Background: Rich sources of data are available in hospitals, but are often housed in different systems. These include electronic health records (EHRs), physician scheduling software, and existing tools that can be used to electronically contact clinicians. Developing a streamlined way to integrate and connect disparate data has enormous potential for clinical care, operations, and research. […]

Background: Due to the importance of rest for inpatients, the American Academy of Nursing recommends preserving patient sleep by reducing unnecessary nocturnal care as part of their Choosing Wisely® campaign. Prior sleep-promotion interventions often fail due to lack of sustained staff behavior change. We designed and implemented SIESTA, which combined staff education with the behavioral economics […]

Background: Hospital-associated venous thromboembolism (HA-VTE) is a serious condition with controversy regarding ideal risk assessment and VTE prophylaxis (VTEP), especially in medical patients. We conducted a collaborative VTE quality improvement project, supported by a charitable grant from the Gordon and Betty Moore Foundation, in 35 hospitals across three states and assessed the impact on HA-VTE […]

Background: Pneumonia is the fourth most common cause of hospital admissions in the United States and the eighth most expensive condition, accounting for over $9.5 billion annually in inpatient costs alone. Multiple clinical trials have shown that shorter durations of antibiotic treatment (5 to 7 days) are as safe and effective as longer courses, findings […]

Background:  Opiate, alcohol and polysubstance abuse are increasingly recognized for their catastrophic consequences on the health of populations across demographic groups.  Inpatient management of polysubstance use or dependence is often a crucial aspect of appropriate medical care.  Hospitalists are regularly involved in the care of patients with substance abuse. Co-management with Addiction Recovery specialists can […]

Background: Co-management across service lines has become increasingly common in hospital medicine. While debate continues over clinical outcomes, some co-management arrangements have led to enhanced provider satisfaction, which may have implications for burnout. We have established successful co-management services with orthopedics, urology (GU), otorhinolaryngology (ENT), trauma and neurosurgery (NS). We are a large urban/suburban academic […]

Background: A variety of risk prediction scores have been devised to identify patients at increased risk for VTE in different patient populations and settings. Guideline recommendations for VTE risk assessment vary greatly. We performed a systematic review to identify and synthesize evidence on clinical risk prediction scores for VTE in medical and surgical hospitalized patients. […]

Background: A growing body of evidence supports the use of point of care ultrasound increasingly as augmentation of the physical exam and clinical decision making. The literature also supports that trainees, both medical students and residents, can acquire these skills. However, there is no consensus on the training approach and development of competency for hospitalists […]

Background: Pneumonia is often treated for longer than necessary, yet factors associated with excess duration of treatment are unknown. We sought to: (a) develop an algorithm to determine appropriate antibiotic duration in non-intensive care unit (ICU) patients hospitalized with pneumonia and (b) apply this algorithm to an ongoing prospective study to determine patient-, provider-, and […]

Background: Today, Medicare patients account for approximately 50% of hospital days, costing $1 trillion annually. Despite this staggering financial burden, hospitalization often results in poor outcomes for older adults. The objective of the study was to test the feasibility and impact of using Assessing Care of Vulnerable Elders (ACOVE) Quality Indicators (QIs) as a therapeutic […]