Background: “Hospital at Home” (HaH) models of care have existed for over 20 years in the U.S. Demand for healthcare value has driven renewed attention to HaH, including from the Centers for Medicare and Medicaid Services. The COVID-19 pandemic has only magnified consideration of alternative sites of care. Where studied, HaH models have had desirable [...]

Background: Patient and family experience have become increasingly important to the hospital community, whereby exceptional patient and family experience is the common ground for all six aims of quality care as defined by the Institute of Medicine in Crossing the Quality Chasm — care that is patient centered, safe, effective, timely, efficient, and equitable (1). [...]

Background: Uncertainty of viral transmission and PPE availability early in the SARS-CoV-2 pandemic created unique infection control challenges for hospitals. Prior to masking recommendations and widespread testing availability, the hospital medicine service at an academic hospital system published “medical distancing” guidelines to reduce the frequency and proximity of physician-patient interactions to minimize transmission. While previous [...]

Background: Hospitalists rely on patients’ family members and caregivers to convey medical history, communicate on the patient’s behalf, assist with decision making, participate in care training, partake in discharge planning and provide support. With the rise of COVID-19 infection rates across the country, hospitals promptly enforced strict visitation protocols to prevent transmission, preserve PPE and [...]

Background: The transition from adolescent to adult care has been associated with worse outcomes including increased mortality (1). Improved patient experience (PEX) correlates with decreased inpatient mortality rates and better adherence to quality guidelines (2) as well as lower 30- day readmission rates for patients with heart failure, acute MI and pneumonia (3). Hospitalized adolescents [...]

Background: Clinical decision making pathways (pathways) embedded within electronic medical record (EMR) systems are an innovative tool intended to assist providers in diagnosing and managing patient conditions. Pathways provide clinical decision trees with the ability access online risk score calculators and select orders for lab and imaging tests, medications, and consultations. Studies have shown that [...]

Background: Hospitalizations related to injection drug use (IDU) are often complicated by complex psychosocial circumstances and behavioral health needs. Despite growing hospitalizations amongst this patient population, little is known about physician experience caring for these patients. Our study aims to explore physician perspectives in caring for patients with IDU to understand the impact of these [...]

Background: With nearly 60 million cases and 1.4 million deaths globally (1), the COVID-19 pandemic has been deemed a traumatic event that transcends the range of normal human experience (2). History suggests those on the frontline of disasters are at risk of burnout, depression, post- traumatic stress disorder, and in grim cases—suicide. (3) The current [...]

Background: As COVID-19 spread across the globe, hospitals restricted visitors in an attempt to protect patients and healthcare providers. The absence of in-person visitors and loved ones, who play a central role in clinical decision-making by clarifying medical histories, elucidating patients’ baseline status, and bridging linguistic and cultural divides, left patients vulnerable to social isolation, [...]

Background: “Hospital at Home” (HaH) models of care have existed for over 20 years in the U.S. Demand for healthcare value has driven renewed attention to HaH, including from the Centers for Medicare and Medicaid Services. The COVID-19 pandemic has only magnified consideration of alternative sites of care. Where studied, HaH models have had desirable [...]