Background: Large hospital medicine groups of 30 or more physicians comprise over 20% of practices (SHM 2018). Our academic hospital medicine service is comprised of 65 faculty members. We recognized a need for multiple levels of leadership beyond the immediate chief and director of clinical operations. Our team, like most hospital medicine groups, is comprised […]

Background: Midlines are peripheral vascular devices inserted in the veins of the upper extremity with the tip located at or below the axillary vein. Greater appreciation of complications associated with peripherally inserted central catheters (PICC) and the diffusion of catheter appropriateness criteria has led to expanded use of these devices. However, single center studies comparing […]

Background: Hospital medicine is the fastest growing subspecialty within internal medicine, growing from 10,000 hospitalists in 2002 to over 50,000 in 2016. Despite this growth, there remain relatively few hospitalists who are clinician investigators. We sought to quantify the number of clinician investigators, their dedicated time for research at major United States academic medical centers, […]

Background: There were approximately 46,000 opioid overdose deaths in 2017. It is known that opioid overdose risk is increased in patients with a diagnosis of substance use disorder, prior opioid overdose, and high suspicion of risk as assessed by clinical teams. The Risk Index for Overdose or Serious Opioid-Induced Respiratory Depression (RIOSORD) is a validated […]

Background: Trauma co-management is a growing field within hospital medicine. While improvements in quality metrics have been documented in other co-management services, the impact of co-management of trauma patients is uncertain. This study aimed to determine whether a hospitalist trauma co-management program improves clinical outcomes. Methods: This was a pre- and post-implementation study comparing trauma […]

Background: Sepsis is a common and life-threatening complication of infection that disproportionately affects patients with chronic comorbidities. Timely fluid resuscitation is a key initial management strategy for reducing sepsis mortality; however, patients with serious comorbidities are often excluded from clinical trials. The Surviving Sepsis guidelines suggest that patients meeting severe sepsis criteria should be administered […]

Background: High levels of interprofessional collaboration and communication have been shown to lead to better patient safety outcomes, improved patients’ satisfaction and quality of care, as well as higher job satisfaction for doctors and nurses alike. Yet, challenges to nurse-doctor collaborations exist. One way of improving interprofessional collaboration may be through structured co-teaching by nurses […]

Background: Prior studies have found racial disparities in how patients are assessed for pain and prescribed opioids from emergency department and surgical settings. However, we do not know whether similar disparities exist among general medicine inpatients. We examined opioid prescriptions at discharge among adults admitted to the general medicine service at our medical center, with […]

Background: In 2016, the Sepsis-3 taskforce posited that acute organ failure is the defining feature of sepsis. Accordingly, they recommended that an acute rise in the Sequential Organ Failure Assessment (SOFA) score by 2 points over baseline should replace the Systemic Inflammatory Response Syndrome (SIRS) score as the sepsis criteria (1). As a justification, they […]

Background: Patient experience is increasingly recognized as a measure of healthcare quality and patient-centered care. However, there is insufficient understanding of patient expectations during hospitalization, and of how these are perceived by physicians, nurses, and administrators. The best way to apply the HCAHPS ratings remain elusive due to variability in practice environments, patient and clinician […]