Background: Medicine procedure services (MPSs) have been shown to increase procedure volume, procedure completion rate, adherence to best practice safety measures, resident involvement, and resident satisfaction, and decrease length of stay within Internal Medicine (IM) [Ref 1-4]. However, the frequency with which MPSs rely on other services, particularly Interventional Radiology (IR), for assistance to complete [...]

Background: The health care transition (HCT) from adolescence to young adulthood is a vulnerable time for youth with special health care needs (YSHCN). Inadequate preparation and support from clinicians, increased responsibilities, and lack of ongoing parental assistance may lead to worsening health conditions. It is generally understood that YSHCN should undergo a structured pediatric to [...]

Background: A challenge facing many hospital medicine programs is matching provider staffing to daily patient volumes. Staffing models and clinical work schedules are typically built weeks or months in advance, with limited ability to flex up or down in real time based on actual patient volumes. Patient volumes can vary significantly on a daily or [...]

Background: Diagnostic error is a major threat to the safety of hospitalized patients, affecting as many as 1 in 4 patients and leading to 7% of inpatient deaths. However, diagnostic error remains difficult to identify and measure, particularly in the hospital setting, where determination of an error relies on medical record review. Measurement difficulty also [...]

Background: Medical errors are the third leading cause of death in the United States yet physicians report minimal education on how to disclose errors and adverse events. To Err is Human shed light on the severity of errors. As a result, communication and resolution programs were developed over the past two decades to attempt to [...]

Background: Inequitable healthcare is delivered to those who are incarcerated and have a history of incarceration. Incarceration has a significant multiplicative impact on the health of those who experience it – worsening outcomes related to chronic illness and shortening life expectancy. Hospital based providers tend to interact sporadically with individuals who are incarcerated, limiting the [...]

Background: Mortality risk assessment is crucial for predicting patient outcomes, assessing patient care delivery, and improving healthcare quality. Although high-quality medical documentation is critical for mortality risk assessment tools, provider documentation may be inconsistent, relies on coding teams for support, and may not directly reflect provider orders. Complete and precise documentation and coding can improve [...]

Background: The under-reporting of adverse events has been a significant issue in patient and healthcare staff safety, and prevents improvement of individual and systemic errors in healthcare. As champions for quality and safety in their institutions, it is essential hospitalists who work with housestaff  serve as role models to encourage trainees to report safety issues. [...]

Background: Obtaining timely intravenous (IV) access can be challenging for pediatric patients due to physiological and behavioral differences. Many pediatric patients experience multiple needlesticks, leading to trauma and delays in medical interventions. Prior investigators have attempted to implement standardized IV access algorithms, ultrasound-guided IV placement, and stratification of IV placement difficulty using the Difficult Intravenous [...]

Background: Point-of-care ultrasound (POCUS) is an invaluable clinical tool gaining traction as more physicians recognize its utility. However, pediatric residency programs lag behind internal medicine (IM) and emergency medicine in incorporating formal POCUS training. A survey of 90 programs found that 37.5% of IM and 43.5% of medicine-pediatrics (MP) programs offered formal curricula, compared to [...]