Background: A fifth of older adults discharged from the hospital require readmission within 30 days. Readmissions impose an enormous burden on both patients and the healthcare system. Previous investigations have found that less than half of discharged patients are able to understand and execute the discharge plan and are likely to overestimate their comprehension of [...]

Background: Although Hospice has been associated with improved symptom management, quality of life, lower costs and length of survival in terminally ill patients, it is underutilized. The primary outcome of this study was to examine the relationship between hospice enrollment status and hospital readmissions in elderly patients with solid tumors. Secondary outcomes were length of [...]

Background: Black seniors have historically had higher readmission rates than white seniors, and hospitals that treat more black seniors have been disproportionately penalized the Medicare Hospital Readmissions Reduction Program (HRRP). Consequently, the policy could exacerbate racial disparities. We sought to determine whether, under the HRRP, trends in 30-day post-discharge mortality differed between black and white [...]

Background: Readmissions within 30 days of discharge is used as a quality metric for the care of hospitalized patients. However, its prognostic value for patient outcomes has not been examined. We hypothesized that patients who get readmitted within 30 days of their index admission discharge may have higher short and long-term mortality. Methods: Using administrative [...]

Background: Diagnostic errors have been cited as a potential contributor to hospital readmissions, particularly early readmissions (e.g. within 7 days). A single prior study of early readmissions applied a binary (yes/no) metric to assess for diagnostic error in early readmissions, but this may be an insensitive method. Past studies of diagnostic error in primary care [...]

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, [...]

Background: Heart failure (HF) is one of the most common discharge diagnoses for Medicare beneficiaries. As part of the Affordable Care Act, the Center for Medicare and Medicaid Services initiated the Hospital Readmission Reduction Program which reduced payments to hospitals for excess readmissions for HF and other diseases. This quality improvement project focused not only [...]

Background: Hospitalists balance efficiency and quality in their daily practice. How a physician’s time management affects care quality is unknown. Accordingly, we aimed to compare the EHR efficiency of hospitalists, as measured by their time spent within the EHR per day, with quality of care, as measured by readmission rates and patient satisfaction. Methods: Data [...]

Background: Nationally, a minority of patients with complex medical and psychosocial needs consume a disproportionate amount of healthcare. In the U.S. in 2015, the top 1% of the population accounted for 23% of all healthcare expenditures and cost ten times more per year than the average patient. No one disease accounts for a large percentage, [...]

Background: Diabetes mellitus is common among hospitalized patients. An inpatient diabetes management service (IDMS) was implemented at a community hospital in suburban Maryland to provide better glycemic control for inpatients. Purpose: To analyze the length of stay (LOS) and 30-day readmission rate (30DR) of patients co-managed by an IDMS team. Description: We retrospectively analyzed LOS [...]