Background: There were nearly 33,000 admissions to Department of Veterans Affairs hospitals for alcohol withdrawal syndrome (AWS) in fiscal year 2017. Symptom-triggered management is the standard of care and, when employed effectively, the number of medication doses during admission is a good proxy for clinical severity of withdrawal. Several evidence-based algorithms for outpatient management of [...]

Background: New hospitalists can often feel overwhelmed by learning system practices, navigating difficult dispositions, and managing difficult patient and family relationships. This can lead to increased length of stay1, increased burn out, and a feeling of lack of mentorship. Purpose: We hypothesized that weekly meetings between a hospitalist director and a junior faculty hospitalist to [...]

Background: Inpatient margins and hospital reimbursement have become increasingly dependent upon improving key metrics, such as length of stay and 30-day readmissions. Hospitalists typically lack access to credible, timely, and insightful metrics that inform their practice. In addition, individualized metrics, when available, struggle to properly normalize for patient complexity, warranted variations in care, shared decision-making, [...]

Background: There were nearly 33,000 admissions to Department of Veterans Affairs hospitals for alcohol withdrawal syndrome (AWS) in fiscal year 2017. Symptom-triggered management is the standard of care and, when employed effectively, the number of medication doses during admission is a good proxy for clinical severity of withdrawal. Several evidence-based algorithms for outpatient management of [...]

Background:   Observation care has evolved significantly since its original inception by the Centers for Medicare and Medicaid Services (CMS).  Originally intended to span less than 48 hours in the majority of cases, the Office of Inspector General (OIG) reported that 11% of all observation stays lasted three or more nights in 2012.[1]Having a higher length [...]

Background: Inpatient margins and hospital reimbursement have become increasingly dependent upon improving key metrics, such as length of stay and 30-day readmissions. Hospitalists typically lack access to credible, timely, and insightful metrics that inform their practice. In addition, individualized metrics, when available, struggle to properly normalize for patient complexity, warranted variations in care, shared decision-making, [...]

Background: New hospitalists can often feel overwhelmed by learning system practices, navigating difficult dispositions, and managing difficult patient and family relationships. This can lead to increased length of stay1, increased burn out, and a feeling of lack of mentorship. Purpose: We hypothesized that weekly meetings between a hospitalist director and a junior faculty hospitalist to [...]

Background: The Institute for Healthcare Improvement tells us that successful discharge planning starts at admission; however, when that admission occurs to a closed Intensive Care Unit (ICU), traditional discharge planning can be delayed until the patient transfers to a general floor. This delay can be exacerbated as a hospital’s adult medical-surgical bed occupancy rises, increasing [...]

Background: Outcomes among hospitalized patients with severe vision impairment or blindness have not been extensively explored. The purpose of this study was to determine clinical and resource utilization outcomes in patients with severe vision impairment/blindness. Methods: This was a retrospective cohort study. Using the Nationwide Inpatient Sample for year 2017, hospitalized adults with and without [...]