Background: Written discharge instructions improve patient understanding and self-management after hospitalization, and they are an evidence-based practice to improve patient understanding. However, over the past three decades, studies have shown that patients have poor understanding and routinely overestimate their understanding of provider recommendations, placing them at higher risk for adverse medication events and hospital readmissions. [...]

Background: Glucocorticoids are prescribed at high rates in the inpatient setting for various autoimmune and inflammatory conditions. A common complication is steroid-induced hyperglycemia (SIHG), diagnosed when blood glucose levels surpass 140 mg/dL (7.8 mmol/l) in response to steroid exposure. Clinical practice guidelines offer strategies for correction of hyperglycemia among hospitalized patients but lack specific best [...]

Background: In our NIH funded multi-site cluster randomized clinical trial (RCT), we used implementation science methods to develop and implement quality improvement programs consisting of evidenced-based interventions to improve care transitions for patients hospitalized with chronic obstructive pulmonary disease (COPD). Since the hospitals were the ‘subject’ of study, typical patient-level RCT enrollment practices were not [...]

Background: Improving hospital throughput is critical to optimizing patient flow and capacity, particularly during periods of high census and ED boarding which can adversely impact patient experience and have downstream safety implications. Prolonged length of stay may result from inadequate alignment among care team members on patients expected to discharge, insufficient communication of discharge barriers, [...]

Background: High hospital readmission rates have both clinical and financial consequences which are associated with worse healthcare outcomes for our patients and costly financial penalties for the hospital. The average cost of a readmission estimated to be at $15,200 and adds burden on hospital systems, resources, and cause further harm to our patients, leading to [...]

Background: The transition period from hospital to home is a critical phase in patient care. Inadequate transitions can lead to adverse events, readmissions, delays in care, increased healthcare expenses and increased morbidity and mortality. Individuals with diabetes are particularly susceptible to readmission, facing a significantly higher risk compared to those without the condition. Furthermore, diabetic [...]

Background: Each year, over 5 million hospital-to-skilled nursing facility (SNF) transitions occur; of these patients, 20% are readmitted within 30 days. SNF transitions can be complex and error-prone, with hospital medicine teams noting unfamiliarity with key handoff information and SNF providers reporting incomplete or inconsistent discharge information. While effective communication between hospital and SNF providers [...]