Background: Executing safe transitions of care for hospitalized patients is important because of the vulnerability of patients during this time period.  While hospital-based providers frequently schedule appointments on behalf of their patients prior to discharge, cancellations and non-attendance (“no-shows”) for post-discharge follow-up appointments are anecdotally common and diminish the quality  of patient care.  Little is [...]

Background: Executing safe transitions of care for hospitalized patients is important because of the vulnerability of patients during this time period.  While hospital-based providers frequently schedule appointments on behalf of their patients prior to discharge, cancellations and non-attendance (“no-shows”) for post-discharge follow-up appointments are anecdotally common and diminish the quality  of patient care.  Little is [...]

Background: Consultation among providers is a foundation of modern health care and a very frequent means of interdisciplinary communication. Classifying consultation requests can facilitate clear communication between providers and across medical specialties, improve workflow, provider satisfaction and ultimately patient care. We previously proposed an organizing framework of 7 specific consultation types: ideal, obligatory, procedural, S.O.S., [...]

Background: Many pediatric hospitalist programs in community hospitals around the country function with a 24-hour shift model for 24/7 coverage. This creates significant discontinuity and daily inefficiencies in patient care. Furthermore, there is a robust amount of adult literature that points to the benefits of both inpatient and outpatient continuity of care. When our community [...]

Background: Health-related social needs (HRSN) are social and economic conditions that adversely affect health. Housing instability, food insecurity, and unreliable transportation may influence decisions during hospitalization, including care transitions. Numerous screening tools have been implemented in ambulatory and emergency care settings to capture HRSN and guide coordination of care. However, disability, which has profound implications [...]

Background: The importance of accurate patient care records for effective communication and medical education is well documented. However, medical documentation as a tool for financial compensation is not emphasized in graduate medical education. We performed a review and analysis of resident charting errors during inpatient rotations to determine the potential revenue loss and economic impact. [...]

Background: Transitions from hospitals to the ambulatory setting are high risk periods for patients. Many interventions have been tried, with varying degrees of success, and often the problem has been with implementation rather than theoretical efficacy of the intervention.Methods: We developed, implemented, refined, and evaluated a multi-faceted, multi-disciplinary transitions intervention across two hospitals and 18 [...]

Background: Chronic Obstructive Pulmonary Disease (COPD) is the 4th leading cause of death and a major driver of healthcare utilization worldwide. Established guidelines exist for hospitalized patients with COPD yet adherence to these has been found in multiple studies to be low. Our question is which Quality Improvement system changes best reduce healthcare utilization and [...]

Background: The division of the hospital medicine at the University of Florida has 52 attending hospitalist physicians with an average daily census of 200 patients. On any given day, one physician carries 16 patients and practices direct care services. This includes chart review, placing orders, answering pages, coordinating with case managers, requesting consultations, rounding on [...]

Background: Transitions from hospitals to the ambulatory setting are high risk periods for patients. The advent of the Patient-Centered Medical Home (PCMH) and Accountable Care Organizations (ACOs) provide an opportunity for true collaboration in which both inpatient and outpatient providers contribute to improving transitions in care. The goal of this study was to develop, implement, [...]