Background: In 2010, the Patient Protection and Affordable Care Act (ACA) aimed to enhance health insurance access through subsidies and Medicaid expansion. The expansion was not adopted by all states, leading to variable coverage. The Centers for Medicare & Medicaid Services (CMS) releases a 3-year running average of 30-day risk-standardized mortality rates for Medicare patients […]

Background: Although hospitals should be a place of healing and restoration, multiple studies demonstrate that hospitalized patients face acute sleep deprivation due to potentially modifiable disruptions (vitals, medications, tests). Acute inpatient sleep deprivation is also associated with worse health outcomes both in-hospital and post-discharge. While staff-directed sleep interventions show benefits, no study has tested whether […]

Background: New hospitalists can often feel overwhelmed by learning system practices, navigating difficult dispositions, and managing difficult patient and family relationships. This can lead to increased length of stay1, increased burn out, and a feeling of lack of mentorship. Purpose: We hypothesized that weekly meetings between a hospitalist director and a junior faculty hospitalist to […]

Background: Remote patient monitoring (RPM) is a promising new tool to monitor patients who have historically required observation visits in a hospital, or would have remained hospitalized longer if initiated at hospital discharge, and was widely used in the COVID-19 pandemic. We report the outcomes of hospital admission and urgent/emergent care service utilization in a […]

Background: The CDC Core Elements of Antibiotic Stewardship recommend that patients initiated on broad-spectrum antibiotics (BSA) undergo antibiotic de-escalation within 48-72 hours based on available culture data. However, adherence with this recommendation in patients with sepsis has not been well studied. We assessed the incidence of, and characteristics associated with, anti-methicillin resistant staphylococcus aureus (MRSA) […]

Background: The low published survival rate of pediatric in-hospital cardiopulmonary arrest (25-38%) 1 has led to the development of early warning systems (EWS) to identify patients at risk for deterioration. On our general pediatric unit, we implemented the published validated Children’s Hospital Early Warning System (CHEWS)2 in 04/2021. This composite scoring tool includes caregiver assessment […]

Background: Facilitating safe transitions of care is a common concern for the discharging hospitalist. Telephone calls are the most common method of contact for post-discharge outreach. These are labor-intensive and therefore limited in scope. To better support patients after hospital discharge, we designed and implemented a 30-day automated texting program. In a pilot study, this […]

Background: Hospital readmissions are frequent and can represent low-quality, high-cost care. Timely post-hospital follow-up has been described as an important element of high-quality transitions of care and readmissions prevention (1-3), yet exactly what type of follow-up is most successful is unclear. We sought to understand the relationship between timing, hospital follow-up visit provider specialty and […]

Background: Administrative harm (AH), defined as negative consequences arising from administrative processes and decisions within healthcare, is pervasive in medicine, yet poorly understood and described. Methods: We sought to explore common AHs experienced by hospitalist clinicians, administrative leaders, researchers, and patient and family advisory council members that were part of two national consortiums for hospitalists […]

Background: Hospital medicine (HM) is a well-established clinical specialty within Internal Medicine, yet its research footprint has lagged its clinical impact. Clarity of top HM research priorities may identify target areas for investment in HM research infrastructure and define areas of hospital medicine expertise. Methods: The Society of Hospital Medicine’s (SHM) Research Committee formed a […]