Background: At the onset of the coronavirus 2019 (COVID-19) pandemic, asthma exacerbations reportedly decreased overall, raising the question if in contrast to other viruses, SARS-CoV-2 infection does not induce asthma exacerbations1,2. Like other viruses including endemic coronaviruses, there is theoretical risk of developing bronchospasm in response to viral infection with SARS-CoV-2 for patients with a [...]

Background: Hospital-associated sleep loss and poor overall sleep efficiency are associated with poor glycemic control and exacerbated insulin resistance. in diabetic patients. The relationship between sleep, sleep hygiene, and diabetes is confounded by social determinants of health, such as health literacy. The evaluation of insomnia often utilizes complex sleep diaries or logs that may not [...]

Background: Geographic localization (GL) has been shown to improve perceptions of physician-nurse, physician-physician, and physician-Case Management communication. However, data on other benefits of GL are mixed. While some studies show that GL improves time allocated by physicians for direct patient care, others report an increased frequency of workday interruptions and greater time spent on indirect [...]

Background: 15% of hospitalized patients have a documented penicillin (PCN) allergy. However, fewer than 1% of those patients have a true IgE-mediated reaction that necessitates avoidance of beta-lactam antibiotics. Labeling a patient with a PCN allergy is associated with prescribing non beta-lactam (NBL) broad spectrum antibiotics and increased adverse outcomes. Patients with a documented PCN [...]

Background: Advance care planning (ACP) informs future medical decision-making, particularly for hospitalized patients with older age or serious illness. The majority of end-of-life conversations are led by hospitalists in the inpatient setting. Despite the importance of ACP in end-of-life care, health disparities exist, with racial and ethnic minorities less likely to have advanced directives and [...]

Background: Written discharge instructions frequently lack guidance on how patients should address problems and questions that arise at home, and this represents an opportunity to enhance discharge safety and prevent readmissions. This study aimed to increase the number of discharge instructions that included anticipatory guidance and self-management among patients discharged from internal medicine teaching services [...]

Background: Asymptomatic bacteriuria (ASB), or bacterial growth on urine culture without localizing urinary symptoms, is common in hospitalized patients.1,2 ASB is often misdiagnosed as urinary tract infection (UTI) and treated with antibiotics3 despite no improvement in mortality1 and multiple harms associated with antibiotic overuse.4,5 To reduce treatment of ASB, many hospitals set urinalysis parameters (e.g. [...]

Background: We evaluated whether a catheter-to-vein ratio (CVR) of >45% increases the risk of venous thromboembolism [VTE] and catheter occlusion associated with peripherally inserted central catheters (PICCs). Methods: From August 2020 to April 2022, trained abstractors collected demographic and clinical data on patients receiving PICCs while admitted at 52 hospitals participating in the Michigan Hospital [...]

Background: Duplicate medical records, where one patient possesses multiple medical record numbers and corresponding charts within a single electronic health record (EHR), pose significant patient safety risks due to incomplete data and repeated interventions, among other areas. The risk is amplified for patients admitted to the hospital, where rapid pace decision making is the norm. [...]

Background: Point-of-care ultrasound (POCUS) is a diagnostic tool that is being increasingly utilized within the hospitalist sector of internal medicine; however, there is currently no summative source of information for POCUS in perioperative medical management. To address this gap in knowledge, we conducted a systematic review of studies assessing the impact of POCUS on clinical [...]