Background: Code Blues, or in-hospital cardiopulmonary arrests, are high intensity, often fatal events occurring frequently within the hospital. National data reviews estimate that survival to discharge following an in-hospital cardiac event is about 24.4%. Further analysis has shown lower survival rates when comparing night shift physicians with day shift physicians (20.7% and 27.5% respectively), but [...]

Background: Oncology comanagement of hospitalized cancer patients is increasingly common. We (1) and others (2-4) have previously demonstrated that when compared with traditional oncologist-only staffing, hospitalist co-management can improve on well-recognized quality outcomes including length of stay, early discharge rates and 30-day readmission rates. Yet, the composition of an oncology hospitalist practice is incompletely understood [...]

Background: Overuse of daily labs (DL), especially CBC and BMPs in hospitalized patients leads to increased costs and utilization of resources, iatrogenic anemia, and patient discomfort. Prior quality improvement (QI) efforts in hospital medicine have worked to reduce excessive lab utilization, but few have focused on labs ordered on the day of discharge (LOD) . [...]

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: The high prevalence of diabetes makes it a common co-morbid condition in hospitalized patients. Healthcare systems have increasingly focused on 30-day readmission rates to improve quality and reduce costs. Readmission rates for patients with diabetes are much higher than the rate for all hospitalized patients. In a recent retrospective analysis, formal diabetes education by [...]

Background: At Barnes-Jewish Hospital/Washington University residency programs, non-internal medicine interns undergo a significant portion of their training via the Hospitalist Medicine Division to fulfill their ACGME requirement of inpatient internal medicine. The hospitalist schedule is a 7-on and 7-off rotation, resulting in new attendings each week for both supervising direct patient care and leading intern [...]

Background: Heart failure (HF) hospital readmissions are a leading cause of US 30-day hospital readmissions. Factors related to clinical complexity and unmet social needs are among the key drivers associated with HF negative clinical outcomes. Digital platforms have shown promise in improving HF outcomes but limitations like patient lack of familiarity with technology and unmet [...]

Background: Hospitalists today are tasked with maintaining quality care while also lowering health care costs. Length of stay and excess day reduction are surrogate markers of the efficiency of a hospitalist group by measuring lower utilization of resources. Despite this metric being attributed to hospitalists, there are many other departments that have key roles in [...]

Background: The after-visit-summary (AVS) is an essential tool used by providers to explain discharge instructions and ensure appropriate post discharge follow up. Studies have shown that post discharge follow up within 7 days is associated with substantially lower risk of readmission, an organizational priority for us (1). However, many patients were not following up within [...]

Background: Since the roll out of the Affordable Care Act in 2012 there has been an increased financial pressure to prevent 30-day hospital readmissions. Yet the readmissions rate has remained relatively unchanged despite myriad of health system interventions have been trialed. To approach this issue from a new perspective we decided to query the patient’s [...]