nursing [...]

Background: Intensive Care Unit (ICU) beds are limited, so effective triage is important for resource utilization. However, inappropriate triage of critically ill patients to non ICU settings can lead to poor patient outcomes, as early unexpected ICU transfers are associated with increased mortality. Purpose: We sought to describe the effectiveness of Hospital Medicine (HM), Emergency [...]

Background: Both inappropriate hospital admissions and inappropriate discharges from the ED are associated with adverse patient outcomes. Little is known about the accuracy (sensitivity and specificity) of the hospital admission triage process. Purpose: We sought to understand the operating characteristics of our triage process to identify opportunities for improvement and project an optimal model. Description: [...]

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 [...]