Background: A small number of patients account for a disproportionate number of hospital readmissions. The Complex High Admission Management Program (CHAMP) is designed to improve care and reduce hospitalizations for frequently readmitted patients. Non-randomized studies of CHAMP found reductions in readmission but may be subject to regression to the mean. We conducted a randomized trial […]

Background: A small number of patients account for a disproportionate number of hospital readmissions. The Complex High Admission Management Program (CHAMP) is designed to improve care and reduce hospitalizations for frequently readmitted patients. Non-randomized studies of CHAMP found reductions in readmission but may be subject to regression to the mean. We conducted a randomized trial […]

Background: As a result of COVID-19, clinical care across the U.S. has changed with virtual services becoming the new normal in many clinics.1-5 How these changes impact patient care following hospitalization is unclear as data are limited.6 We report on characteristics and rates of clinic follow up and satisfaction with care in patients discharged during […]

Background: As a result of COVID-19, clinical care across the U.S. has changed with virtual services becoming the new normal in many clinics.1-5 How these changes impact patient care following hospitalization is unclear as data are limited.6 We report on characteristics and rates of clinic follow up and satisfaction with care in patients discharged during […]

Background: The transfer of patients between hospitals (interhospital transfer, IHT), exposes patients to risks of discontinuity of care, such as errors in communication and gaps in information transfer. In this study, we aim to quantify clinician-reported medical errors attributable to incomplete communication/information transfer during IHT to a tertiary referral hospital. Methods: We included all patients […]

Background: Hospital discharges represent an important transition of care between the inpatient and outpatient setting. Discharge summary documentation enables providers to convey clinical reasoning and important updates in patient care; however, reviews of these documents suggest error rates as high as 36.4% (1.42 errors per document) (McMillen, et. al. 2006). Formalized resident discharge summary curricula […]

Background: Communication between referring Veterans Health Administration (VHA) facilities and home health care agencies in the community is imperative for comprehensive care for Veterans. However, to date little is known about communication during care transitions from VHA facilities to home health care. The purpose of the present study is to conduct a preliminary exploratory survey […]

Background: The majority of states have implemented Prescription Drug Monitoring Programs (PDMPs) in an effort to curb opioid prescribing in high-risk patients; however, the effectiveness of these programs at hospital discharge is not well established. Studies in the post-operative setting have demonstrated mixed results in opioid prescribing after requiring PDMP queries.1-2 Little is known about […]

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: Post-discharge appointment follow-up is recognized as a key intervention in reducing readmissions. Studies show that having a follow-up visit can reduce readmission risk, particularly for patients at higher risk for readmission. [1] Among Medicaid patients, primary care physician (PCP) follow-up within seven days of discharge was associated with reduced 30 and 90-day readmissions. [2] […]