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: 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 [...]

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: A discharge summary serves as a crucial means of communication between inpatient and outpatient providers. Appropriate transitions of care rely on updates to patient problems, diagnostics, treatment history, and discharge plans. Many studies have identified lacking components in discharge summaries that may lead to poor medical management.In an effort to improve patient transitions of [...]

Background: Patients with advanced cancer have high readmission rates, up to 27% in some studies, and represent unique challenges related to transitions of care, complex disease management, and care coordination. Recent efforts have focused on better identification of potentially avoidable readmissions (PARs). One study found that primary reasons for PARs in cancer patients included pre-mature [...]