Background: Prolonged lengths of stay (PLOS) on general internal medicine wards are associated with increased mortality and morbidity for patients and represent a costly source of health care spending [1]. Increasingly, nonmedical barriers to discharge, including the need for guardianship, limited facility options, and lack of home support are recognized as contributors to PLOS in [...]

Background: Patients admitted to hospitals often have impaired capacity and contribute to a significant number of prolonged non-acute hospital days, often due to requiring a guardian for decision-making.(1,2) This puts incapacitated, unbefriended patients at a disproportionately increased risk of healthcare associated complications, loss of functional ability, and impacts those people and systems that care for [...]