Background: Patient-centered communication has been associated with positive patient outcomes such as improved patient understanding and adherence to therapy. Teaching patient-centered care (PCC) and communication throughout a hospital stay, with an emphasis on understanding each patient’s perspective and circumstances, is a focus on one of four general inpatient medicine services at our hospital. We did […]

Background: Medicare observation stays are increasing nationally. Beneficiaries frequently hospitalized under observation, as well as those needing post-acute care skilled nursing facility coverage, may face increased financial burdens from these services. Patients living in the most disadvantaged neighborhoods have increased risk of inpatient 30-day re-admissions. It is not known whether neighborhood socioeconomic disadvantage increases 30-day […]

Background: Hospital Medicine is being increasingly involved in improving various metrices of inpatient care such as length of stay and cost of care. Patients who do not meet ‘inpatient criteria’ often contribute to significant financial costs to hospitals and remain in ‘observation status’ during their hospital stay. Observations units which were introduced by emergency doctors […]

Background: Observation status was designed to reduce health care costs for patients in need of short hospital stays. CMS suggests that observation care should typically require less than 24 hours, and only rarely last more than 48 hours. However, studies suggest that length of stay for observation patients is often longer than CMS guidance.[1,2] An […]

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 […]

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 […]