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 [...]

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 [...]

Background: Publically reported data is increasingly important to a hospital’s reputation and bottom line. Programs such as CMS Hospital Value Based Purchasing (HVBP) place 2% of a hospital’s base payments at risk, while the CMS Star Rating is frequently used by consumers to select a hospital for elective care. Both programs incorporate claims data to [...]

Background: Interprofessional collaboration (IPC) is vital for high-quality patient care, and effective IPC among medical professionals, especially trainees, is crucial to supporting positive individual and team outcomes. Measuring IPC and understanding its impact on patient care remains underexplored. Understanding which IPC patterns are associated with better patient and individual outcomes will inform how to best [...]

Background: CMS launched the Hospital Value-Based Purchasing (VBP) Program in 2010 as part of their initiatives to incorporate healthcare quality into Medicare payment structures. Participating hospitals are assessed according to four domains: Clinical Care, Person and Community Engagement, Safety, and Efficiency and Cost Reduction. Interventions to improve patient safety such as hand hygiene, contact precautions, [...]

Background: Computed tomography (CT) can provide critical information for diagnosis and is a prevalent and easy-to-use imaging test, but overtesting becomes a big probleｍ. The previous report showed 30-40% of abdominal CT scans were medically unnecessary. Therefore, head CT is a research topic in overtesting, and clinical predictive scores have been developed to avoid overtesting [...]

Background: Frequent blood draws are implicated in hospital-acquired anemia as well as rising costs. Critically ill patients undergo frequent venous and arterial blood sampling, both providing electrolyte concentrations. In this study, we sought to examine electrolyte values obtained by arterial blood gas testing (ABG) and central laboratory testing (VCL) and determine the extent of essentially [...]

Background: There is a paucity of literature examining length of stay for medical patients requiring discharge to subacute rehabilitation facilities (SAR). At our institution, this subset of patients had an average length of stay (ALOS) of 8.2 days while medical patients being discharged to home had ALOS of 4.2 days during the first half of [...]

Background: In the US, hospitalist system has been introduced with improvement of quality and safety of care, education and value. Japan now face rapidly declining birthrate and aging population. Organ-based subspecialty system has difficulty in managing patients with multiple diseases. Patient-centered general medical care is required for inpatient management. However, in Japan, there are only [...]

Background: COPD is the third leading cause of death and hospital readmissions. Inpatient care for patients with COPD exacerbations varies widely across the US which can lead to patients failing to receive recommended evaluation, treatment, education, and follow-up to reduce the likelihood of recurrent exacerbations and unnecessary acute care utilization. In an effort to innovate [...]