Background: The transition between hospital discharge and primary care follow-up is a vulnerable period for patients that can result in adverse health outcomes and preventable hospital readmissions. The COVID-19 pandemic has exacerbated this transitional period, as many patients have forgone their routine healthcare visits, lost touch with their primary care providers (PCPs), and lacked a [...]

Background: Point-of-care ultrasound (POCUS) is being adopted by hospitalists and internal medicine (IM) residencies due to its impact on procedural safety, diagnostic accuracy and efficiency, provider and patient satisfaction, and its role as a teaching adjunct in medical education. Studies demonstrating impact on system efficiency and cost are few and mostly limited to the emergency [...]

Background: Hospital medicine is a rapidly growing and advancing field. In 2020, pediatric hospital medicine became a board-certified specialty requiring successful completion of an ACGME accredited two-year fellowship and examination1. Adult hospital medicine fellowships, which do not require ACGME accreditation, have grown organically. We sought to characterize the current landscape of hospital medicine fellowships. Methods: [...]

Background: Rapid response teams (RRT) are critical to the timely and appropriate management of acutely decompensating patients within many hospital systems. In the academic setting, the vital role of RRT leader is often filled by a resident physician who may lack the necessary medical knowledge and experience to initiate timely management for these patients. 100% [...]

Background: Accurate documentation of the patient’s diagnoses helps to reflect the severity of illness which has several downstream impacts: clinical outcomes data, risk stratification, hospital quality metrics data such as readmission and mortality index, hospital reimbursement. For this reason, our health system has various ongoing initiatives on clinical documentation to improve the specification of certain [...]

Background: Up to 10% of hospitalized patients report an allergy to penicillin, however studies have shown that the majority of these are not clinically significant reactions.1,2 Unverified penicillin allergies increase overall patient mortality as they lead to use of broad-spectrum antibiotics that are less effective and have more side effects.3 Recent studies have found that [...]

Background: Catheter Associated Urinary Tract Infections (CAUTI) and Central Line Associated Bloodstream Infections (CLABSI) carry a huge health care burden and is associated with increased length of stay and potential harm for the patient. There is an estimated total healthcare cost of $896 per infection for CAUTI and $45,814 per infection associated with CLABSI. The [...]

Background: The transfer of patients between hospitals (interhospital transfer, IHT), exposes patients to risks of discontinuity of care, such as errors in communication and gaps in information transfer. In our prior work evaluating IHT to general medical (GMS), cardiology, oncology and ICU services at an 800-bed tertiary care referral hospital, we found that in 37% [...]

Case Presentation: A previously healthy 7-month-old male infant was admitted after having a new onset 10-minute seizure. He was exclusively breastfed until 2 weeks prior to admission. His mother reported decreased oral intake since switching to formula and introducing solid foods. The infant had not been taking any vitamins.Physical exam: The patient was afebrile, alert, [...]

Case Presentation: A 56 year old female patient with past medical history of hypertension and diabetes mellitus type 2 presents to the emergency department with a 1 day history of fever and confusion. Vitals showed a temperature of 101.4 F, heart rate at 112 beats per minute, blood pressure at 136/73. Initial lab work was [...]