Background: Studies have shown that early exposure to statins preoperatively have been associated with significant reductions in perioperative mortality and improved post-operative outcomes [1]. Despite guideline recommendations, use of statin therapy remains sub-optimal [2]. A retrospective study at our institution revealed over 40% of patients that presented to our preoperative optimization clinic were not on [...]

Background: Reducing length of stay to improve access, minimize hospital-associated morbidity, and reduce cost is a top priority at many hospitals. Information about barriers and delays impacting discharge (i.e., arranging subacute nursing facility placement, setting up a new dialysis seat, receiving consult recommendations for discharge) is rarely documented and often obtained anecdotally or qualitatively. This [...]

Background: Health information technology (HIT) systems, though designed to improve clinical workflow efficiency, have ironically contributed to clinician burnout, especially among hospitalists who depend on these systems for patient care and coordination (Adler-Milstein 2020). Addressing these challenges requires a detailed, resource-intensive process to identify workflow inefficiencies. Because this process is difficult, it is often performed [...]

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: Effective discharge instructions are critical for safe patient transitions to outpatient care. However, patients may misunderstand the information they receive, particularly those with complex plans and limited English proficiency. The Institute for Healthcare Improvement and Solutions for Patient Safety recommend discharge instructions that outline the patient’s primary issue, care steps, signs of worsening, where [...]

Background: Studies have shown geographically co-locating patients of the same physician (also known as regionalization) have improved provider satisfaction and increased team efficiency and collaboration. At most institutions, including ours, assigning physicians to patients and units is done manually. Furthermore, interventions to regionalize hospitals in the literature focus on grouping conditions, specialties, or teams (i.e., [...]