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: Literature regarding resident education in transitions of care is limited, particularly in geriatric populations. The University of Colorado performed a pilot of a virtual multidisciplinary conference call between providers on the geriatric inpatient unit of the University of Colorado Hospital and its Seniors Clinic. Residents rotating on the Acute Care of the Elder (ACE) [...]

Background: Although many older adults will be hospitalized in their lifetime, most do not consider or plan ahead for their post-hospitalization support needs. When older adults experience a hospitalization, families often must react to the crisis leaving the older adult out of the decision process (e.g. choosing a skilled nursing facility, caregivers). With PCORI funding, [...]

Background: Persons with opioid use disorders (OUD) represent a disproportionately high percentage of hospitalized patients, have greater lengths of stay and readmissions, can incur higher costs, and are at greater risk of drug-related death immediately post-discharge. Further, despite the availability of effective medications for OUD, patients often are not offered treatment during the inpatient encounter. [...]

Background: Nearly half of hospitalized patients with bacteriuria or treated for pneumonia receive unnecessary antibiotics (non-infectious/non-bacterial syndrome, e.g., asymptomatic bacteriuria), excess duration (antibiotics prescribed for longer than necessary), or avoidable fluoroquinolones (safer alternative available) at hospital discharge.1-3 However, it is unknown whether antibiotic overuse at discharge varies between hospitals or is associated with patient outcomes. [...]

Background: Between 2007 and 2015, inpatient fluoroquinolone use declined in U.S. Veterans Affairs (VA) hospitals. Whether fluoroquinolone use at discharge has also declined, in particular since antibiotic stewardship programs became mandated at VA hospitals in 2014, is unknown. Methods: In this retrospective cohort study of hospitalizations with infection between January 1, 2014 and December 31, [...]

Background: Hospital Medicine is a young and growing specialty. About 50% of our academic hospital medicine group of nearly 70 physicians are in their first 5 years out of residency. And about 90% of our faculty are millennials (born 1982-2000), the fastest-growing generation in the workforce and the first generation to grow up in a [...]

Background: In 2011, ~3.3 million adult 30-day US hospital readmissions generated $41.3 billion in hospital costs. $8.26 billion (20%) of this was considered preventable. Numerous studies demonstrate relationships between hospital readmissions and social determinants of health (SDoH). Lack of education, socioeconomic status, and lack of social support have all been cited as core contributors to [...]

Background: End-of-service handoffs on inpatient general medicine services occur when there is a transfer of care to new providers, often at the end of a scheduled rotation. This is high-risk time for patients as increased in-hospital mortality has been observed around the time of end-of-service handoffs. The Society of Hospital Medicine recommends use of a [...]

Background: Handoffs are critical to safe and efficient transfer of patient care between hospitalists. While patient handoffs are essential to hospitalist practice, there is great variability in handoff content, preparation, and delivery. Our study aimed to characterize handoff practices at a large academic hospitalist group, which primarily utilizes a written handoff platform. Methods: We conducted [...]