Background: Half of US hospitalists have contracts with pay-for-performance incentives based on quality outcomes such as length of stay (LOS) and readmission according to the 2023 State of Hospital Medicine Report. Traditionally, these measures have been linked to the discharging provider. However, as the length of a patient’s stay increases, the influence of the discharging [...]

Background: At our multi-hospital system, our utilization management (UM) program found that the length of stay (LOS) for observation patients in one hospital was, on average, 10 hours longer than the rest of the hospital system. There was a challenge of having better observation management, but there was no space or staffing to create a [...]

Background: Identifying discharge barriers, reducing length of stay (LOS) and optimizing the observed over expected (O/E) ratio for LOS are crucial in healthcare management. Addressing obstacles—DME needs, medical issues, diagnostic/procedure delays, administrative hurdles—can streamline discharge, enhancing outcomes, optimizing resources, cutting costs, and improving hospital efficiency. Effective discharge planning, interdisciplinary collaboration, and patient education are vital [...]

Background: Kidney injury significantly reduces renal clearance, posing unique challenges for patients with type II diabetes, particularly those on insulin. This reduced clearance can lead to elevated insulin levels, increasing the risk of hypoglycemia and subsequent complications, which often extend the patient’s length of stay (LOS). Chronic kidney disease (CKD) itself is an independent risk [...]