Background: Delays in medical care are frustrating for all stakeholders involved, including patients, their families, and the clinical teams responsible for moving their care forward. These delays, particularly in inpatient care, not only extend hospital stays but also have a cascading effect on patient throughput and inpatient bed availability. Hospitalists regularly navigate these challenges and [...]

Background: Sound Hospital Medicine (HM) and Sound Emergency Medicine (EM) staff a 385-bed hospital in California. The Utilization Review (UR) nurses in the ER were not following the hospital’s Utilization Management (UM) Plan of doing initial InterQual reviews before the hospitalist wrote the initial admission order because of the focus on disposition from the ER. [...]

Background: Insurance companies are issuing more denials and causing financial instability for hospitals. On average, hospitals are paid $6,000 less for a patient in outpatient observation status as compared to inpatient status. According to Kaiser Family Foundation Health, the average expense in 2022 for a hospital per inpatient day was $3,025 and is only increasing. [...]