Scoring a patient's function on the ward predicted where they would go home to, days before the team knew

The edition in brief

In 21 Kaiser Permanente hospitals and 493,035 encounters, a five-item physical function score (PROMIS PF5) recorded daily in the electronic record predicted discharge to a skilled nursing facility far better than clinicians' expected discharge entries — an area under the curve of 0.89 against 0.75 by day three — and was most useful early in the stay, when clinicians' estimates were often blank. A narrative review in the American Journal of Medicine catalogued injuries after ground-level falls in older people that go beyond fractures and head injury — thoracic, abdominal, vascular and thromboembolic events, herpes zoster reactivation and psychological harm — each uncommon but often recognised late. A single academic centre found that encounters needing post-acute care referral accounted for 85.5% of excess hospital days, with a median 2.11 extra days after adjustment. A before-after study found that closing an intermediate care unit raised ICU admissions from 14.2% to 20.5% of hospital admissions, with more low-risk monitoring admissions, but no rise in ICU readmissions or mortality.