Background: As the field of HM continues to evolve, many hospital medicine groups (HMGs) are expanding their scope of practice outside of the care of the hospitalized patient. Our HMG, a 120-physician team working at 2 tertiary care hospitals in the New York Metropolitan area, is no exception. Over the past 3 years, our HMG [...]

Background: Physician turnover is associated with poor morale and low job satisfaction. Turnover is costly to hospital systems and provider groups given decline in productivity, need for expensive alternative staffing, and increased recruitment efforts. Physician groups with high turnover and low job satisfaction lack the ability to gain traction on quality improvement work reflected in [...]

Background: A publicly funded Health Authority embraced a Hospitalist service in 2000 as a quality improvement initiative. This relationship turned contentious over several contract renegotiations. With each successive contract, trust declined and the working environment became adversarial. Failed negotiations lead to a contract termination in 2015, ultimately affecting the stability of this medical service. Purpose: [...]

Background: National data document that hospital medicine groups frequently lack representative diversity in terms of race, ethnic background and gender. This diversity gap further expands with career development and promotion. Traditional physician hiring strategies are susceptible to elements of bias that may contribute to these disparities. Purpose: To design and implement a structured process for [...]

Background: Clinician well-being is the pre-requisite to the triple aim of improving the health of populations, enhancing the patient experience, and reducing the cost of care. Engagement in local SHM chapter activities promotes the efficiency of practice, a culture of wellness, and personal resilience. Each hospital medicine group (HMG) faces similar challenges but approaches to [...]

Background: Event reporting has been the cornerstone of patient safety culture since the IOM report “To Err is Human” was published. Over the past 20 years, the medical literature has focused on improving the overall rates, but not the quality, of reporting. To inform change, event reports must have a standard quality of content for [...]

Background: Catheter associated urinary tract infections (CAUTI) are one of the most common hospital acquired infections and cost on average $13,793 per case according to the AHRQ. Many quality and safety organizations including the Society of Hospital Medicine recommend reducing the prevalence of indwelling urinary catheters (IUC) as a means to reduce the incidence of [...]

Background: In March 2019, the CEO of our public teaching hospital set a goal for the institution to become a high reliability organization. At that time, the hospital’s rates of catheter associated urinary tract infections (CAUTIs), central line associated blood stream infections (CLABSIs), and hospital acquired pressure injuries (HAPIs) were above the national average. Evaluation [...]

Background: Hospital based providers are often tasked with leading cardiopulmonary arrest resuscitations known as code blues. This responsibility can be stress provoking and poorly executed without appropriate training resulting in poor patient outcomes. At our academic medical center, internal medicine residents on their inpatient hospital based rotations are responsible for this assignment. The process of [...]

Background: Missed, incorrect, or delayed diagnoses may lead to preventable harm and are common in U.S. hospitals. Until recently, little attention has been placed on mitigating risk attributed to diagnostic error in hospitalized patients. Because system and cognitive factors contribute to these errors, they are also uniquely difficult to systematically address. Many studies have demonstrated [...]