Background: There is growing adoption of Observation units as an answer to increasing payment denials in short stay admissions (ranging from 24-72 hours), overcrowding in emergency room, need for inpatient capacity and mismatched resource utilization. There is quite a bit of variation in the type of OBS units like Level I OBS unit- which is [...]

Background: While multiple organizations have recommended reducing unnecessary and repetitive lab tests in hospitalized patients, this has not resulted in a widespread change in behavior. There is agreement that unwarranted labs increase costs, but data around specific lab costs have not been readily available. At baseline, there were 125,586 labs ordered by the UNC Rex [...]

Background: The merging of academic and community hospitals into a single large healthcare system often does not account for the differences in health care delivery between sites, despite attempts by the system to streamline care through standardized policies, common metrics, and a shared medical record system. Multi-site service lines can be an effective strategy for [...]

Case Presentation: A 54 year-old woman with history of pulmonary embolism and deep vein thrombosis (with prior placement of inferior vena cava (IVC) filter on apixaban) presents with recurrence of hematemesis and dark stool. This was her third hospitalization with GI bleed requiring transfusion in the last few weeks. Her prior work up included multiple [...]

Background: Patient out-of-pocket costs are a critical consideration when providing care as they can represent a substantial portion of a patient’s income and when they are exceedingly high can become a barrier to care. We sought to better understand Physician interaction with and reaction to out-of-pocket costs at the trainee level. Methods: A nineteen-question survey [...]