Background: Point-of-Care Ultrasound (POCUS) is becoming an increasingly valuable tool in Internal Medicine. With the proper training, POCUS can provide insight into diagnostic dilemmas, resulting in expedited management and enhancing patient care. However, the ability to effectively utilize POCUS is directly related to the extent of each individual’s training. It is therefore critical to implement […]

Background: While many Hospital Medicine groups employ overnight providers to exclusively care for previously admitted patients (cross-coverage), little data exists regarding factors contributing to the perceived workload of this role. The NASA-Task Load Index (NASA-TLX) is a validated questionnaire used to quantify perceived workload. Methods: Overnight providers completed the NASA-TLX at the end of each […]

Background: Centers for Medicare and Medicaid Service (CMS) publicly report patient experience star ratings for hospitals generated from their performance on the Hospital Consumer Assessment of Healthcare Provider and Systems (HCAHPS) survey. The objective was to make the information more understandable for patients. However, the ratings may not be intuitive or help consumer choice. For […]

Background: In sepsis, every hour of delay in antibiotic administration after the onset of hypotension is associated with 4-7% increase in mortality, but little is known about the characteristics of patients with treatment delays. Our objective was to determine if septic adults presenting to the Emergency Department (ED) who receive antibiotics more than 60 minutes […]

Background: Hospital Onset Clostridium difficile infection (HOCDI) is one of the most common causes of hospital acquired diarrhea. As per a recent study, the mean healthcare costs attributable to primary Clostridium difficile infection (CDI) is about $24,205 per patient. This would be a lot more if the patients were to be discharged to skilled nursing […]

Background: A substantial proportion of peripherally inserted central catheters (PICCs) are placed for inappropriate indications. We performed a multi-hospital intervention to improve the appropriateness of PICC use. Methods: We conducted a collaborative cohort study of hospitals participating in the Hospital Medicine Safety Consortium. An evidence-based intervention centered on the Michigan Appropriateness Guide for Intravenous Catheters […]

Background: Beginning in 2015 Mission Hospital in Asheville, NC began noticing a rise in the number and associated length of stay (LOS) of patients admitted for medical complications of injection drug misuse. What began as a small team mainly focused on LOS reduction strategies quickly morphed into a multidisciplinary team to formalize a Care Process […]

Background: Stony Brook University Hospital (SBUH) identified an opportunity to develop and implement prevention strategies to reduce hospital onset C. difficile infections (CDI). Hospital Onset (HO) CDI are included in National Healthcare Safety Network (NHSN) reporting and included with other hospital-acquired infections as publically reported data. CDI contribute to prolonged hospital stays, inappropriate antimicrobial use, […]

Background: Geriatric and palliative care patients who have been discharged from hospital and are home-limited face challenges in effectively accessing ongoing healthcare and clinical follow-up after being discharged, leaving them at risk for unnecessary re-hospitalization. Health care video visits present a novel opportunity to expand patient access to clinical care remotely in their home, potentially […]

Background: Endoscopies are commonly performed in the inpatient setting, and successful completion frequently requires close coordination among nurses, hospitalists, gastroenterologists, and anesthesiologists. Given the complexity of this multidisciplinary involvement, as well as variability in patient factors like clinical stability and presentation, endoscopies are prone to delays. These delays may cause frustration amongst care providers and […]