Background: In the throughput arena, one of the most challenging groups of hospitalized patients is the long length of stay (LLOS) patients. Although representing a minority of inpatients, this LLOS population contributes to the majority of excess days. At our urban tertiary academic institution, a LLOS is defined as greater than 15 excess days. In [...]

Background: Discharge delays occur because of inconsistent communication among all clinicians and providers. Inefficient utilization of resources also contributes to delays. Effective communication among the patient care team is a foundation of creating an effective discharge planning process. We must standardize the process of communication as well as resource optimization in order to provide our [...]

Background: One year all-cause mortality rates after a fragility fracture are as high as 24%. Treatment of osteoporosis following fracture reduces mortality, recurrent fractures rates, and healthcare costs. Without endocrinology involvement, clinicians often fail to recognize and treat osteoporosis. We aimed to assess the frequency of fragility hip fractures including recurrence rates at our academic [...]

Background: New York State has identified a list of controlled medications that require frequent monitoring and review. New York State law dictates that these medications, when disbursed in a hospital setting, must be reviewed and re-ordered on a weekly basis. In order to maintain compliance with New York State law, the Electronic Medical Record (EMR) [...]

Background: Advance care planning (ACP) helps patients plan end of life care in accordance with their goals and values, but is often performed too late and infrequently. Hospitalists play an important role in delivering ACP for patients admitted for serious illnesses, but often cite competing inpatient priorities, lack of time and training, and uncertainty about [...]

Background: Communication between team members is fundamental to providing high quality care to hospitalized patients (1). Breakdowns in communication lead to compromised patient safety, delays in care, and poor utilization of resources (2). Our Veterans Affairs (VA) hospital has about 200 inpatient beds, primarily staffed by resident physician teams. Bedside nurses use the admission order [...]

Background: Improving the quality and safety of the care provided is the some of the most essential and critical work done in hospitals today. In the current system of health care education, health care professionals are often trained on improvement methodology. Several methodologies are provided as improvement frameworks in our health care professional schools around [...]

Background: In November 2021, we initiated a project to improve our length of stay (LOS) and plan of care for patients with a LOS of ≥6 days. We created the Complex Cases Rounds (CCRs) for all patients hospitalized under the hospital medicine service in our community hospital, Emory Johns Creek Hospital. Purpose: CCRs provide a [...]

Background: As the prevalence of patients admitted with a diagnosis of acute decompensated heart failure rises, hospitalists are at the forefront of delivering care for this complex patient population. Heart failure (HF) exacerbations are one of the leading causes of hospitalizations with high rates of readmissions and associated mortality. Evidence based studies show that optimizing [...]

Background: At our Tertiary Care, Academic, Level 1 Trauma Center, length of stay (LOS) has increased over the past year. This has been associated with increased occupancy, increased boarding in the ED and increased volumes on the Medicine teams. In response, reducing LOS has has been targeted as a strategic priority for the institution. Existing [...]