Background: Sepsis is a life-threatening condition involving organ dysfunction caused by a dysregulated response to infection [1]. Sepsis is the leading cause of 30-day unplanned readmissions nationwide [2]. At UF Health Shands Hospital, the 30-day readmission rate for sepsis patients is 17% compared to 13% for all adult patients. Of those readmitted for sepsis, 38% [...]

Background: An estimated 20-30% of inpatient standing labs are medically unnecessary1, contributing to iatrogenic anemia2, sleep disruption3, and increased healthcare costs. The Society of Hospital Medicine identified routine repetitive complete blood count (CBC) and chemistry (BMP) as a common wasteful inpatient practice4. At our institution, repetitive inpatient CBC, BMP, magnesium, and phosphorus account for 500,000 [...]

Background: Hospital at Home (HaH) provides inpatient level of care to patients within their homes and replaces the brick and mortar inpatient experience. Our institution’s HaH program has had incredible success and has enrolled over 2000 patients to date and continues to expand. The growth of our program has allowed us to accept more complex [...]

Background: Evaluating a patient’s post-hospitalization course is critical feedback for refining future diagnostic and therapeutic decisions, yet it rarely happens formally during residency. The Out of Sight, Out of Mind (OOSOOM, pronounced like “awesome”) conference addresses this gap. Purpose: To provide a structured forum for residents to review post-discharge outcomes of the patients they managed [...]

Background: Nocturnists often start their positions immediately after residency. It has been shown that early career hospitalists benefit from mentorship for scholarly productivity, academic promotion and personal career satisfaction (1,2). However, as nocturnists typically work at different hours than senior clinicians and service leaders, there are decreased opportunities for informal mentorship, modelling, and visibility. Purpose: [...]

Background: Increased Emergency Department (ED) boarding times have been associated with delays in care, longer length of stay, lower patient satisfaction, increased adverse events, and increased mortality. Kobayashi et. al., coined the term “dead time” to describe the time spent awaiting admission during which meaningful contribution to the advancement of care is limited. In the [...]

Background: Penicillin is the most commonly documented drug “allergy” on hospital admission. Patients with listed penicillin allergies have higher rates of treatment failures, antibiotic resistance, and average length of stay. This has downstream implications impacting healthcare utilization, infection prevalence, and cost. However, the majority of these reported allergies are inaccurate, and over 90% of these [...]

Background: Mortality rates are a critical quality metric for hospitals, influencing both clinical outcomes and institutional reputation. The Centers for Medicare and Medicaid Services (CMS) incorporates 30-day mortality rates into its Value-Based Purchasing (VBP) program and Star Ratings, directly impacting hospital reimbursement and public perception. Similarly, U.S. News & World Report factors 30-day mortality into [...]

Background: We created a generative artificial intelligence chatbot (“VLRChat”) that draws from a comprehensive curricular resource (the 480-page Vanderbilt Housestaff Handbook) to answer point-of-care clinical questions by hospitalists and inpatient clinical teams. Time constraints and cognitive overload frequently prevent hospitalist faculty and learners from determining the optimal, most current answers to clinical questions: as many [...]

Background: Hospitalists vary in their ordering practices related to labs, imaging, and discharge order times. Variations in these practices has been associated with over-utilization of services and inefficient clustering of discharges later in the day. Prior studies suggest that peer comparison can be effective to change provider behavior and reduce unnecessary variation in ordering practices, [...]