Background: Sleep disruptions for routine care, such as vital sign assessments, are common during hospitalization and are associated with negative health outcomes and patient satisfaction. While higher risk patients may benefit from increased monitoring at night, the tradeoff is less obvious for lower risk patients. We hypothesized that assigning overnight vital sign assessment based on [...]

Background: Sleep disruptions for routine care, such as vital sign assessments, are common during hospitalization and are associated with negative health outcomes and patient satisfaction. While higher risk patients may benefit from increased monitoring at night, the tradeoff is less obvious for lower risk patients. We hypothesized that assigning overnight vital sign assessment based on [...]

Background: Most medical centers have limited ICU beds to directly admit high acuity patients from the emergency department. This is compounded by the trend towards increased medical acuity. Thus, rising numbers of patients with higher acuity are being admitted to general medical units and later requiring transfer to ICU. These patients have higher in-hospital mortality [...]

Background: The hospitalist role is gaining increasing presence for inpatient care, with the opportunity to care for a variety of higher acuity patient across a breadth of specialties in the hospital setting. Further examination into the types and amount of MS-DRG categories seen by hospitalists and their ordering volumes can provide a better picture of [...]

Background: There is evidence that physicians consider a variety of “non-medical” factors (e.g. lack of social support, barriers to access) in hospital admission decision-making out of concern for patient safety, and that patients are hospitalized even in the absence of a level of medical acuity warranting admission. The rationale underlying this decision may overvalue the [...]

Background: Emergency department (ED) crowding has been proven to worsen outcomes and increase mortality for patients presenting to the ED. Our innovative ED Surge program works collaboratively with our ED to transfer lower acuity patients to an on-site, same-day ambulatory setting after initial evaluation in the ED. We aim to characterize the impact of our [...]

Background: Despite system-level focus on avoidance of potentially preventable hospitalizations, the decision to admit a patient with low medical acuity has been understudied. Our study sought to identify factors associated with admission versus discharge from the Emergency Department (ED) for patients considered unlikely to be medically appropriate for admission. Methods: We conducted a retrospective cross-sectional [...]

Background: Emergency room crowding has been proven to lead to poor outcomes (e.g., mortality) and has worsened during the COVID-19 pandemic. Novel clinics that work collaboratively with emergency departments (ED) to transfer lower acuity patients to receive care in ambulatory settings rather than the ED have emerged. Our innovative ED Surge program cares for these [...]