Background: Previous studies have documented discriminatory refusals from post-acute care facilities related to opioid use disorder or opioid agonist therapy, however the impact of inability to secure skilled nursing facility (SNF) placement for patients with any substance use disorder (SUD) has not been fully explored. The objective of this study is to measure the odds […]

Background: Emergency Department (ED) overcrowding and lack of hospital bed capacity are pervasive problems made worse by the Covid-19 pandemic. Bed capacity is a significant concern at Academic Medical Centers (AMCs), as patients depend upon AMCs for specialized in-hospital care not available at other regional hospitals. Bed capacity shortage is acutely felt at rural AMCs, […]

Background: Patients discharged from the hospital often face challenges accessing timely and effective follow-up care after discharge from the inpatient setting. Prior studies have demonstrated that lack of primary care clinic access can raise patients’ risk of readmission (1, 2). Effectiveness of a virtual transitions of care clinic has not been reported in the literature […]

Background: Interhospital transfers are shown to be associated with increased length of stay (LOS), mortality, and discharge to facility.[1,2] Delirium has been associated with similar outcomes.[3] Our prior data showed that interhospital transfers had 1.91 times the risk of delirium when compared to ED admissions. We hypothesized that an interaction between admission source, namely interhospital […]

Background: Many patients admitted to the hospital are seriously ill and at risk of dying. Inpatient providers must be able to communicate to their patients the severity of their illness so that they may have realistic expectations and be able to make informed medical decisions.1 However, evidence suggests that physicians perform poorly in predicting prognosis […]

Background: Patients hospitalized with COVID-19 are at risk for clinical deterioration after discharge. Because of this concern, hospitals established home monitoring programs during the pandemic. This study sought to describe these programs among a sample of US academic medical centers. Methods: We conducted a voluntary survey of hospital medicine leaders who participate in the Hospital […]

Background: The Centers for Medicare & Medicaid Services (CMS) uses a five‐star quality rating system to measure Medicare beneficiaries’ experience with their health care system. Unplanned readmission rates serve as a marker of the effectiveness and safety of its transitional care process and carry significant weight in determining a hospital’s overall rating. Our institution, an […]

Background: Effective communication at hospital discharge between inpatient and outpatient providers is critical to improving transitions of care and reducing hospital readmissions. A key part of transitions communication is the hospital discharge summary (DCS). Prior studies show that DCSs are often not available to primary care providers (PCPs) at the time of hospital follow-up and […]

Background: Observation Units (OUs) are a common healthcare delivery model for health systems across the United States. OUs vary from a type 1 to type 4 based on several factors[1]. Another category of OUs – second-level OUs – does not fit this traditional classification due to a different patient population composition and staffing model. The […]

Background: Prolonged hospital stays can decrease bed availability for new patients, place patients at risk for adverse events, and increase costs for the individual and system. There are few published studies that cover data of patients throughout an entire hospital; most only cover data from a specific service line. Our study aims to review patient […]