Background: 22% of the hospitals overall STAR rating is based on readmission reduction for the following disease specific groups: pneumonia, chronic obstructive pulmonary disease, acute myocardial infarction and congestive heart failure. Creating strategies surrounding prevention of readmissions that create workload balance leads to improved ability to manage these patients. The hospitalist medicine, emergency medicine, pulmonary, [...]

Background: Care coordination during the patient’s hospitalization is one of the most important goals to achieve as it affects quality and efficiency outcomes, including length of stay. Multidisciplinary Rounds (MDR) aim to discuss each patient’s care plan in every unit. In our inner-city safety net hospital, each inpatient unit conducted MDR differently. The MDRs varied [...]

Background: In November 2021, we initiated a project to improve our length of stay (LOS) and plan of care for patients with a LOS of ≥6 days. We created the Complex Cases Rounds (CCRs) for all patients hospitalized under the hospital medicine service in our community hospital, Emory Johns Creek Hospital. Purpose: CCRs provide a [...]

Background: As the prevalence of patients admitted with a diagnosis of acute decompensated heart failure rises, hospitalists are at the forefront of delivering care for this complex patient population. Heart failure (HF) exacerbations are one of the leading causes of hospitalizations with high rates of readmissions and associated mortality. Evidence based studies show that optimizing [...]

Background: Hospitals are facing increasing pressure to optimize throughput in order to reduce excess length of stay and improve emergency department (ED) boarding times. Improving coordination and throughput in complex organizations with multiple care sites can be particularly challenging. Health systems have implemented numerous initiatives to improve hospital throughput, but these efforts have mainly been [...]

Background: At our Tertiary Care, Academic, Level 1 Trauma Center, length of stay (LOS) has increased over the past year. This has been associated with increased occupancy, increased boarding in the ED and increased volumes on the Medicine teams. In response, reducing LOS has has been targeted as a strategic priority for the institution. Existing [...]

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: Hospital discharge is a complex process for patients, caregivers, and providers. A patients’ understanding of new diagnoses, medications, and appointments improves the capacity for self-care and post-discharge outcomes. A new “Team Discharge” initiative was piloted to improve patients’ understanding of the discharge plan through patient-centeredness and interdisciplinary communication during the critical transition from hospital [...]

Background: As inpatient medical care has increased in complexity and fragmentation, rounding has become siloed away from patients and by discipline, resulting in disjointed and inefficient care models. In response, hospitalist groups across the country have been implementing unit-based rounding programs to centralize communication and align work-flow of health care team members. At UC San [...]

Background: Hospitals continue to experience pressures to optimize efficiency and quality outcomes and to reduce practice variation. In surgical patient populations, the Enhanced Recovery After Surgery (ERAS) pathways have been shown to reduce length of stay, postoperative complications, hospital readmissions, and cost by integrating multidisciplinary, evidence-based interventions throughout the perioperative period (1). A similar model [...]