Background: A small number of patients account for a disproportionate number of hospital readmissions. The Complex High Admission Management Program (CHAMP) is designed to improve care and reduce hospitalizations for frequently readmitted patients. Non-randomized studies of CHAMP found reductions in readmission but may be subject to regression to the mean. We conducted a randomized trial [...]

Background: The COVID-19 pandemic has necessitated rapid changes in healthcare delivery in the United States, including changes in the care of hospitalized children. Our study aimed to identify the major changes in inpatient pediatric healthcare delivery and potential learnings from these changes. Methods: We conducted semi-structured interviews for this qualitative study. We purposefully sampled hospitals [...]

Background: Frequently hospitalized patients represent a vulnerable population due to discontinuity between episodes of inpatient, outpatient, and specialty care. This discontinuity puts patients at risk for unnecessary over-treatment, dangerous under-treatment, medication errors, and loss of trust due to conflicting messages from healthcare providers. Providers face rising clinical volumes, decreasing familiarity between providers, and ever more [...]

Background: Frailty is a clinical syndrome characterized by vulnerability to stressors resulting from a loss of physiological reserve across multiple systems. Frailty is a common condition in older adults and is associated with disability, morbidity, increased healthcare utilization, and mortality. Frailty assessments derive from two major frameworks: the frailty phenotype and the deficit accumulation model. [...]

Background: Delirium is associated with increased morbidity, mortality and health care costs in the hospital setting secondary to increased length of stay and poor long term outcomes (1,2). A systematic review of different delirium prediction models found limitations with these models including derivation from small patient populations, lack of heterogeneity, accuracy and reliability as noted [...]

Background: While delirium may affect patients of any age, delirium prevention and management protocols have focused mostly on the elderly, as older adults (>65 years old) are more vulnerable to developing delirium. Delirium has been reported in 19-31% of younger adults during their hospital stay, and 15-56% of older adults.There is lack of literature on [...]

Background: Disparities in screening mammography use persist among low-income women, even those who are insured, despite the proven mortality benefit. We evaluated the prevalence of breast cancer screening non-adherence among hospitalized women and their receptivity to inpatient screening mammography as a novel approach to increase breast cancer screening rate. Methods: A cross sectional study was [...]

Background: Addressing the needs of the geriatric population is critical, as “baby boomers” comprise a larger proportion of hospitalized patients. Hospitalists increasingly care for these complex geriatric patients. The “BEERS Criteria” are evidence-based guidelines that encourage medication safety by describing potentially inappropriate and harmful medications (PIMS) among geriatric patients. BEERS guidelines recommend that with a [...]

Background: Approximately 15% of women in the United States aged 35-79 year are at high risk for developing breast cancer, however less than 0.2% of these women reported taking chemoprevention to reduce their risk. Objective of the study was to characterize the current utilization of chemoprevention agents among hospitalized women who are at higher risk [...]

Background: Frequently hospitalized patients face unique challenges in navigating health care systems. Although practice-, hospital-, and accountable care organization-level programs to address the needs of these patients exist, interventions have had mixed results, with only some demonstrating reduction in hospitalizations or costs. To best serve frequently hospitalized patients and improve future interventions, clinicians, leaders, and [...]