Background: For many inpatient wards teams, morning rounds remain the primary time many attendings use to engage learners in clinical decision making and education. Literature supports the use of bedside rounds to improve learner communication and patient engagement. However, many institutional, learner, and patient factors may impact attending choice in how they round with learners. [...]

Background: Alcohol Use Disorder (AUD) is prevalent among hospitalized Veterans and is associated with increased mortality.[1] AUD contributes to both morbidity and mortality through its direct physiological effects and its association with various medical, psychiatric, and social consequences. The World Health Organization estimates that alcohol use accounts for approximately 4.7% of all deaths in 2019 [...]

Background: Early warning scores are used with increasing frequency, but little data exist on the impact of these scores on clinical outcomes. Our health system’s experience with two prior early warning scores was associated with complaints of alarm fatigue and no demonstrable improvement in clinical outcomes. After performing a retrospective validation comparing six early warning [...]

Background: The opioid epidemic is a national health crisis, and veterans in particular, at increased risk for developing substance use disorders. The use of medications for treatment of opioid use disorder (MOUD) is a life-saving, cost-effective intervention. However, MOUD is consistently underutilized, particularly in the inpatient setting and little has been published regarding Veterans Affairs [...]

Background: Patient experience metrics heavily impact healthcare institutions’ rankings, reputations, and funding. Prior research has shown that 92% of patients consider “listening to you” to be very or extremely important, ranking third in importance after clear communication and being treated with courtesy and respect (The Beryl Institute, 2024). However, few studies have explored what behaviors [...]

Background: Interhospital transfer patients experience substantially higher morbidity and mortality than those admitted from the emergency department, yet predictors of early deterioration after transfer remain poorly defined. Rapid ICU escalation within 24 hours is distressing to receiving teams and may reflect challenges in triage, pre-arrival risk assessment, or communication between referring and receiving centers. Clarifying [...]

Background: High workloads in the inpatient setting affect clinician well-being, patient outcomes, and organizational performance, yet decisions around work-design rarely links to outcomes outside of productivity and financial measures. Emerging technologies, including EHR use data (i.e., clickstream data), may offer real-time insights into workload and work patterns when paired with clinician-, patient-, and organization-level outcomes. [...]

Background: Hospital medicine physicians (hospitalists) are essential to inpatient care delivery and coordination. As the population grows and ages, demand for hospital-based care continues to rise, raising concerns about whether the current workforce can meet future needs. Despite the central role of hospitalists in quality, efficiency, and patient safety, few studies have projected long-term workforce [...]

Background: Prior cross-sectional studies have confirmed the anecdotal experience of many hospitalists: that many older adults are getting “stuck” in the hospital after completing medical treatment. However, these studies have been limited to select hospitals using a single point-in-time estimate. Nationally representative data is needed to better understand this phenomenon and characterize potential underlying contributors. [...]

Case Presentation: A 34-year-old female with a history of focal epilepsy diagnosed during childhood complicated by status epilepticus, anxiety, depression, ADHD, and history of chronic hyponatremia presented to the hospital at 25 weeks gestation with complaints of recurrent seizures. During the admission process she had multiple witnessed generalized tonic-clonic seizures with nystagmus requiring multiple rounds [...]