Background: Hospitalists are key stakeholders in patient flow throughout the hospital and are pivotal in creating efficient patient movement. Throughput metrics are a large focus for all hospitals, and it takes collaborative effort from many disciplines to effectively shift patient flow toward efficiency. Purpose: To reduce decision to admit to bed minutes in a collaborative [...]

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: Third and fourth year medical students’ experience on general internal medicine ward teams is an integral part of medical student education. At many institutions this experience includes participation in unit based Care Coordination Rounds (CCRs), including our own. These daily multidisciplinary discharge planning meetings are ubiquitous, however students are often uncomfortable presenting at these [...]

Background: Many hospitalized patients spend most of their admission laying in their hospital beds. This can lead to in-hospital complications such as skeletal muscle atrophy, bedsores, and venous thromboembolism. In-hospital decline in ability to perform ADLs is associated with need for post-acute facility placement and readmission. We aimed to increase the percentage of patients admitted [...]

Background: Millions of people are hospitalized in the United States annually and many of those patients are medically complex requiring a team-based approach to care for their medical problems and complex planning for discharge and the transitions thereafter. The process of discharging a patient is multilayered, time-consuming, and arguably one of the most pivotal times [...]

Background: Catheter Associated Urinary Tract Infection (CAUTI) is the most common hospital acquired infection and constitutes upto 40% of all Healthcare Associated Infections. Urinary catheter is used in 15% to 25% of hospitalized patients and often utilized for inappropriate indications. Daily risk of Urinary Tract Infection (UTI) is 3 to 7% with the use of [...]

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: 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: As inpatient medical care has increased in complexity and fragmentation, rounding has become siloed away from patients and by discipline, resulting in disjointed and inefficient care models. In response, hospitalist groups across the country have been implementing unit-based rounding programs to centralize communication and align work-flow of health care team members. At UC San [...]