Background: Discharge to post-acute care settings (PACs), such as skilled nursing facilities (SNFs), requires significant, complex discharge planning which often needs to be started early during hospitalization to be complete by time of discharge. This study sought to identify and model factors which predict a given patient’s likelihood of requiring PAC after discharge, using routinely [...]

Case Presentation: A 25-year-old woman with a remote history of intravenous drug use, last reported seven months prior, presented with two days of progressive cyanosis and pain of the medial right hand with associated paresthesia, hyperesthesia, and stiffness. Physical exam revealed well-demarcated cyanosis of the fourth, fifth, and medial third digits extending to the wrist [...]

Background: People experiencing homelessness (PEH) face barriers to accessing regular ambulatory care, which increases their risk of having poorly controlled chronic medical conditions and contributes to high acute care utilization. The role of field-based homeless healthcare teams in improving hypertension and diabetes control and reducing acute care utilization (e.g., emergency department [ED] visits, inpatient hospitalizations) [...]

Background: Point-of-care ultrasound (POCUS) of the inferior vena cava (IVC) can help to noninvasively predict the effectiveness of treatment for volume-sensitive conditions, such as acute heart failure and shock. Recently POCUS-IVC has also been used to iteratively tailor fluid treatment to patient-specific targets. In real-world clinical settings, such iterative assessments are necessarily obtained by multiple [...]

Background: Hospitalization in older adults with cognitive impairment is a seminal event that often leads to iatrogenic complications and exacerbation of behavioral disturbances that require a higher level of observation to ensure the patient’s safety. Our study aimed to determine whether an innovative model, using Patient Engagement Specialists (PES) improves care for hospitalized older adults [...]

Background: Previous studies have documented discriminatory refusals from post-acute care facilities related to opioid use disorder or opioid agonist therapy, however the impact of inability to secure skilled nursing facility (SNF) placement for patients with any substance use disorder (SUD) has not been fully explored. The objective of this study is to measure the odds [...]

Background: Hospitalists increasingly confront patient care and policy dilemmas due to financial incentives created by bundled payments, single payments that “bundle” acute and post-acute care for specific diagnoses. The most common and most successful bundled payment has been for total joint replacement, where cost savings have been achieved through discharging patients to home rather than [...]

Case Presentation: A 12 year-old girl with a history of asthma and migraine headaches presented to the ED with a one week history of headaches and bloody tears. She first developed headache and left eye pain and pruritis one week prior, followed by blurry vision and bloody discharge from the left eye. She presented to [...]

Case Presentation: A 25-year-old woman with a remote history of intravenous drug use, last reported seven months prior, presented with two days of progressive cyanosis and pain of the medial right hand with associated paresthesia, hyperesthesia, and stiffness. Physical exam revealed well-demarcated cyanosis of the fourth, fifth, and medial third digits extending to the wrist [...]

Background: Point-of-care ultrasound (POCUS) of the inferior vena cava (IVC) can help to noninvasively predict the effectiveness of treatment for volume-sensitive conditions, such as acute heart failure and shock. Recently POCUS-IVC has also been used to iteratively tailor fluid treatment to patient-specific targets. In real-world clinical settings, such iterative assessments are necessarily obtained by multiple [...]