Background: Despite years of intense focus, inpatient and observation readmission rates remain high and largely unchanged. Little robust evidence exists to guide hospitals in the selection of interventions effective at reducing 30 day readmissions in real-world settings. Our local healthcare system incorporated the most recent recommendations for preventing readmissions into a comprehensive program called Transition [...]

Background: Recently, the Association of American Medical Colleges (AAMC) and the Accreditation Council for Graduate Medical Education (ACGME) put forth their latest expectations of residents using Entrustable Professional Activities (EPA). Furthermore, prompted by an interest in improving the health of the population, enhancing the experience and outcome of the patient, and reducing the per capita [...]

Background: Chronic Obstructive Pulmonary Disease (COPD) is a lung disease characterized by chronic, irreversible airway obstruction that can precipitate into acute exacerbations (AECOPD) of cough, dyspnea and sputum production, often requiring hospitalization. Hospital systems aiming to improve outcomes for patients with AECOPD are testing innovative approaches to care in the acute care setting. To enroll [...]

Background: Children with medical complexity (CMC) are a growing pediatric population with disproportionately high health needs and costs often insured by Medicaid. Identification of CMC using complexity classification systems applied to population-level data and establishment of baseline patterns of population-level health care utilization are essential to target patients who may benefit most from complex care [...]

Background: Health care expenditures in the United States have been increasing exponentially while hospital care accounts for one-third of the costs. Approximately 18% of hospitalized Medicare beneficiaries are being readmitted within 30 days following their discharge. As a quality measure, penalties for high readmission rates are inversely affecting the reimbursements.  Currently, research on the factors [...]

Background: Hospital at Home (HaH) care is an alternative to traditional hospitalization with potential to address issues of cost and hospital capacity, while improving outcomes and patient satisfaction. In 2017, the US Department of Health and Human Services began to consider bundled payments for HaH despite a lack of US-based evidence on patient outcomes, real-world [...]

Background: Growth faltering or failure to thrive is a common cause of admission in infancy and early childhood. In the United States, approximately 2-10% of children experience lower-than-expected growth associated with malnutrition (Tang et al). Growth faltering accounts for 3-5% of pediatric hospitalizations (Mazze et al, 2019). Malnutrition is associated with complications of increased risk [...]

Background: Patients diagnosed in-hospital with acute venous thromboembolism (VTE) are at high risk for post-discharge complications and readmission similar to patients with chronic conditions. Patient navigation reduces post-discharge complications and readmissions in patients with chronic diseases, however its role in acute conditions is less clear. Similarly, the use of mobile technology to improve patient engagement [...]

Background: Geographic information science and technology (GIST) is an academic field that explains the importance of geospatial data and analysis. GIST is a powerful tool that has been successfully implemented to help address a number of significant health issues ranging from disease management to improved services. In this study, we have used GIST to help [...]

Background: Observation units were initially intended to function as a short stay unit for lower acuity patients with specific diagnoses, however this traditional model is currently evolving.  Rising health care costs and changing health care policy have resulted in an increase utilization of the observation unit and an expansion of diagnostic criteria to include more [...]