Background: Discharge summaries assist in the transition from inpatient to outpatient care by communicating key diagnoses, medication changes, and follow-up instructions. Despite use of standard formats for discharge summaries through electronic medical records (EMR), primary care physicians (PCPs) report dissatisfaction with locating important information in discharge summaries. Purpose: The aim of our project was to […]

Background: The transitioning from pediatric to adult care has been correlated with worsened outcomes including increased mortality [1]. Improving patient experience (PEX) has been correlated to improved adherence and lower inpatient mortality rates [2] as well as lower 30-day readmission rates for patients with heart failure, acute MI and pneumonia [3]. Young adults transiting from […]

Background: Hospitalization despite lack of medical acuity (so-called “non-medical” or “social” admission) is relatively common, especially in a safety-net setting. Hospitalists directly involved in triaging admission requests from the Emergency Department (ED) bring unique insight of the process. Here, we use a qualitative approach to explore hospitalist perspectives on disposition decisions for patients thought not […]

Background: Despite system-level focus on avoidance of potentially preventable hospitalizations, the decision to admit a patient with low medical acuity has been understudied. Our study sought to identify factors associated with admission versus discharge from the Emergency Department (ED) for patients considered unlikely to be medically appropriate for admission. Methods: We conducted a retrospective cross-sectional […]

Background: Hospitalists have increasingly engaged in admission decision-making for acute care medical patients. The role, duties, and impact of a Hospital Medicine Triage Attending (“triagist”) are emerging yet ill-defined. To our knowledge, no study thus far has catalogued the activities of these physicians in a comprehensive way. Our objectives were to 1) characterize the demands […]

Background: The first years of transition from pediatric to adult care are associated with an increased mortality in select disease states [1]. While transitioning the outpatient care of children into adult care is well-established [2-4], there is no data on how to best transition young adults in the inpatient setting [5]. The first experience of […]

Background: In 2011, ~3.3 million adult 30-day US hospital readmissions generated $41.3 billion in hospital costs. $8.26 billion (20%) of this was considered preventable. Numerous studies demonstrate relationships between hospital readmissions and social determinants of health (SDoH). Lack of education, socioeconomic status, and lack of social support have all been cited as core contributors to […]

Background: End-of-service handoffs on inpatient general medicine services occur when there is a transfer of care to new providers, often at the end of a scheduled rotation. This is high-risk time for patients as increased in-hospital mortality has been observed around the time of end-of-service handoffs. The Society of Hospital Medicine recommends use of a […]

Background: Limited data exist about the magnitude of and the factors associated with one-year mortality of medical patients after their hospital discharge. Factors known during the hospitalization may be associated with high mortality risk. One may also wonder whether healthcare utilization during the first 30 days after discharge are also of any prognostic value for […]

Background: Handoffs are critical to safe and efficient transfer of patient care between hospitalists. While patient handoffs are essential to hospitalist practice, there is great variability in handoff content, preparation, and delivery. Our study aimed to characterize handoff practices at a large academic hospitalist group, which primarily utilizes a written handoff platform. Methods: We conducted […]