Background: Bridging anticoagulation is commonly prescribed to patients with atrial fibrillation who are initiating therapy or require interruption of anticoagulation for procedures. Current guidelines recommend bridging for patients at high risk of stroke, but no data guide this recommendation. Among patients with atrial fibrillation and one or more risk factors for thromboembolic stroke, the recently [...]

Background: Alternative payment models have been proposed for lower extremity joint replacement surgeries to deliver well-coordinated and high quality care. It is speculated that while these payment models may lead to more cost effective care, institutions may “cherry pick” less costly and less complex patients to minimize financial risks. In this study, we aim to [...]

Background: Venous thromboembolism (VTE) is a common preventable condition in hospitalized medical patients. Chemoprophylaxis with heparin or fondaparinux has been recommended for all hospitalized patients who are not at low risk, and appropriate thromboprophylaxis is a hospital quality measure. However, the specific threshold of VTE risk that warrants prophylaxis has not been defined. We used [...]

Background: Early discharge from the hospital improves hospital throughput as well as patient and staff satisfaction. At times, our emergency room tends to board many admitted patients for more than 24 hours, which further distresses our patients and staff. We noticed that the total number of patients leaving the hospital earlier in the day decreased [...]

Background: Healthcare institutions face a narrow operating budget to provide patient care. Centers for Medicare and Medicaid Services (CMS) evaluate healthcare institutions based on efficiency, quality and customer experience–in other words: length of stay, readmission rate and patients’ perception of the care they received. The effectiveness of decreased readmission is based on multiple variables, and [...]

Background: Venous thromboembolism (VTE) is a preventable cause of morbidity and mortality in the hospital setting. While respiratory symptoms are the fundamental feature of COVID-19 infection, VTE is a known sequelae given the hypercoagulable state of the disease. Therefore, it is common for hospitalists to prescribe prophylactic anticoagulation in the inpatient setting for patients with [...]