Background: Administrative harm (AH), defined as negative consequences arising from administrative processes and decisions within healthcare, is pervasive in medicine, yet poorly understood and described. Methods: We sought to explore common AHs experienced by hospitalist clinicians, administrative leaders, researchers, and patient and family advisory council members that were part of two national consortiums for hospitalists [...]

Background: Administrative harm (AH), defined as negative consequences arising from administrative processes and decisions within healthcare, is pervasive in medicine, yet poorly understood and described. Methods: We sought to explore common AHs experienced by hospitalist clinicians, administrative leaders, researchers, and patient and family advisory council members that were part of two national consortiums for hospitalists [...]

Background: Oropharyngeal dysphagia affects up to 86% of hospitalized patients with dementia. Texture-modified food and thickened fluids are the mainstay of dysphagia management in patients with dementia, yet data on whether these diets improve clinical outcomes is lacking. Using a mixed methods approach, this study aimed to evaluate the following: 1) adherence to dysphagia diets [...]

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: Following a hospitalization, older adults, their caregivers, and clinicians caring for them face a complex decision regarding post-acute care (PAC). The purpose of PAC, delivered by a skilled nursing facility (SNF) or home health (HH), is to support the recovery of patients after hospital discharge. However, the transition to PAC is a vulnerable time [...]

Background: The VA, like many health care systems, seeks to meet the needs of a rapidly growing older adult population. The transition from hospital to post-hospital care – particularly in older adults- is increasingly common, but unfortunately is high-risk and low-value. Further, 85% of older adults choosing a skilled nursing facility had a higher-quality facility [...]