Background: In our NIH funded multi-site cluster randomized clinical trial (RCT), we used implementation science methods to develop and implement quality improvement programs consisting of evidenced-based interventions to improve care transitions for patients hospitalized with chronic obstructive pulmonary disease (COPD). Since the hospitals were the ‘subject’ of study, typical patient-level RCT enrollment practices were not [...]

Background: Patient-reported measures including health confidence correlate with health outcomes, such as hospital utilization and post-acute care (PAC) needs within research settings. A more recent approach has been to develop learning health systems (LHS) with these measures to incorporate research findings into clinical care at a rapid rate. We have found that a measure of [...]

Background: Hospitalists provide around-the-clock care for patients. There is a need to characterize the work and workflows of hospitalists during different times of the day in order to ensure that clinicians are tasked with workloads that enable safe patient care, alignment with quality goals, professional fulfillment, and efficient use of resources. While there are relatively [...]

Background: In-hospital delirium is associated with poor hospital outcomes, including longer hospital stays and increased morbidity. Nonpharmacological approaches have proven beneficial in reducing delirium occurrence by nearly 40%. Staffing shortages in healthcare have prompted the need for innovative strategies to prevent in-hospital delirium development. As such, we implemented a pilot program for delirium optimization with [...]

Background: Resident physicians are responsible for mastering a vast array of clinical and affective competencies. In the modern clinical learning environment, it is vital that residents can effectively use the electronic health record (EHR) to deliver safe and high-quality care, and that attending physicians and health organizations develop standards by which to supervise trainees in [...]

Background: Hospital medicine groups are rapidly expanding with an increasing presence across academic medical centers yet little data exist to identify which models yield the best outcomes for patients, hospitalists and the health system. Poorly designed staffing models can contribute to hospitalist burnout and turnover. We sought to explore hospitalist clinicians’ perceptions of care delivery [...]

Background: All oxygenation devices are the aerosol-generating procedures and can generate some contaminated aerosols and droplets from the patient’s airway and transmit them through the air, especially in close contact or in an enclosed space. Increasing the flow rate in O2 devices can provide more FiO2, such as using HFNC, which can improve the hypoxia [...]

Background: In the ever-evolving field of healthcare, the need for physicians to understand cost considerations is paramount. Cultivating cost awareness among residents is critical as residents play a pivotal role in shaping the future of medicine. However, the incorporation of cost-consciousness into medical education remains a challenge, often overshadowed by clinical priorities. By examining current [...]

Background: Kidney injury significantly reduces renal clearance, posing unique challenges for patients with type II diabetes, particularly those on insulin. This reduced clearance can lead to elevated insulin levels, increasing the risk of hypoglycemia and subsequent complications, which often extend the patient’s length of stay (LOS). Chronic kidney disease (CKD) itself is an independent risk [...]

Background: Social determinants of health (SDOH) play a critical role in predicting hospital readmission rates across various patient populations. Key SDOH factors, such as neighborhood crime index, income, and household size, are important predictors of unplanned readmissionsi. Importantly, including SDOH in readmission prediction models has been shown to improve accuracyii, highlighting the need for addressing [...]