Background: Length of stay (LOS) is a key metric that hospitals follow closely for quality and operational purposes. Hospital Medicine groups frequently use LOS to evaluate their providers and to identify opportunities for improvement; however, the most appropriate methods to apply specific hospital encounters to individual providers is debated. Complex schemes of weighted Observed to [...]

Background: Understanding a hospitalist’s efficiency is important to identify opportunities to provide support and prevent burnout (1). This is key when onboarding new hospitalists, as early intervention can lead to rapid improvement and a long-term sustainable career. The evaluation of hospitalist efficiency can be difficult and is often thought to require close clinical shadowing or [...]

Background: Quality improvement and patient safety (QI/PS) is a major focus for hospitalists in both their day-to-day clinical care. In addition, many hospitalists have educational and administrative QI/PS duties, and salary support for them is highly sought after. As part of an ongoing effort to help identify opportunities to further support members of the Society [...]

Background: Fall for hospitalized patients can cause significant injury and have devastating long term consequences for patients with 33% resulting in injury, 4-6% causing serious injury (1). Information is available regarding risk factors for falls and specific patient or nursing centric interventions to prevent falls, but there is little known about the physician perspective in [...]

Background: Among the challenges clinicians face when performing cardiopulmonary resuscitation (CPR) are difficult decisions regarding duration of resuscitative efforts, which may be informed by perceived prognosis as well as patient and family values and directives. There is a dearth of information on clinicians’ attitudes in these scenarios. Our aim was to determine which factors most [...]

Background: The Hospital Readmissions Reduction Program (HRRP) incentivizes acute care hospitals to decrease their preventable readmissions by putting hospitals at risk of reduced Medicare reimbursements. There exist many sources of heterogeneity in the actual incentives individual hospitals face each year. The HRRP applies the same methodology to hospitals regardless of their share of Medicare patients, [...]

Background: Misalignment of goals of care at the End-of-Life exposes patients to risk and the health care system to considerable costs. A lack of end of life conversations can lead to unrealistic patient expectations, patient harm, and multiple hospital readmissions. This study aims to identify physician perspectives on the barriers to initiating end of life [...]

Background: Hospital Medicine is being increasingly involved in improving various metrices of inpatient care such as length of stay and cost of care. Patients who do not meet ‘inpatient criteria’ often contribute to significant financial costs to hospitals and remain in ‘observation status’ during their hospital stay. Observations units which were introduced by emergency doctors [...]

Background: Drug overdose deaths involving opioids are on the rise in the setting of the current opioid epidemic in the United States (US).1 In 2017 there were ~46.6 drug overdose deaths a day in the US involving prescription opioids.1 Naloxone is a proven and effective opioid antagonist that is FDA approved for use in the [...]

Background: Guidelines suggest venous thromboembolism risk stratification, and against use of prophylaxis in low risk medically ill hospitalized patients. Our hospital did not have a formal risk stratification process embedded into the electronic medical record (EMR) for provider use, and therefore it was common practice to administer pharmacologic prophylaxis to most medically ill patients regardless [...]