Background: Hospitalists balance efficiency and quality in their daily practice. How a physician’s time management affects care quality is unknown. Accordingly, we aimed to compare the EHR efficiency of hospitalists, as measured by their time spent within the EHR per day, with quality of care, as measured by readmission rates and patient satisfaction. Methods: Data [...]

Background: Persons with opioid use disorder (OUD) represent an estimated 4-11% of hospitalized patients and are increasingly admitted for opioid-related complications. In response to the opioid epidemic, national organizations have recommended hospitals develop protocols to engage patients with OUD in opioid agonist treatment (OAT) during hospitalization. Buprenorphine is an effective OAT for OUD that is [...]

Background: Immobility in the hospital setting is associated with persistent inability to perform activities of daily living, increased length of stay, and decreased return to independent living; this loss of function is identified by patients as a commonly unaddressed barrier to discharge. The reasons for immobility are multifactorial; however, lack of provider interest or value [...]

Background: Hospitalized patients are often disrupted at night for routine medical care, some of which is unnecessary. These sleep disruptions have implications for patient satisfaction, delirium, mobility, immune status, as well as hospital outcomes such as length of stay and readmissions. Interventions to improve inpatient sleep would benefit from the ability to objectively measure sleep, [...]

Background: Healthcare systems need formal processes for recognizing achievements in healthcare improvement to support promotion. To aid in the recognition of faculty members’ contributions to healthcare improvement, institutions have begun to use portfolios to document and highlight an individual’s achievements and successes. All healthcare professions contribute to healthcare improvement. Yet, existing healthcare improvement portfolios have [...]

Background: Recent studies suggest that glucose gel is effective for treating neonatal hypoglycemia, thus it may reduce neonatal intensive care unit (NICU) admissions. The purpose of this study is to compare NICU admissions and care for hypoglycemia pre- and post-implementation of a glucose gel protocol for the management of neonatal hypoglycemia. Methods: This is a [...]

Background: Nationally, a minority of patients with complex medical and psychosocial needs consume a disproportionate amount of healthcare. In the U.S. in 2015, the top 1% of the population accounted for 23% of all healthcare expenditures and cost ten times more per year than the average patient. No one disease accounts for a large percentage, [...]

Background: We see high rates of Emergency department (ED) use in urban settings, and pregnant women are no exception. There are numerous valid concerns a woman may have that lead her to seek care in the ED during pregnancy, accompanied by potential underlying factors that explain increased ED use during this time. We examined a [...]

Background: Readmission rate at UMASS Memorial Hospital medicine division is high at 15.5%. Majority of patients are admitted to Hospitalist service. Given the challenges in obtaining real time readmission data, physician engagement is poor. Etiology of most of the readmissions gets attributed to system related issues. To improve physician engagement, the concept of weekly Idea [...]

Background: Proton pump inhibitors (PPIs) are one of the most prescribed medications in the United States. Long-term PPI use is increasingly being associated with many adverse health consequences such as Clostridium difficile infections, osteoporosis, impaired nutrient, increased risk of spontaneous bacterial peritonitis, increased risk of pneumonia, and increased risk of acute interstitial nephritis. These adverse [...]