Background: Although supervision is central to resident education and patient safety, there is little to guide the use of effective supervision strategies. The aim of this study is to describe effective supervision for on‐call internal medicine residents. Methods: Between January and November 2006, internal medicine residents and attending physicians at a single hospital were interviewed […]

Background: Medication reconciliation (med rec) is an active process, occurring at transition points in care, whereby medications received by the patient prior to the transition are reviewed and considered when developing the next medication regimen. An adverse drug event (ADE) is the harm caused by the use of a drug. Med rec can prevent some […]

Background: In July 2003, the Accreditation Council for Graduate Medical Education implemented duty‐hour rules for all U.S. residents. In December 2008, the Institute of Medicine released a report urging additional restrictions. The issues at stake are patient safety, resident education, and resident well‐being. Given that 6 years have elapsed since the initial rules, we undertook […]

Background: Patients' accurate identification of their hospitalist likely leads to increased satisfaction with the quality of care and better communication, especially during the discharge transition. A recent study found that 75% of patients on a teaching service were unable to identify any of their hospital physicians. Furthermore, 55% of palienIs were unclear as to the […]

Background: Hospitals are increasingly interested in patient satisfaction as an outcome measure. The Press‐Ganey (PG) patient satisfaction survey contains items related to satisfaction with individual physician's communication. On receipt of the completed survey these results are matched to the discharging attending. However, the survey does not specify which physician, among the many a patient might […]

Background: Prior research has shown that hypoglycemia is associated with worse outcomes for the elderly, in sepsis, and in children with pneumonia. The purpose of this study was to examine whether hypoglycemia (< 70 mg/dL) is associated with increased 30‐day mortality, after adjusting for potential confounders. for adults hospitalized with pneumonia. Methods: A retrospective cohort study […]

Background: Many patients that hospitalists care for have complex social situations and poor access to medical care. These vulnerable populations often do poorly after discharge and may repeatedly return to the hospital for unresolved medical issues. We hope that a more thorough understanding of factors that lead to hospital readmission will ultimately guide targeted discharge […]

Background: With 1%–2% of patients leaving the hospital against medical advice (AMA), the potential for these patients to suffer adverse health outcomes is of major concern. Prior studies have shown an increased rate of hospital readmission, but none have been able to evaluate the risk of death after discharge. Using 5 years of Veterans Administrafcn […]

Background: Hospitalists must help find innovative solutions to challenging problems that face hospitals today. Hospitals face a physician shortage for both hospitalists and other specialty physicians. And hospitals face falling revenues and are under intense pressure to cut costs. Telemedicine has seen dramatic leaps in capability recently and has the potential to help resolve these […]

Background: Coombs‐positive (DAT+) infants are commonly encountered in the newborn nursery. These infants are at risk for developing severe hyperbilirubinemia and bilirubin encephalopathy. Multiple hospitalists may care for each infant daily, with diverse approaches to this common clinical problem. The resulting variability in management increases the opportunity for a missed diagnosis of severe hyperbilirubinemia. Our […]