Background: Hospitalized older adults are increasingly referred to skilled nursing facilities (SNFs) for post-acute care following hospitalization. However, whether hospitalized older adults are enabled to make high-quality decisions about different post-acute care options is unclear. This is important because a high-quality decision aligned with patient values and expectations may lead to a better match of [...]

Background: Hospital admissions are the majority contributor to the cost in caring for diabetes, accounting for about 40% of the costs. As most hospital reimbursements are based upon diagnosis-related groups, hospitals have strong financial incentives for quicker discharges to control length of stay and costs. This can limit the time available to develop a comprehensive [...]

Background: Virtual Hospitalist (VH) care models are emerging in hospital medicine to address workforce shortages and improve patient access. VH programs are any programs where the hospitalist and patient are located at different sites, but the patient requires an acute level of care. This can include arrangements where: 1) the patient is located in a [...]

Background: Patients, particularly the elderly and those who have chronic illnesses, often experience adverse events when transitioning from the hospital to home. An estimated 20% of all discharged patients suffer a preventable adverse event (e.g., reaction to medication) within three weeks of discharge and 20% of Medicare patients are readmitted to the hospital within 30 [...]

Background: Throughput is a hospital priority. Decreasing length of stay is essential to decongesting overcrowded hospitals and maintaining financial viability. Purpose: The purpose of the project was to improve throughput through enhanced interdisciplinary communication. Description: We used the LEAN methodology of process improvement to perform a Value Stream Mapping exercise, which brought diverse clinical staff [...]

Background: Inpatient experience quality improvement efforts have traditionally been focused on increasing scores on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. Patients’ open-ended responses about their inpatient experiences may represent a previously unexamined resource for understanding patient motivation behind closed-ended responses. We aimed to describe responses to an HCAHPS open-ended survey [...]

Background: The AHRQ-funded REdesigning SystEms to Improve Teamwork and Quality for Hospitalized Patients (RESET) study was designed to improve teamwork and quality for hospitalized patients by providing mentorship and resources to hospitals as they implemented 5 interventions, which included (1) Unit-based Physician Teams, (2) Unit Nurse-Physician Co-leadership, (3) Enhanced Interprofessional Rounds, (4) Unit-level Performance Reports, [...]

Background: The REdesigning SystEms to Improve Teamwork and Quality for Hospitalized Patients (RESET) study sought to improve teamwork and quality for hospitalized patients by providing mentorship and resources to hospitals as they implemented: (1) Unit-based Physician Teams, (2) Unit Nurse-Physician Co-leadership, (3) Enhanced Interprofessional Rounds, (4) Unit-level Performance Reports, and (5) Patient Engagement Activities. Two [...]

Background: Discharge planning is an important component of safe and efficient hospital care. While standardization of these practices can be useful, adopting general approaches may overlook important nuance for unique patient populations. In particular, we are interested in how patients who live in a baseline unsafe situation conceptualize a “safe” discharge plan. Thus, our study [...]