Letter from the Editor


As physicians and administrators well know, health care reform has meant an increasing emphasis on high-value care. Medicare initiatives like the Value-Based Purchasing Program and Bundled Payments for Care Improvement Initiative have hospitals and hospitalists seeking innovative ways to improve quality while lowering expenses. In general, there are few factors that affect expenses more than length of stay; the trick is to reduce patient hospitalization time without increasing readmissions. Our cover story examines how length of stay is currently prioritized as a quality measure; its relationship with readmission goals; and strategies that do and don't work to achieve an optimal hospitalization duration. In doing so, we take a look at what several hospital medicine services are trying in the quest to balance quality with cost-effectiveness.

Sometimes, the best chance a patient has for optimal care is to be transferred from your facility to one with more appropriate resources. Ideally, hospitals that frequently transfer patients have well-established relationships with accepting hospitals, including designated on-call physicians who can hear cases and accept patients seamlessly. In reality, however, several barriers may exist that prevent transfers from going smoothly. Our piece in this issue discusses what hospitalists on both ends can do to reduce challenges and improve the transfer process.

Delivering optimal care means staying up to date on the latest drug innovations and how they affect treatment. Indeed, the approval of 3 new antibiotics for skin infections in the last 6 months has led hospitalists and others to rethink how best to treat patients with these conditions. Read Stacey Butterfield's feature on the topic.

What new initiatives has your hospital undertaken in response to the Affordable Care Act? Write to us about them.

Sincerely,
Jessica Berthold
Editor-in-Chief, ACP Hospitalist