Background: Currently, Physical and Occupational Therapy (PT/OT) documentation dictates next site of care. PT/OT recommends how much therapy is needed upon discharge and where the therapist believes these services should be provided, which is often a Skilled Nursing Facility (SNF). This practice eliminates meaningful conversations between provider and patient regarding the patient’s wishes on next [...]

Background: The Choosing Wisely campaign aims to engage clinicians and public in addressing overuse in healthcare. Through adoption in 20 countries and 75 organizations, clinician engagement is largely successful. However, patient and public engagement remains a challenge, and there is concern that the impact of Choosing Wisely will be dampened if this is not achieved. [...]

Background: At our medical center, there are 14,716 discharges annually from the general medicine services. Post discharge appointments are made by residents, nurse practitioners, and hospitalists. In a baseline survey, clinicians identified logistical barriers to successfully making appointments and revealed that patients are rarely involved in scheduling discharge appointments. Only an estimated 66% of attempted [...]

Background: Over the last 2 decades there has been increasing adoption of Observation (OBS) units across the healthcare facilities in United States. Health reforms like 2 midnight rule and 30 day readmission penalties, congestion in the ED, poor operational outcomes in OBS population mixed with inpatients (IP) etc. further added to the need for dedicated [...]

Background: Interhospital transfers (IHT) for additional care are a necessary, if high-risk, part of the healthcare system. Return transfers, in which the patient is returned to the referring hospital once higher-level care is no longer needed, are also a part of the healthcare system but are even more varied and less systematized and studied within [...]

Background: Providing patient centered care is a core value of all healthcare systems in our nation. However, having a code status discussion with patients and their families continues to be a challenging endeavor due to multiple factors such as competing priorities and time constraints, especially in the hospital setting. To improve code status discussion and [...]

Background: Patients with sickle cell disease (SCD) often face frequent emergency department (ED) visits and hospital readmissions, primarily driven by challenges in pain management, stigma, and system-level barriers. Existing interventions at the CU Division of Hospital Medicine, such as cohorting patients with specific teams, multidisciplinary care conferences, and implementing care plans for high-utilizer patients, have [...]