Background: Late afternoon hospital discharges contribute to admission delays, leading to occupancy increase and increased length of stay. However, prominent workplace barriers often exist towards improvement initiatives that target early discharge. Team members cite timing of rounds, absence of early discharge support resources, communication breakdowns, and increased daytime admission volume as barriers to change. Furthermore, [...]

Background: Many studies have demonstrated the negative effects of emergency department (ED) crowding on outcomes, including increased length of stay, inpatient mortality, and risk of readmission. Early evidence suggests effective and timely triage of patients with hospitalist input can mitigate some of the detrimental effects of ED crowding. In contrast to prior studies focused on [...]

Background: Ensuring that hospitalized patients have a clearly documented Advance Care Plan (ACP) is important to provide them with goal-concordant care. Our institution undertook an inpatient Quality Improvement (QI) initiative to improve accessible ACP documentation. Though this work significantly improved ACP documentation rates, ACP rates for Latinx patients were significantly lower than those of the [...]

Background: Discharging complex patients at an academic tertiary care center requires comprehensive evaluation, interprofessional coordination, and meticulous planning to address what is needed to ensure safe and timely discharges. Misalignment across care team members on discharge needs and barriers can lead to a delayed discharge which may result in poor patient satisfaction, increased task burden [...]