Background: Hospitalists play a key role in procedural training at many academic institutions and are frequently called on to assist with vascular access. PICCs have been shown to be safe and cost effective. Their use in hospitalized patients continues to increase, which can overburden interventional radiology (IR) services. Bedside placement with ultrasound can result in [...]

Background: We have implemented an inpatient “apprenticeship” for all PGY1 IM residents. We hypothesize this rotation will expedite the development of core competencies as related to care of hospitalized patients by having a one‐on‐one experience with our hospitalist faculty. Purpose: The competencies we hope to achieve are improvement in: (1) patient‐centered care; (2) clinical skills [...]

Background: Caring for acutely ill patients in a 40‐bed ward while constantly admitting, discharging, and transferring care is a challenge. The clinical staff spends significant time completing nonclinical tasks (eg, searching for supplies). This time would be much better spent on direct patient care Purpose: We applied Lean/TPS methods to a medical ward to improve [...]

Background: Hospitalists often care for patients on multiple hospital units simultaneously, limiting opportunities for consistent interactions and collaboration on quality improvement initiatives with a familiar group of unit staff members. Our hospitalist group partnered with staff members (eg, nurses, nurse aides, clerks, discharge planners, social workers, physical therapists) on a new dedicated hospitalist service unit [...]

Background: The Centers for Medicare and Medicaid services (CMS) established an incentive program referred to as Physician Quality Reporting Initiative (PQRI) in 2007 for voluntary reporting of at least 3 of the 74 designated measures in at least 80% of eligible patient encounters. The Society of Hospital Medicine (SHM) has identified 11 measures that are [...]

Background: Individual case review is an important mechanism for peer assessment and quality improvement. Today, most case reviews of hospitalized patients are performed in an unstructured manner outside the context of a broader quality improvement framework. Aside from resource‐intensive root cause analyses, hospitals lack simple, systematic case review tools. Given trends in performance measurement, there [...]

Background: Residents often feel inadequately instructed to perform invasive procedures and believe this poses a risk to patients. Formal teaching using task trainers (ie, models) has the potential to improve competence and confidence, and advance patient safety. Purpose: To describe the development and initial evaluation of an innovative pilot program to teach internal medicine residents [...]

Background: As part of a larger initiative to increase capacity for subspecialty patients, this university hospital (UH), a 573‐bed quaternary‐care facility in a large urban center, decreased the size of its general medicine service (GMS) by a third in the last 18 months. Because the UH is in an area with high hospitalization rates for [...]

Background: Emergency department (ED) physicians in our hospital commonly use exercise treadmill testing (ETT) to manage low‐risk patients who present with chest pain. Selected patients undergo ETT either on the day of presentation or within days after discharge. Purpose: A hospitalist‐run ETT laboratory was opened in the ED to improve the accessibility of ETT to [...]

Background: Every day, internal medicine (IM) house staff members work on the wards with hospitalist teachers and attendings. Increasing numbers are choosing careers in hospitalist medicine postresidency despite limited exposure to the full range of available hospitalist roles. Jobs in academic centers are very different from those in nonteaching community hospitals. New rotations can provide [...]