Background: Length of stay is an important marker for quality of care in the hospital. Increased length of stay can affect patient flow through the hospital and can lead to overcrowding, increased boarding in the emergency department, delays in inter-hospital transfer, and cancellation of elective procedures due to bed availability (1). In addition, longer hospitalizations [...]

Background: “Geographic rounding” describes physicians focusing on patient care in a single hospital unit. Studies have suggested that geographic rounding may improve efficiency and communication. Prior to our pilot, physicians at EUHM were seeing patients distributed across 13 units making rounding inefficient and care coordination challenging. Methods: We designed a geographic-based rounding system on unit [...]

Background: Improving efficiency and throughput in cancer patients with high acuity is challenging and requires a multi-disciplinary effort to coordinate care delivery. In The James Cancer Hospital, two separate Internal Medicine Divisions (Medical Oncology and Hospital Medicine) have historically provided inpatient oncology hospitalist care to an average daily census of 98 patients throughout The James, [...]

Background: Hospitals across the nation are gripped with capacity constraints, and some hospitals have indicated they are operating at “Capacity Disaster” status. It is critical to identify solutions that are beneficial to both hospitals and patients. Destino (2019) indicated that early discharges help decrease emergency department and post-anesthesia care unit hospital bed times. The Reverse [...]

Background: Patient-reported measures including health confidence correlate with health outcomes, such as hospital utilization and post-acute care (PAC) needs within research settings. A more recent approach has been to develop learning health systems (LHS) with these measures to incorporate research findings into clinical care at a rapid rate. We have found that a measure of [...]

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: Length of stay is an ongoing challenge for hospitals across USA. Large number of medically stable patients continue to remain in the hospital. There are multiple barriers including social, financial, and poor communication between team members. This delays discharge leading to poor patient care, burnout of team members, reduced bed capacity and access. Purpose: [...]

Background: Patients undergoing induction chemotherapy for acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL) often experience prolonged hospital stays due to the length of induction therapy, follow-up bone marrow biopsies, and count recovery. While the average length of stay (LOS) for these patients may exceed 30 days, most diagnosis-related groups (DRGs) assign a LOS [...]

Background: Traditional Length of Stay (tLOS) is commonly used in Hospital Medicine to assess hospital resource utilization and to incentivize reductions in patient stays. However, tLOS is often attributed to the discharging physician, which can lead to attribution errors and fairness concerns. These limitations can reduce the metric’s utility. In response, Pierce, Harrison, and Patel [...]

Background: Physicians often document patients’ anticipated discharge dates and care progression needs; however, this documentation can be challenging to locate in clinical notes and may be overlooked during care progression. At our institution, physicians are unable to consistently attend multidisciplinary rounds (MDRs), relying heavily on documentation to communicate plans of care and anticipated discharge dates. [...]