Background: During the initial COVID-19 surge in the Spring of 2020, adequate inpatient bed availability was a key factor in determining the quality of the care provided to our patients. Timely and efficient daily discharges were vital to creating bed capacity and decompressing access points. At our institution, an 800-bed tertiary care medical center outside [...]

Background: At our 583-bed tertiary care nonprofit teaching hospital serving the greater metropolitan New York area, ESRD (End-Stage Renal Disease) patients on hemodialysis presenting with complaints like chest pain, shortness of breath, hypertensive urgency, pulmonary edema, would sometimes wait for more than 6 hours to get dialysis started. While they were “waiting” to get admitted [...]

Background: There is a rising demand for hospitalist involvement in quality improvement (QI). Hospitalists now assume larger patient volumes and have become natural leaders in daily patient care, interdisciplinary rounding and patient safety. Despite a seemingly direct fit into QI, the majority of hospitalists have received minimal QI training in medical school, residency or beyond. [...]

Background: Prioritizing hospital discharges to improve throughput and safety is a common theme in hospital systems. More recently, there has been an increasing importance placed on early discharges. Earlier discharges help to improve flow for admitted patients through the emergency department. In addition, by expediting patient care, patients are able to have their questions answered [...]

Background: Internal medicine and hospital medicine providers are under pressure to move patients quickly through the hospital and decrease length of stay. Providers spend most of their clinical time seeing patients, documenting or coordinating care and have minimal time to disrupt workflow to perform common bedside procedures such as paracentesis, lumbar punctures, central lines, arthrocentesis [...]