Background: The Accreditation Council for Graduate Medical Education (ACGME) sets strict guidelines governing work hours for internal medicine trainees, not to exceed 80 hours per week. Though many programs grapple with achieving adherence, few published studies report successful changes to meet these limits. Previous efforts at our institution to reduce patient census on the teaching […]

Background: Despite benefits of early Serious Illness Conversations (SICs), including increased satisfaction and earlier hospice referral, rates of SICs remain low. The primary aim of this study is to assess if standardized documentation of SICs increase following implementation of interventions for providers to have more of these conversations with patients admitted to a general medicine […]

Background: Nearly 6 million pediatric patients are discharged from the hospital yearly in the United States (AHRQ 2012), and social determinants of health (SDoH) impact discharge outcomes (Nacht 2022). Effective discharge planning prevents patient readmissions (Shapiro 2021), but the literature on how best to educate pediatric trainees is limited (Key-Solle 2010, Widmer 2015). We assessed […]

Background: Academic medical centers (AMCs) have experienced significant clinical growth and have responded to the increase clinical demand by growing the number of hospital medicine services.[1,2] While this unprecedented growth has occurred, it has often outpaced the growth of housestaff training programs which has led to academic hospitalist teams evolving their clinical and educational models […]

Background: Medical students report that approximately 1/3 of their medical education is provided by residents. As a moderate sized community-based hospital, we conducted a needs assessment about our residents’ attitudes and comfort with teaching medical students, which identified residents did not feel prepared to teach medical students nor feel confident in creating teaching talks, and […]

Background: Ascorbic acid (AA) deficiency affects disproportionally the older population. The recognition of AA deficiency is elusive since we do not measure AA routinely. We assessed the influence of AA supplementation on hospitalization outcomes for community geriatric patients. Methods: Single-center, retrospective study of community-dwelling patients older than 65-years old admitted to a community hospital from […]

Background: Most cases of pneumonia in older people are aspiration pneumonia,[1] and the prognosis among patients hospitalized for aspiration pneumonia is very poor.[2] After being hospitalized for aspiration pneumonia, a certain number of patients become unable to take orally, and some chronic conditions are reported to be negatively associated with the retrievement of oral intake.[3] […]

Background: The growth of oral muscle relaxant prescriptions among older adults in the U.S. raises safety concern. Baclofen is a commonly used gamma-aminobutyric acid (GABA) agonist muscle relaxant that is associated with encephalopathy. We aimed to compare the risk of fall and fracture associated with oral baclofen against other muscle relaxants (tizanidine or cyclobenzaprine) in […]

Background: The American Geriatric Society (AGS) creates a consensus report, the Beers Criteria, of medications that may potentially inappropriate for older persons. The 2019 Beers Criteria consists of medications across many classifications and indications that could have potentially harmful effects on older patients, including contributing delirium, falls, hypotension, and urinary retention. Providing the highest quality […]

Background: At our Level 1 trauma center, geriatric trauma (GT) patients are primarily managed by hospitalists with surgical consultation. This care model offloads the trauma surgical services, improving time to surgery and hospital throughput. As the number of injured GT patients rose, so did the need to address a higher complication risk, longer hospital stays, […]