Background: Sodium-glucose cotransporter-2 inhibitors (SGLT2i) reduce the risk of heart failure (HF) hospitalizations and cardiovascular mortality among patients with HF and left ventricular ejection fraction (LVEF) ≤40%. There is emerging evidence of the benefits of SGLT2i in HF patients with a higher LVEF (>40%). We aimed to evaluate the benefits of SGLT2i in different subgroups […]

Background: Several institutions have implemented a medical procedure service (MPS) to improve timeliness of bedside procedures and standardize performance and training of procedures by internal medicine (IM) residents (1-2). A critical barrier to starting an MPS has been a lack of experienced proceduralists (3). In 2011, our IM residency program created an MPS led by […]

Background: Acute heart failure (AHF) exacerbations are a leading cause of hospitalization in the United States. Despite the frequency of AHF hospitalizations, there are inadequate data or practice guidelines on how quickly diuresis should be achieved. Methods: We conducted a pooled cohort study using data from three acute heart failure trials (DOSE, ROSE, and ATHENA-HF). […]

Background: Diagnostic errors (DEs) represent ongoing threats to patient safety in the hospital. Little is known about the factors present on admission that can predict DE during the hospital encounter. Such knowledge is essential for prospective identification of hospitalized patients at risk for DE who can be targeted for early intervention. The purpose of this […]

Background: Subspecialty consultation among hospitalists varies significantly across and within hospitals. While in many cases consultation is clinically necessary, in other cases it may represent overuse. Recent studies have explored predictors of consultation using observational administrative and EHR data. Qualitative methods may generate knowledge about additional factors and complex processes influencing consultation behavior not ascertainable […]

Background: Complex non-pharmacologic interventions containing multiple, or bundled, components can successfully prevent and treat hospital-acquired delirium in older adults. However consistent implementation, and the measurement of compliance, of these bundled interventions can be challenging to sustain in hospital settings especially in presence of COVID-19. Developing workflows with a smaller sub-set of components that are feasible […]

Background: Post hospital discharge review during the transition from hospital to skilled nursing facility (SNF) is critical to avoid medication errors, improve patient outcomes and reduce hospital readmissions (1-3). Despite increased integration of electronic health records (EHR) across health entities, communication gaps and discharge-related medication errors still persist (2,4). These challenges can be more predominant […]

Background: Research suggests that high workloads in the inpatient setting (often measured through patient encounters/visits) contribute to increased hospital length of stay, increased costs, and delayed discharges. High workloads also negatively impact our quality improvement efforts and result in a mismatch in job demands and job resources leading to clinician burnout. To date, there is […]

Background: Research suggests that high workloads in the inpatient setting (often measured through patient encounters/visits) contribute to increased hospital length of stay, increased costs, and delayed discharges. High workloads also negatively impact our quality improvement efforts and result in a mismatch in job demands and job resources leading to clinician burnout. To date, there is […]

Background: Although readmission rates have decreased since the implementation of higher-than-expected 30-day readmission penalties by the Centers for Medicare & Medicaid Services (CMS), rates remain above optimal. Hospital readmissions reflect two processes: discharge planning and access to care after discharge. To increase access to care, the US Congress passed the Patient Protection and Affordable Care […]