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Search Results for VA
Hospital Medicine 2015, March 29-April 1, National Harbor, Md.
Background: Caring for patients involves multitudes of moving parts – from teams of physicians, nurses and radiologists to tests, medications and an array of electronic health record (EHR) systems. However, as medical care has evolved, instead of these components working together seamlessly, they often work in silos – both at the provider and patient data […]
Hospital Medicine 2015, March 29-April 1, National Harbor, Md.
Background: Emergency department (ED) crowding is a widespread national issue which has been shown to negatively impact patient experience and the quality and safety of care delivery. A community hospital within our academic health system was experiencing significant ED crowding with long ED length of stay (LOS) and high left without being seen (LWBS) rates. […]
Hospital Medicine 2015, March 29-April 1, National Harbor, Md.
Background: Per the 2014 State of Hospital Medicine Survey, 94% of adult hospital medicine groups (HMGs) reported financial shortfalls, with a mean of $169,886 in financial support per full time equivalent physician. In addition, many groups face recruitment challenges which lead to workforce shortage and physician burnout. To offset these problems, some groups employ increasing […]
Hospital Medicine 2017, May 1-4, 2017; Las Vegas, Nev.
Background: Observation care has evolved significantly since its original inception by the Centers for Medicare and Medicaid Services (CMS). Originally intended to span less than 48 hours in the majority of cases, the Office of Inspector General (OIG) reported that 11% of all observation stays lasted three or more nights in 2012.[1]Having a higher length […]
Plenary Presentations
Hospital Medicine 2016, March 6-9, San Diego, Calif.
Background: Hospital medicine is a maturing field that increasingly focuses on providing high value patient care. A key question in the value equation is how different patient census sizes impact care. Our recent research showed that higher patient censuses were associated with longer hospital length of stay and costs. This study follows up on this […]
Oral Presentations
Hospital Medicine 2018; April 8-11; Orlando, Fla.
Background: Inpatient margins and hospital reimbursement have become increasingly dependent upon improving key metrics, such as length of stay and 30-day readmissions. Hospitalists typically lack access to credible, timely, and insightful metrics that inform their practice. In addition, individualized metrics, when available, struggle to properly normalize for patient complexity, warranted variations in care, shared decision-making, […]
Hospital Medicine 2015, March 29-April 1, National Harbor, Md.
Background: In an effort to improve pediatric inpatient asthma care, the Joint Commission developed standards for hospital management in 2003. Despite this initiative, inpatient management of asthma exacerbations and adherence to these guidelines varies by institution. Such differences have an impact on hospital cost, length of stay, and readmission rates. Based on data from the […]
Hospital Medicine 2015, March 29-April 1, National Harbor, Md.
Background: The financial success of a hospital medicine practice is dependent on accurate billing and documentation practices. Academic hospitalists face the additional challenge of educating resident physicians on appropriate documentation. As most patients admitted to a tertiary care center are medically complex, initial inpatient E/M code 99221 often signifies a deficiency in documentation rather than […]
Hospital Medicine 2015, March 29-April 1, National Harbor, Md.
Background: To maximize its effectiveness, performance feedback must be personalized, accurate, timely, and visually appealing. In the clinical environment, effective feedback must therefore extract accurate data from an electronic health-record system, link patient care activity to care teams, and report on meaningful metrics. This requires a synthesis of EHR data, scheduling data, which is often […]
Plenary Presentations
Hospital Medicine 2019, March 24-27, National Harbor, Md.
Background: Hospital-acquired delirium is serious, leading to increased falls, pressure ulcers, length of stay, cost, patient institutionalization, and patient and caregiver distress. In addition, it is associated with mortality rates as high as 35-40% within one year in older patients who develop delirium. Programs targeted at delirium prevention and treatment may affect these outcomes. We […]