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, [...]

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, [...]

Background: The approach to managing and admitting patients with syncope in an emergency setting lacks standardization. Our study aims to investigate how regional variation in management of emergency department (ED) patients presenting with syncope impacts outcomes and resource utilization in this patient population. Methods: We used the 2006 to 2014 Nationwide Emergency Department Sample to [...]

Background: Previous work suggests that hospitals’ teaching status is correlated with readmission rates, cost of care, and mortality. This research has focused on conditions closely tracked by the Centers for Medicare and Medicaid Services (CMS). The extent to which hospitals’ teaching status impacts care processes for syncope has not been extensively studied. Methods: We merged [...]

Background: The number of hospitalized patients varies significantly throughout the year. Fine prediction of the number of hospitalized patients is essential to provide adequate staffing and quality care. We aimed to identify the factors affecting the number of hospitalized patients and develop a prediction model. Methods: Daily number of hospitalized patients on the medical floor [...]

Background: Misuse of laboratory tests can be difficult to determine unless tests are clearly overused or repeated routinely. However, excessive testing of chronically critically ill patients treated in long-term acute care hospitals (LTACHs) can be potentially harmful. A previously reported quality improvement initiative designed to increase physician awareness of their patterns of lab utilization in [...]

Background: Appropriate use of consultation can improve mortality and decrease cost of care. However, inappropriate consultation may carry risks to patients. Little is known about the variability of inpatient consultation. We aim to describe patient-, admission-, and physician- level factors that influence the variability of inpatient consultation. Methods: We conducted a secondary analysis of 2011-2015 [...]

Background: Current guidelines recommend against routine neurodiagnostic testing for evaluation of simple febrile seizures. We aimed to assess variation in rates of neurodiagnostic testing and establish Achievable Benchmarks of Care (ABCs) for children evaluated for simple febrile seizures at children’s hospitals. Methods: We conducted a cross-sectional study of children 6 months to 5 years with [...]

Background: Hospitalists vary in their ordering practices related to labs, imaging, and discharge order times. Variations in these practices has been associated with over-utilization of services and inefficient clustering of discharges later in the day. Prior studies suggest that peer comparison can be effective to change provider behavior and reduce unnecessary variation in ordering practices, [...]

Background: Prior studies of routine blood culture (BC) testing in uncomplicated community acquired pneumonia (CAP), skin and soft tissue infections (SSTI), and urinary tract infections (UTI) have demonstrated low utility given similar rates of pathogen versus contaminant detection and little effect on clinical management. Understanding patterns and outcomes of BC testing can identify opportunities to [...]