Background: Pneumonia is one of the most common conditions seen in hospitalized patients. While utilization of inhaled bronchodilators would be a consideration in the treatment of patients with exacerbations of underlying lung disease (ULD; i.e. asthma, COPD), their role in the absence of such underlying pathologies is not well defined. There is very little information [...]

Background: Opioid analgesia is an important treatment modality for patients with chronic pain, including pain attributed to cancer- and noncancer-related illness. Unfortunately, an estimated 40%–80% of opioid users experience opioid-induced constipation (OIC). Methylnaltrexone (MNTX) is indicated for the treatment of OIC. In clinical trials, the most common adverse events (AEs) were gastrointestinal (GI) in nature. [...]

Background: Clinical ethics consultation can promote ethical delivery of care by helping identify ethical questions, frame clinical decisions in the context of values, clarify policies and address the care team’s moral distress. Though hospitalists routinely grapple with ethical dilemmas, there is a paucity of literature on characteristics and value of ethics consults (ECs) in hospital [...]

Background: The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey distributed by The Center for Medicare and Medicaid (CMS) services measures patient perceptions of hospital experience and impacts annual CMS reimbursement. This study focuses on the “Quiet at Night” variable, to identify the top box institutions and identify the key characteristics that enable [...]

Background: The optimal duration of hospitalist clinical blocks is unknown. Longer block lengths may offer greater continuity and discontinuity between providers has been adversely associated with 30-day mortality and readmissions. However, extending days worked may lead to fatigue and negatively impact hospitalist satisfaction or contribute to burnout. We conducted a randomized trial comparing two different [...]

Background: Tertiary hospitals and academic medical centers often operate near full capacity while smaller community hospitals have difficulty filling open beds. At our institution, a program was set up to transfer lower acuity patients needing admission from the emergency department of an academic medical center to a community partner hospital for direct admission. This and [...]

Background: Gout is a condition that is commonly diagnosed and treated in hospitalized patients. The gold standard for diagnosis of gout is identification of negatively birefringent, needle shaped uric acid crystals within neutrophils in fluid obtained by joint aspiration of affected joints. There have been a number of small studies that have shown serum uric [...]

Background: Feedback in clinical training is essential to reinforce positive behaviors and to provide areas for improvement. Numeric ratings from student performance evaluations are helpful but are not sufficient to guide the learner in areas where they excel and where they may need additional development. Narrative written feedback both reinforces verbal feedback and provides support [...]

Background: Hospital Medicine continues to be a rapidly evolving field. Within our own institution, 15-20% of our graduates in the Internal Medicine Residency Program in recent years have pursued careers in hospital medicine. Although hospitalists and residency program leaders recognize the importance of clinical documentation and accurate coding, curricula to teach the basics are lacking [...]

Background: Appropriate and timely documentation of rapid response events has been shown to have a significant impact on patient care and outcomes. Prior to January 2021, our institution did not have a standardized rapid response note template to facilitate best clinical documentation practices. A review of rapid response events at our institution that occurred during [...]