Background: Mental illness is common among hospitalized patients and is associated with increased length of stay, higher costs, and worse clinical outcomes. Inpatient psychiatry consultations have traditionally held a reactive model, in which primary teams obtain consultation for patients that have developed active psychiatric symptoms. The reactive model has frequently led to missed opportunities to [...]

Background: The hospitalist service at this large Academic tertiary center has a length of stay index that is longer than expected. Despite improvements in multi-disciplinary rounds and co-locating patients on a geographical units, improvements in length of stay slowed. Interviews of hospitalist physicians indicate that there are frequent delays in procedures, imaging and consult recommendations. [...]

Background: ST elevation MI is an acute event that mandates immediate intervention. Often, resources play a major role to enable prompt intervention. Our study aims to elaborate any differences that may exist between weekend and weekday outcomes at a national level. Methods: We conducted a retrospective analysis of the Nationwide Inpatient Sample (HCUP-NIS) database. Patients [...]

Background: Acute kidney injury (AKI) is a common complication of renal cell carcinoma or its treatment. It is unclear whether AKI, compared to inpatients with similar clinical and hospital-level characteristics without AKI, is associated with worse clinical outcomes and higher costs. To address this void, our study aimed to evaluate how an AKI diagnosis affects [...]

Background: Cardiovascular disease remains the leading cause of death in the United States. Approximately every 40 seconds, an American will have a myocardial infarction. The aim of this project is to assess the progress of the prevention and management of myocardial infarction by using the National Inpatient Sample (NIS) data. Methods: This is a retrospective [...]

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: It has been recently shown that patients admitted at night and during the weekend have worse mortality outcomes. The impact of those variables on other important outcomes such as length of stay (LOS) and readmission is less clear. We sought to analyze this relationship in a large cohort of inpatients. Methods: We performed a [...]

Background: Readmission and length of stay are two hospital level metrics commonly used to assess the performance of hospitalist groups. Health care systems implement strategies aimed at reducing both. It is possible however that tactics aimed at improving one measure in individual patients may adversely impact the other. Studies in focused populations of patients hospitalized [...]

Background: Until the advent of novel oral anticoagulants (NOACs), Warfarin was the only oral agent available for the treatment of deep venous thrombosis (DVT) and Pulmonary embolism (PE). Bridging with parenteral anticoagulation until warfarin reaches a full therapeutic level often results in prolonged hospitalization. Rivaroxaban, Dabigatran, Apixaban, Edoxaban were approved by the FDA for DVT [...]

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 [...]