Background: Publically reported data is increasingly important to a hospital’s reputation and bottom line. Programs such as CMS Hospital Value Based Purchasing (HVBP) place 2% of a hospital’s base payments at risk, while the CMS Star Rating is frequently used by consumers to select a hospital for elective care. Both programs incorporate claims data to […]

Background: Alcohol withdrawal is a common disorder faced by hospitalists. The pharmacologic standard of care involves the use of benzodiazepines, administered either as fixed doses or with doses adjusted per patient symptoms. At our institution, the alcohol withdrawal protocol previously in place used an institution-specific scale to evaluate patient symptoms, and nurses had latitude within […]

Background: Point of Care Ultrasound (POCUS) is a goal-directed, bedside ultrasound examination performed by a healthcare provider to answer a specific diagnostic question or guide performance of an invasive procedure at the bedside. More hospitalists have begun to use POCUS, but little is known about current POCUS usage by hospitalists. We conducted a national survey […]

Background: With access to big data in medicine, it is becoming increasingly necessary to use tools to automate the pooling of data into relevant thematic structures. Topic modeling is most often used to uncover these thematic structures in large sets of textual data. Latent Dirichlet allocation (LDA) is one such algorithm-based topic model that has […]

Background: Discharge to post-acute care settings (PACs), such as skilled nursing facilities (SNFs), requires significant, complex discharge planning which often needs to be started early during hospitalization to be complete by time of discharge. This study sought to identify and model factors which predict a given patient’s likelihood of requiring PAC after discharge, using routinely […]

Background: A fifth of older adults discharged from the hospital require readmission within 30 days. Readmissions impose an enormous burden on both patients and the healthcare system. Previous investigations have found that less than half of discharged patients are able to understand and execute the discharge plan and are likely to overestimate their comprehension of […]

Background: Hospital capacity constraints remain an immense concern throughout the US and has been recognized as a national crisis for greater than a decade. ER overcrowding is of particular concern due to its downstream effects. It occurs when admitted patients are boarded in the emergency room for greater than 2 hours, while inpatient beds become […]

Background: From 2016 to 2018, advanced practice provider (APP) utilization in academic hospital medicine groups (HMGs) has increased by 23.6%, with 75.7% of academic HMGs now employing APPs. Due to a lack of standardization around APP utilization, and the frequent use of shared billing models, determination of return on investment for APPs is challenging and […]

Background: Internal medicine residency contains procedural training, including guidance in paracentesis, thoracentesis, lumbar puncture, arthrocentesis, and central line placement. As a result, most hospitalists are able to perform these bedside procedures. However, national trends confirm that these procedures are increasingly referred to interventional radiology, and these referrals are associated with higher direct hospital costs.1 Enhancing […]

Background: This is an exciting time for Telemedicine with new programs being implemented across the continuum of care including acute care, post-acute care, and in home settings. Proving the value of telemedicine programs when no access to providers exist is relatively straightforward but proving value of programs where implemented to augment existing care by the […]