Letter to the Editor

This month's issue includes articles on improving nights and weekends care, choosing the best readmission risk prediction strategies, and establishing hospitalist preoperative care clinics.

While the jury on the subject is still out, a growing body of research suggests that inpatient care is less robust on nights and weekends, especially for time-critical conditions like heart attacks. It's not hard to see why: Physicians who work these shifts often have less access to subspecialists, support staff, tests, and social workers who can help with transitions and discharge. However, there are ways to guard against deterioration in care at these times, experts say, including establishing protocols, having guidelines on when to call a subspecialist, and using creative staffing and rounding. Read our cover story to learn how you can make your hospitals as safe as possible during the off hours.

Another continuing area of concern for hospitals is how to reduce 30-day readmissions, especially in the face of another penalty percentage hike this October under the Affordable Care Act. Researchers have been building risk prediction models, ideally for integration into an EHR, so clinicians can anticipate who might be at highest risk for readmissions and take preventive steps. Read about some of the factors to consider when choosing or designing a prediction model, as well as how the models are currently working for some hospitals.

Another feature this month discusses the value hospitalists can add to their facility by running its preoperative clinic—a role traditionally reserved for anesthesiologists. Learn about the challenges and advantages of taking on this task, and tips on how to get started. Additionally, this issue features a Brief Case installment from Mount Sinai Medical Center, conference coverage on treating meningitis from the American Academy of Neurology meeting in April, and a Perspectives piece on the best way to use copy-and-paste in your clinical documentation system.

How does your hospital try to curb readmissions and ensure off-hours care is of high quality? Let us know. We're always happy to hear from you.

Jessica Berthold
Editor-in-Chief, ACP Hospitalist