Background: Clinically stable inpatients may receive potentially unnecessary care, such as overnight vital sign assessment. Nighttime vital signs can disrupt sleep and adversely affect patient satisfaction and contribute to delirium. However, it may be difficult for individual clinicians to determine which patients could safely forego overnight vital signs. Purpose: We developed a predictive algorithm designed [...]

Background: Adolescent reproductive health education is essential to prevent transmission of sexually transmitted infections (STIs) and teen pregnancy. Half of all new STIs occur among 15-24 year-olds and 1 in 4 adolescent females has had an STI. In the United States, approximately 750,000 teenagers become pregnant per year. Adolescents are known to have poor access [...]

Background: Sub-optimal communication during care transitions contributes to poor patient outcomes. Patients who undergo interhospital transfer (IHT, the transfer of patients between hospitals) are at especially high risk given their level of illness severity. In examination of the IHT process at Brigham and Women’s Hospital (BWH), a 740-bed tertiary care referral hospital, we previously found [...]

Background: In hospital-based medicine, maintaining an open line of communication between inpatient teams and community pediatricians serves as an essential component of providing comprehensive patient care and ensuring continuity at time of discharge. At St. Louis Children’s Hospital, inpatient resident teams are responsible for providing timely communication with community pediatricians regarding major patient events. Despite [...]

Background: Hospitalists on inpatient resident teaching services receive variable training in how to facilitate high-quality education during rounds. Teaching of cognitive skills such as clinical reasoning, acknowledging uncertainty, and non-cognitive behaviors such as eye contact are important techniques of effective educators. To enhance bedside teaching, the Hospital Medicine Division of the University of Michigan and [...]

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 [...]