Background: Ideally, all patients should have a designated medical durable power of attorney (MDPOA) in the event that they are incapable of making decisions for themselves when admitted to the hospital. This best practice ensures that patient wishes are being followed and eliminates the burden of identifying a medical proxy during a critical and stressful [...]

Background: The Centers of Medicare and Medicaid (CMS) in 2024 will require hospitals to screen and report two of the following five health-related social needs (HRSN): food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety (1). These regulations improve screening, however, institutions are still left with questions on how to address these HRSN, [...]

Background: Hospital Medicine (HM) based procedure services have demonstrated improved outcomes for patients by reducing time to procedure, improving throughput, and decreasing length of stay. Notable barriers to service implementation and sustainability include staffing shortages, training, and payment models. Provision of bedside procedural care in the community teaching hospital setting may facilitate access to other [...]

Background: Advanced practice providers (APPs) are among the fastest growing occupations in the US. Onboarding APPs is imperative to ensure adequate training in hospital medicine, but can be challenging given the resources required for optimal training. Team-based training offers opportunities to provide comprehensive onboarding while efficiently utilizing existing staff and resources. Purpose: To develop a [...]

Background: Physician burnout is a persistent stress reaction which can include emotional exhaustion, depersonalization, and feeling of decreased personal accomplishment. Burnout affects all specialties and all practices, but burnout rates are higher among women physicians as compared to men (56% vs 41%). Gender disparities in burnout have many causes, including inequities in recruitment, pay and [...]

Background: In-hospital patient deterioration, often unpredictable and multifaceted, presents a significant challenge in hospital medicine. Despite existing measures like illness severity scoring systems and rapid response teams (RRT), patient outcomes remain suboptimal. Delays in recognizing and treating worsening conditions lead to adverse effects and increased healthcare costs. Purpose: In our large healthcare system, covering two [...]

Background: To address the risk of missed or delayed diagnoses, organizations need to identify and learn from their diagnostic opportunities. However, current approaches to identifying diagnostic opportunities are insensitive, resource intensive and often have low yield.(1,2) Evaluation of diagnostic trajectories can highlight diagnostic opportunities. For example, a patient may re-present to the healthcare system with [...]

Background: Critical event management skills are required for resident training. Critical events include rapid response events, acute clinical decompensation, and code blue events. Evidence supports simulation-based training to improve mastery and retention of these skills. We recognized a need for resident training in critical event management following concerns raised by interprofessional teams and safety event [...]

Background: Background: As healthcare systems evolve to provide more efficient and patient-centered care, the utilization of ambulatory surgery centers (ASCs) has become increasingly common. These centers offer a convenient and cost-effective alternative to traditional inpatient hospitalization for a wide range of surgical procedures. However, proper preoperative evaluation and decision-making are critical to ensure patients are [...]

Background: At Thomas Jefferson University Hospital (TJUH) in Philadelphia, Pennsylvania, 4th year medical students can complete an elective in Perioperative and Consultative Medicine. The Farber Hospitalist Division is a unique Hospital Medicine Division in the Department of Neurosurgery that runs the medicine consult service and specializes in neurosurgical co-management at both TJUH Main Campus and [...]