Background: Immobility in hospitalized patients remains prevalent, leading to multiple hospital acquired complications including pressure injuries, venous thromboemboli, and falls. In our large tertiary care, academic hospital we piloted an innovative interprofessional education course which demonstrated health professional students could mobilize inpatients without increasing falls. Our initial promising results led to an expansion of the [...]

Background: Medication reconciliation is one of the most time-consuming processes in hospital medicine. An internal survey within our Division of Hospital Medicine found that 69.9% of providers strongly agree that thorough medication reconciliation is essential to patient care. Despite its importance, the process remains highly time intensive, with 26% of providers spending 15-20 minutes per [...]

Background: Reducing 30-day readmissions for CMS-targeted conditions—pneumonia, AMI, COPD, and CHF—remains a national priority. While our hospital historically maintained strong readmission performance for fee-for-service patients, rates rose sharply from 9% in 2023 to 16% in 2024. This prompted a hospital-wide reassessment and the launch of a multidisciplinary initiative to identify system gaps, standardize transitions of [...]

Background: Our Queens, NY community hospital serves an aging, diverse population with substantial socioeconomic barriers to care transitions. These factors create obstacles to discharge planning and disposition, contributing to prolonged hospitalization. A structured, proactive process that identifies discharge challenges early and coordinates multidisciplinary actions is essential to reduce excess days. Purpose: To implement twice-weekly multidisciplinary [...]

Background: Albumin, the predominant plasma protein, maintains oncotic pressure and transports hormones, drugs, and endogenous molecules. Intravenous albumin leverages these functions to mobilize interstitial fluid and stabilize intravascular volume in specific scenarios such as large-volume paracentesis (LVP), spontaneous bacterial peritonitis (SBP), hepatorenal syndrome (HRS), and therapeutic plasma exchange. Medication-use evaluation at our community hospital revealed [...]

Background: Heart failure, particularly in patients with reduced ejection fraction (HFrEF), is a leading cause of hospitalization and readmission in the U.S., significantly impacting healthcare costs and quality of life. Improving compliance with guideline-directed medical therapy (GDMT) and early post-discharge follow-up is crucial to reducing readmissions. We describe a resident-driven quality improvement project aimed at [...]

Background: Sleep disturbances among hospitalized adults are associated with impaired glucose regulation, increased pain intensity, prolonged length of stay, and reduced patient satisfaction. On our general medicine unit, Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) responses to the “Quietness of Hospital Environment” question consistently revealed opportunities to improve the nighttime environment. Recognizing the [...]

Background: Peer feedback is well-known as a beneficial, low resource tool for enhancing clinical excellence among healthcare professionals.1,2 Anonymous, consistent peer feedback is less likely to be construed as punitive. 3 It allows individuals to learn from mistakes and correct behavior prior to a severe event, 4 as accuracy of self-assessment is generally poor. 2 [...]

Background: Accurate and complete documentation is essential to ensure clarity, compliance, and appropriate reimbursement in hospital medicine. The 2023 Centers for Medicare & Medicaid Services (CMS) Evaluation and Management (E/M) revisions shifted the emphasis toward Medical Decision Making (MDM), requiring providers to clearly articulate the problems addressed, the data reviewed, and the risk of morbidity [...]

Background: Hospitals are facing increasing admission denials from insurance companies while simultaneously managing limited resources due to ongoing financial pressures and the residual effects of the COVID-19 pandemic. Patients are also experiencing growing frustration with rising out-of-pocket costs and unnecessary hospitalizations that can lead to additional copayments and hospital acquired conditions (HACs). Purpose: To address [...]