Background: Over 6.5 million Americans aged 20+ live with heart failure (HF) which is one of the most common reasons people age >65 are admitted. 2017 an estimated 924,000 patients resulted in 1.2 million HF admissions (26% increase from 2014). HF results in frequent re-hospitalizations, prolonged LOS with the CDC estimating (2012) cost of care [...]

Background: The interface between two distinct disciplines of medicine with different training regimens and practice cultures can present challenges to effective collaboration. “Few practice-based conceptual frameworks exist to inform interdepartmental QI collaboration in hospital settings, despite a widespread emphasis on QI within hospitals.”.These tensions can be exacerbated by constraints and demands prevalent in healthcare including [...]

Background: Emergency department (ED) crowding leads to prolonged boarding times, delayed admissions, and decreased operational efficiency. Level loading (LL) in a multi-hospital organization is the intentional balancing of patient volume across all hospitals in the system, rather than allowing one hospital to become overloaded while others have capacity. A clinical expeditor (CE) is a patient [...]

Background: Hospital medicine services often face challenges in maintaining continuity of care, interdisciplinary collaboration, and operational efficiency across medical‑surgical units. Traditional rounding models can fragment communication and accountability, limiting opportunities to improve patient outcomes and staff satisfaction. Purpose: To implement and evaluate a Hybrid Geographic Rounding Model designed to strengthen continuity of care, foster interdisciplinary [...]

Background: Hospital Medicine (HM) and Emergency Medicine (EM) teams across 15 hospitals in the Jefferson Health–Lehigh Valley Region identified inefficiencies in the admission process that delayed initiation of inpatient care. Common barriers included disagreements regarding appropriate disposition such as ICU versus medical wards, or Hospital Medicine versus other specialty services. These delays hindered timely treatment [...]

Background: The “July Effect” describes operational deterioration when launching residency programs. A 910-bed hospital with the nation’s second-busiest emergency department (180,000 visits/year) launched an internal medicine residency in July 2023. Leadership hypothesized that a bundled innovation could transform this high-risk transition into operational improvement. Teaching rounds experience frequent interruptions degrading efficiency and education. Geographic cohorting [...]

Background: Penicillin allergies are commonly reported, yet many patients who carry this labelhave never had a true allergic reaction. A significant proportion of individuals with a reported childhoodpenicillin (PCN) allergy have been misdiagnosed, often due to viral illnesses that were incorrectlyattributed to the drug. This mislabeling leads to suboptimal antibiotic use, including unnecessaryavoidance of penicillin [...]

Background: Delirium is a common and serious condition affecting hospitalized patients,particularly the elderly. It is associated with poor outcomes such as prolonged hospital stays, increasedrisk of falls, and long-term cognitive impairment. Despite its impact, delirium often goes unrecognized,specially outside the ICU due to the absence of a standardized protocol for its identification andmanagement. At Lakeland [...]

Background: Documentation is a major contributor to clinician workload and burnout. Most clinicians complete notes manually, or through dictation often after hours, which affects efficiency and delays patient care tasks. Artificial intelligence enabled voice dictation tools like OpenEvidence may streamline this process by reducing charting time while improving documentation completeness. Despite growing interest in AI [...]

Background: Hospitalized patients have been shown to spend 87-100% of the day sitting or lying in bed, leading to many complications including venous thromboembolism and hospital acquired pneumonia. An important step to improve mobility amongst a diverse patient population is to establish an individualized mobility goal, which can be accomplished via a simple, validated mobility [...]