Background: Hospital Onset Clostridium difficile infection (HOCDI) is one of the most common causes of hospital acquired diarrhea. As per a recent study, the mean healthcare costs attributable to primary Clostridium difficile infection (CDI) is about $24,205 per patient. This would be a lot more if the patients were to be discharged to skilled nursing [...]

Background: Discharge to post-acute care settings (PACs), such as skilled nursing facilities (SNFs), requires significant, complex discharge planning which often needs to be started early during hospitalization to be complete by time of discharge. This study sought to identify and model factors which predict a given patient’s likelihood of requiring PAC after discharge, using routinely [...]

Background: Hospital capacity constraints remain an immense concern throughout the US and has been recognized as a national crisis for greater than a decade. ER overcrowding is of particular concern due to its downstream effects. It occurs when admitted patients are boarded in the emergency room for greater than 2 hours, while inpatient beds become [...]

Background: Discharging patients is a complicated process that requires planning, coordination and communication between multiple care team members. Ideally this process begins at admission and is updated in real time as the patient care plan evolves and discharge needs become known. Discharge plans are often made using some form of static communication, such as in-person [...]

Background: Discharge delays occur because of inconsistent communication among all clinicians and providers. Inefficient utilization of resources also contributes to delays. Effective communication among the patient care team is a foundation of creating an effective discharge planning process. We must standardize the process of communication as well as resource optimization in order to provide our [...]

Background: Research on post-discharge outpatient care often focuses on single types of encounters, such as primary care in-person appointments or primary care phone calls. However, patients interact with the healthcare system following discharge using a range of communication methods. This study seeks to examine the role of different types of post-discharge encounters on unplanned hospital [...]

Background: Though the advent of highly active anti-retroviral medications has improved survival in HIV infection, mortality from non-infectious complications such as pulmonary arterial hypertension (PAH) has increased. Also, studies have shown that PAH is the leading cause of hospitalization and death in patients with HIV associated PAH (HIV-PAH). However, not much is known about the [...]

Background: Length of stay (LOS) outliers are a focus of cost and resource utilization for hospitals in the United States. Limited research has been done to characterize outliers, risk factors, and barriers to discharge. Methods: We conducted a case-control study of inpatient admissions to the general medicine service line between September 2015 and August 2016. [...]

Background: Tests Pending at Discharge (TPAD) is a common patient safety concern at transitions of care due to provider discontinuity, suboptimal communication, and lack of ownership. A significant proportion of inpatients, up to 70%, are discharged with one or more TPAD. Recent studies show that 30-40% of resulted TPAD warrant a change in patient management. [...]

Background: The Improving Pediatric Patient-Centered Care Transitions (IMPACT) multi-site quality improvement collaborative aims to improve discharge transitions by use of a transition bundle, including use of a discharge checklist (DCL) to ensure completion of important transition tasks. These tasks included identification of a primary care provider, establishing follow up appointments, and ensuring access to medications, [...]