Background: Delays in the discharge of the hospital ward patients cause a backlog for new admissions from the Emergency Department, and transfers from the Intensive Care Units and telemetry units. This bottleneck unnecessarily increases overall resource utilization and also negatively impacts patient care and satisfaction. Therefore, our Internal Medicine Residency Program aimed through this quality [...]

Background: Discharge summaries assist in the transition from inpatient to outpatient care by communicating key diagnoses, medication changes, and follow-up instructions. Despite use of standard formats for discharge summaries through electronic medical records (EMR), primary care physicians (PCPs) report dissatisfaction with locating important information in discharge summaries. Purpose: The aim of our project was to [...]

Background: The discharge process is complex and high-risk. Clear and accurate communication between the physician or Advanced Practice Provider (providers), nurse, and patient are essential to ensure a safe and effective transition of care. Upon literature review, there have not been studies looking at interprofessional communication during the discharge process. Also, our institution (a large [...]

Background: Commonly used discharge communication workflows hinder timely and efficient discharge. Studies exploring the use of the electronic health record (EHR) for discharge planning have been limited to electronic reports constructed from EHR data elements, including barriers to discharge documented at admission, care management data, and discharge criteria or other targeted interventions such as improving [...]

Background: Multidisciplinary rounding (MDR) is a necessary component to safe and effective patient care and discharge during hospitalization. However, there are many barriers to daily MDR that can limit the effectiveness of the team. An interdisciplinary needs assessment of MDR at our institution revealed poor communication on plan of care and limited understanding of interdisciplinary [...]

Background: Discharge planning should begin at the time of admission and, among its many purposes, involves preparing patients for the transition out of the hospital. Unfortunately, many hospitalized patients do not understand or agree with their provider about their discharge plan, including the timing and location of dismissal. When patients and their providers do not [...]

Background: The relation of a patient’s age to survival in cardiac arrest is often discussed at the bedside when clinicians, patients, and families are faced with the question of whether CPR is medically appropriate for elderly individuals. Few studies are available to help guide this conversation. This study sought to evaluate in-hospital cardiac arrest (IHCA) [...]

Background: Many hospitals have focused on discharging patients before noon as a goal to improve throughput and decrease length of stay. However, those patients who can be discharged early in the day may actually represent a loss and not a win for the system, as they could have potentially been discharged the evening before. Methods: [...]

Background: Prescription opioids have come under increasing scrutiny in recent years due to the rise in use and misuse which has resulted in significant morbidity and mortality. There have been several efforts by government agencies to address this such as the FDA issuing a Risk Evaluation Mitigation Strategy (REMS) for extended release/long acting (ERLAs) opioids [...]

Background: Length of stay (LOS) is a key metric that hospitals follow closely for quality and operational purposes. Hospital Medicine groups frequently use LOS to evaluate their providers and to identify opportunities for improvement; however, the most appropriate methods to apply specific hospital encounters to individual providers is debated. Complex schemes of weighted Observed to [...]