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: Medicare patients account for over 50% of hospital days at a cost of over $1 trillion per year. Yet, hospitalization of older adults often results in poor outcomes. Furthermore, the number of geriatric healthcare providers dedicated to the care of hospitalized vulnerable older adults is currently insufficient. Purpose: Our objective was to create an [...]

Background: Complex patients represent a challenge in the health care system, as they are frequently associated with high health care utilization, longer hospital stays, and higher costs. Nonetheless, the characteristics of the complex patients in the hospital setting are not well known, and tools to help hospitals to identify them early in the process of [...]

Background: Background: Geographic cohorting (GCh) of clinicians to a single unit may improve teamwork and improve outcomes. The physical proximity between the care team is purported to mediate these positive effects. We conducted an exploratory time-and-motion study of physicians to assess differences in daily activities between GCh and traditionally dispersed or ‘At-Large’ (AL) physicians. We [...]

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: Cost-related medication non-adherence (CRN) is a persistent and serious challenge among the elderly population in the US. For elderly patients with limited economic means at increased risk of hospitalization, CRN may elevate the risk of repeated hospitalizations and emergency department visits, and lead patients into a downward spiral of worse heath and higher non-adherence. [...]

Background: The prevalence of delirium among hospitalized patients ranges up to 56% and results in increased hospital mortality and duration of hospitalization. Symptoms of delirium may be subtle in early stages and may present clinically as hyperactive, hypoactive or mixed type. As such delirium often evades early detection. In addition, delirium in the hospital setting [...]

Background: Previous studies demonstrate patient readmissions to the Medical Intensive Care unit (MICU) from the ward are potentially associated with worse outcomes due to breakdowns in communication during ICU-ward transfer. Though previous work highlights the importance of shared mental models (whether clinicians have a mutual understanding) during handoffs, no studies examined the prevalence of a [...]