Background: Vertebral fractures are the most common type of osteoporotic fracture in older adults in the United States, and can result in acute and chronic pain, reduced quality of life, decreased survival, and increased costs. The identification and management of vertebral fractures is important because they serve as robust predictors of future fractures. Yet, hospital [...]

Background: There is no formal curriculum for medical students, residents or advanced practitioner students on appropriate clinical documentation improvement (CDI). As the primary documenters for medical records, several studies have shown benefit in billing, coding and hospital metrics with trainee education [1-2]. Despite this, there remains a scarcity of education on documentation for residents and [...]

Background: Structural inequities in healthcare are widespread and best documented in racial and income related inequalities to care. Prior studies show macro level differences in access to healthcare, insurance and medications as explanations for healthcare inequities. The opening of a second hospital in a suburban academic center with entirely private patient rooms presented a rare [...]

Background: Lab testing is critical for clinical decision-making and used throughout healthcare systems. Overuse of lab testing is known to be commonplace and contributes to shortages in lab testing materials. While practices exist at medical institutions that aim to limit lab test overuse, it is unclear which interventions are effective. Methods: We aimed to reduce [...]

Background: The importance of accurate patient care records for effective communication and medical education is well documented. However, medical documentation as a tool for financial compensation is not emphasized in graduate medical education. We performed a review and analysis of resident charting errors during inpatient rotations to determine the potential revenue loss and economic impact. [...]

Background: Burnout is a syndrome characterized by three dimensions: emotional exhaustion, depersonalization, and low sense of accomplishment from work. Long work hours, sleep deprivation and loss of autonomy all contribute to higher prevalence of burnout in medical providers1. Organizations are increasingly being encouraged to routinely measure burnout in their providers and implement strategies to mitigate [...]

Background: Hospital at Home (HaH) programs provide feasible and effective inpatient-level care in patients’ homes, with interest in this value-based care model increasing substantially as health systems strain to meet capacity and resource demands.1-6 Despite well-documented benefits, adoption of HaH outside of capacity surges remains limited, hindering scalability efforts.7 Furthermore, patient and provider experiences of [...]

Background: Post operative VTE is higher among orthopedic surgeries when compared to other surgical fields. Within orthopedic surgery, hip and knee surgeries have the highest risk of post-op VTE. This risk is highest in the first 10 days but persists up to three months after surgery. Current American Academy of Orthopedic Surgeons (AAOS) guidelines recommend [...]

Background: With the broad implementation of electronic health records, clinical documentation integrity continues to be under increasing scrutiny. On average, physicians spend over a third of their time documenting patient data¹; this burden has been extensively correlated to burnout². Leveraging automated note templates with integrated safety rounding checklists, we attempted to standardize more efficient documentation [...]

Background: Phenobarbital (PB) has important pharmacological advantages over benzodiazepines (BZDs) for treatment of alcohol withdrawal syndrome (AWS). The American Society of Addiction Medicine recommends PB monotherapy as an alternative to BZDs for prophylaxis or treatment of AWS by providers experienced with its use. Few studies have described the use of PB for AWS outside of [...]