Background: While sleep is critical for health and healing, the hospital setting is not conducive to sleep and few efforts have been made to improve the sleeping environment. To date, there have been no efforts to describe the current practices to improve the sleep of hospitalized patients at highly-ranked hospitals. Methods: A multicenter mixed-methods study […]

Background: Evidence-Based and Informed Clinical Practice is identified by the ACGME as a core clinical milestone (PBLI1). The Evidence Based Medicine (EBM) curriculum in the University of Wisconsin (UW) Internal Medicine Residency Program previously focused on didactics, journal clubs, and independent study. The COVID-19 pandemic interrupted these traditional EBM teaching methods, prompting us to re-evaluate […]

Background: Continuing medical education (CME) sessions that teach the principles of root cause analysis (RCA) and offer CME credit to attendees are already widely available (1.) However, to our knowledge, no institutions offer physicians CME credit for participation in actual RCAs that are conducted to investigate real adverse events. A 2015 review recommended increasing the […]

Background: Evidence-based guidelines/protocols for electrolyte replacement that safely encourage oral (PO) and/or intravenous (IV) dosing attain goal levels more successfully than standard care. PO is generally more comfortable and less dangerous than IV. Between 5/2017-11/2017, our institution dosed ~300,000 doses of potassium (K) and magnesium (Mg), with 30% and 19% of doses being PO, respectively. […]

Background: In Hospital Medicine, triaging a patient is the process of evaluating an admitted patient and assigning the patient to an appropriate service. Triaging patients is a manual and challenging process which burdens Hospitalists. As with any manual process, there is an inherent risk of missed steps, and in the case of patient triage, the […]

Case Presentation: A 37-year-old female with Systemic Sclerosis (SSc) presented with new-onset elevated blood pressure. She was on medium to high dose Corticosteroids (CS) a month prior to admission. Her significant vitals on admission included a heart rate of 103 and blood pressure of 193/97. Labs showed hemoglobin 9.6, sodium 130, BUN 63, creatinine (Cr) […]

Case Presentation: A 21-year-old previously healthy female presented with a myriad of symptoms including one month of unintentional 20-pound weight loss, dyspnea with minimal exertion, syncopal episodes, palpitations, nausea, and vomiting. Prior to this, she had occasional syncopal episodes throughout her life but was athletic and participated in track in high school. Three months ago, […]

Case Presentation: A 74-year-old male with past medical history of hypertension, and prior tobacco abuse presented with complaints of left sided abdominal pain for one day. He denied any chest pain, shortness of breath, or any other symptoms. The patient quit smoking 14 years ago, drank alcohol weekly and denied illicit drug use. Family history […]

Case Presentation: A 38-year-old female presented with 4-weeks of intractable nausea with non-bloody, non-bilious vomiting and 6-days of vertigo. She was initially hospitalized for nausea and vomiting 4 weeks ago. She underwent a CT abdomen-pelvis, upper gastrointestinal series, and an esophagogastroduodenoscopy (EGD); no cause for her symptoms was identified and she left against medical advice. […]

Case Presentation: A 52-year-old unvaccinated male with past medical history of asthma and uncontrolled obstructive sleep apnea presented to the ED ten days after receiving a diagnosis of COVID-19 with worsening dyspnea. He endorsed a cough, fever, chills, and non-bloody diarrhea, and denied chest pain, leg edema, and anosmia. His initial vitals were remarkable for an oxygen saturation of 65%. A CBC demonstrated leukopenia […]