Background: On a daily basis, hospitalists prescribe Venous Thromboembolism (VTE) prophylaxis. While of benefit to certain populations, VTE prophylaxis has not been proven to benefit medical patients at low risk for VTE. Pharmacologic prophylaxis may increase the risk of serious bleeding, mechanical prophylaxis is associated with an increased risk of delirium, and both methods are […]

Background: Unit-based care teams offer inherent benefits to hospitalist services, including opportunity for improved efficiency, interdisciplinary collaboration, and enhanced patient experience. However, many barriers exist to creation of these care teams such as high occupancy rates and conflicting interests among stakeholders.  Failure to account for such barriers has led to unsuccessful initiatives to achieve regionalization, […]

Case Presentation: We report the case of a 69-year-old Honduran male with a long history of non-valvular atrial fibrillation with a CHA2DS2-VASc Score= 2 (Age > 65 and Hypertension) anticoagulated with Rivaroxaban 20 mg po daily since 2013.  He presented with sudden onset of excruciating upper and lower back pain while seated at his cardiologist’s […]

Case Presentation: A 44-year-old female with end-stage renal disease on hemodialysis presented to the hospital with progressive nausea, vomiting and abdominal pain. The etiology of her renal disease was unknown. She had received a renal transplant 17 years ago, which then failed. She was maintained on peritoneal dialysis (PD) for 12 years until she was […]

Case Presentation: A 37 year old Caucasian man with known peptic ulcer disease and generalized anxiety disorder presented with a three week history of worsening right upper quadrant pain, nausea and generalized malaise.  He denied taking any prescribed medications or acetaminophen.  He denied any alcohol use during the week of admission. The patient was afebrile […]

Background: Both the ACP through its High Value, Cost-Conscious Care Initiative, and the ABIM through its Choosing Wisely campaign, have called on clinicians to engage in efforts to improve the value of the care we provide Purpose: We sought to develop a curriculum to provide internal medicine residents both a theoretical and a practical exposure […]

Background: Through collaborative neurosurgical comanagement services, hospital medicine has had an increasing role in the hospital-based care of the neurosurgical patient.  This care model has evolved with the change in demographics of traumatic brain injury (TBI), in which patients are increasingly likely to be medically complex older individuals sustaining their injury after ground-level fall.  Compared […]

Background: Previous research has explored the impact of delayed ICU transfer on patient outcomes, but the subjective nature in defining onset of critical illness in many of these studies has made it difficult to accurately quantify this association.  We sought to investigate this impact using the electronic Cardiac Arrest Risk Triage (eCART) score, a previously […]

Background: Transitions from hospitals to the ambulatory setting are high risk periods for patients. The success of efforts to improve transitional care likely depends in part on local attitudes, culture, workload, and training. Prior to implementation of a multi-faceted transitions intervention, we strove to better understand these contextual factors among providers involved in care transitions […]

Background: Point-of-care ultrasound (POCUS) has been rapidly adopted by emergency medicine (EM) as a tool for clinical care. There is growing evidence that POCUS may improve care outside of EM, and POCUS has recently seen increased application in other specialties including internal medicine (IM). Nevertheless, no formal training recommendations exist for IM, and there is […]