Case Presentation: A 59-year-old male with a past medical history of hypertension and cocaine use disorder presented to the emergency department for altered mental status (AMS) and weight loss. For two months he had been having progressively more frequent episodes of left facial grimacing with sudden flexion of the left arm. Additional symptoms included progressive [...]

Case Presentation: A 62-year-old male with no significant past medical history presented with a two-month history of diffuse rash, generalized weakness, fever, weight loss, progressive dyspnea and recurrent bronchitis and pneumonia unresponsive to outpatient antibiotics. On admission, he was febrile (102.9 F), hypoxic, tachycardic and hypotensive. On physical exam, he appeared ill with bibasilar crackles, [...]

Case Presentation: A healthy 15-year-old male developed cough, nasal congestion, and abdominal pain. After several days, he presented to the hospital with worsening pain and emesis. He was febrile to 100.4 degrees Fahrenheit, with a heart rate of 121 beats per minute and a respiratory rate of 27 breaths per minute. He appeared pale and [...]

Case Presentation: A 7-year-old female presented with 3 days of bilateral knee pain and 1 day of left wrist pain and swelling. Knee pain resolved 1 day prior to presentation at which point left wrist symptoms started. No fevers, recent illnesses, or history of trauma. History notable for Acute Myeloid Leukemia (AML) diagnosed at 4 [...]

Case Presentation: A 17-year-old girl presented with one month of progressive cough and exertional dyspnea. She denied fever, chest pain, or hemoptysis. Vitals were normal for age. Growth review showed recent weight loss from the 38th to 15th percentile with stable height at the 5th percentile. Pulmonary exam revealed faint bilateral crackles but was otherwise [...]

Case Presentation: A previously healthy 16-year-old male presented with six days of headache and abdominal pain followed by three days of fever, myalgias, stiff muscles, nausea, anorexia, and fatigue. He denied exertional activity, trauma, substance use, or recent illness. ED diagnostic evaluation revealed leukopenia (1.96 ×10³/µL), CD4 count 155/µL, thrombocytopenia (121 ×10³/µL), LDH 1210 U/L, [...]

Background: Staffing shortages can impact a rural hospital’s viability. Nighttime coverage is particularly difficult given limited resources, low patient volumes and high provider costs. A tele-hospitalist coverage model split between multiple sites is one solution to minimize these challenges. After successfully creating a daytime tele-hospitalist program to support two rural hospitals, our group at a [...]

Background: Emergency Department (ED) boarding has increased nationwide since the COVID-19 pandemic and poses additional risks to patients, including increased length of stay, worsened health outcomes, and overall mortality (1,2). Oregon Health & Science University (OHSU), a 562-bed academic health center and tertiary/quaternary referral center for the region, has faced increasing capacity constraints causing prolonged [...]

Background: Hospital medicine is a high-volume, high-demand specialty where frontline clinicians frequently identify system challenges but lack structured opportunities to influence solutions. Leadership is often occupied with urgent operational needs, leaving hospitalists’ concerns under-addressed. This gap contributes to inefficiency, disengagement, and burnout. An innovative forum—the “Think Tank”—was created to empower hospitalists to generate, prioritize, and [...]

Background: Surgical co-management (SCM), a care model in which hospitalists jointly manage medically complex perioperative patients with surgical teams, has demonstrated decreases in surgical complications, decreases in length of stay, and cost savings (1-6). At Stanford Health Care (SHC), SCM physicians manually screen elective surgeries to identify patients requiring co-management services. However, this process contributes [...]