Background: Hospitalists frequently lead family meetings with patients and family members. Shared decision making employed during family meetings is believed to foster mutual understanding of its participants, including understanding of prognosis. However, this assumption has not been empirically assessed. Methods: We performed a secondary analysis of data from a trial of a decision support tool [...]

Background: Over the past few decades, many institutions have elected to implement night float systems in place of traditional call systems for residents. With the Accreditation Council for Graduate Medical Education enacting duty hour restrictions in 2003, these changes toward stricter work hour requirements and institution of night float systems have been found to have [...]

Background: Recognizing the significant effect that social factors have on health outcomes, national stakeholders have developed policies requiring healthcare organizations to identify and address health-related social needs (HRSN). However, the effectiveness of HRSN screening strategies remains unclear. Notably, policymakers provide minimal guidance on how screening should be conducted and allow hospitals to use self-selected screening [...]

Background: The direct oral anticoagulants (DOACs) apixaban and rivaroxaban are increasingly prescribed due to convenient oral formulation without the need for routine laboratory monitoring and are now commonly regarded as first line anticoagulants in most cases of venous thromboembolism (VTE). However, the optimal choice of subsequent anticoagulant in instances of first line DOAC failure is [...]

Background: Increased Emergency Department (ED) boarding has been linked to worse patient outcomes, including delays in treatment (Jiraporn et al 2014), increased length of stay (Singer et al 2011), and increased mortality (Singer et al 2011; Sun et al 2013). Patients who meet time zero (T-0) for diagnosis with severe sepsis while boarding in the [...]

Background: Among patients undergoing cardiac surgery on cardiopulmonary bypass (CPB), post-operative complications are common, occurring in up to 67% of patients, and significantly impact long-term outcomes. We conducted a Phase 2 clinical trial of RBT-1, a pharmacologic preconditioning drug, to assess cytoprotective biomarkers and clinical outcomes. Herein, we report our final results. Methods: This randomized, [...]

Background: Urinary tract infection (UTI) and community acquired pneumonia (CAP) are the two most common infections treated in hospitalized patients and are often inappropriately diagnosed. Due to myriad factors—including diagnostic uncertainty—patients are commonly inappropriately diagnosed with UTI or CAP in the emergency department (ED). Antibiotics may be continued throughout the hospitalization even if new information [...]

Background: Half of US hospitalists have contracts with pay-for-performance incentives based on quality outcomes such as length of stay (LOS) and readmission according to the 2023 State of Hospital Medicine Report. Traditionally, these measures have been linked to the discharging provider. However, as the length of a patient’s stay increases, the influence of the discharging [...]

Background: Efforts have been made to increase social determinants of health (SDoH) screening to connect patients and families to community-based organizations (CBOs) and other resources. Tracking closed loop referrals is one potential measure to assist in assessing whether the resulting referrals and interventions have affected the child’s SDoH or improved the family’s well-being. Our team [...]

Background: Ambulatory care sensitive conditions (ACSCs) are a set of diagnoses that if not recognized and addressed properly in the ambulatory setting can lead to preventable hospitalizations. People experiencing homelessness (PEH) often have barriers to access of ambulatory care services and chronic disease self-management. These place them at high risk for having ACSCs, and contribute [...]