Background: In tertiary care centers, transfers from outside hospitals are a common occurrence. Prior studies have shown that interhospital transfers (IHT) in certain populations are associated with an increased adjusted odds of ICU transfer (Mueller 2019). In the age of the electronic medical record(EMR), patient transfer has been improved by direct access to patient records. [...]

Background: A discharge summary serves as a crucial means of communication between inpatient and outpatient providers. Appropriate transitions of care rely on updates to patient problems, diagnostics, treatment history, and discharge plans. Many studies have identified lacking components in discharge summaries that may lead to poor medical management.In an effort to improve patient transitions of [...]

Background: Social isolation and loneliness (SI+L), two largely silent social determinants of health (SDOH), are associated with negative health outcomes such as the increased risk of cardiovascular disease, higher rates of depression, increased hospital readmissions, and increased use of healthcare services. SI+L are also common, with one in five US adults reporting feelings of SI [...]

Background: Hospitalists are tasked with improving care quality across several different inpatient metrics. These include length of stay, readmission rates, health care associated infections, system capacity and patient satisfaction scores. While most quality metrics are driven by systems of care, it can be challenging for frontline providers to address variations in individual practice, if any, [...]

Background: At our Tertiary Care, Academic, Level 1 Trauma Center, length of stay (LOS) has increased over the past year. This has been associated with increased occupancy, increased boarding in the ED and increased volumes on the Medicine teams. In response, reducing LOS has has been targeted as a strategic priority for the institution. Existing [...]

Background: Measures to reduce hospital readmissions help to improve the quality of care patients receive, as well as reduce healthcare costs. The Institute for Healthcare Improvement’s Triple Aim of improving the quality of care through standardization, decreasing the cost of care by reducing hospital utilization, and patient-centeredness around transitions of care, resonate strongly with readmission [...]

Background: Sepsis is a leading cause of morbidity and mortality in the US. Annually, over 250,000 people die from sepsis nationwide. Therefore, in 2013 New York State mandated that hospitals adhere to standardized protocols designed to improve sepsis outcomes. A recent cohort analysis on the rollout of these standards demonstrated that mortality decreased by 6% [...]

Background: Congestive heart failure (CHF) is a major cause of mortality and morbidity among general population despite recent advancements in goal-directed therapies. The advent of mechanical circulatory devices, the increased availability and improvement in heart transplant techniques have improved some metrics; however, CHF patients continue to have multiple readmissions for acute exacerbations. The frequency of [...]

Background: Prevalence of alcohol use disorder (AUD) on inpatient medicine wards exceeds 40%. Only 50% of these patients develop alcohol withdrawal, of whom only 5-20% develop complicated alcohol withdrawal syndromes (AWS) that warrant treatment and monitoring. Overutilization of the Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised (CIWA-Ar) scale is well-reported in the literature. CIWA-Ar [...]

Background: Over the last 2 decades there has been increasing adoption of Observation (OBS) units across the healthcare facilities in United States. Health reforms like 2 midnight rule and 30 day readmission penalties, congestion in the ED, poor operational outcomes in OBS population mixed with inpatients (IP) etc. further added to the need for dedicated [...]