Background: In the quest to improve patient satisfaction scores, providers and health systems alike are frustrated with the inability to obtain real-time satisfaction data. Indeed, HCAHPS data lags by six months, and makes it exceedingly difficult to provide real-time feedback to physicians on their communication with patients. As a result, we developed a patient-centered audit [...]

Background: There are no guidelines for designing or evaluating fixed-content signs or electronic displays used to communicate patient-related information in hospital rooms. Accordingly, there is the potential for the displayed information to be ignored, misinterpreted, or distracting in the complex hospital room environment where patients, nurses, and physicians change frequently. Purpose: To address this shortcoming, [...]

Background: The electronic health record (EHR) is a major focus of a hospitalist’s daily work but is also often a frustration. Organizations offer providers the chance to recommend improvements to the system, but frequently there are significant delays in implementation or the request does not even cross the threshold for institutional action. Additionally, of those [...]

Background: As inpatient medical care has increased in complexity and fragmentation, rounding has become siloed away from patients and by discipline, resulting in disjointed and inefficient care models. In response, hospitalist groups across the country have been implementing unit-based rounding programs to centralize communication and align work-flow of health care team members. At UC San [...]

Background: POCUS is increasingly being used across medical specialties, and adds value to diagnostic accuracy for numerous pathologies and levels of acuity. Emergency Medicine providers were early adapters, providing examples of how POCUS increases patient satisfaction and diagnostic clarity (1, 2). Internal Medicine and Family Medicine have been slower to adopt this technology; however, general [...]

Background: The Department of Veterans Affairs (VA) originally released the Computerized Patient Record System (CPRS) in 1997. While revolutionary for its time, there has been limited substantial update in the last twenty years. Customization opportunities and ease of acquiring data are limited compared with newer, widely adopted electronic health record (EHR) systems. Purpose: To develop [...]

Background: Rural areas are disproportionately affected by physician shortages, and small rural hospitals in particular struggle to staff acute medicine services 24/7. Telehospitalist models are emerging as an alternative to provide inpatient medicine services in rural settings. In a 2018 needs assessment of rural Veterans Health Administration (VHA) hospitals, 60% percent reported being short on [...]

Background: Medically acute patient patients are cared for by housestaff and advance practice provider (APPs) overnight. The severity of illness in these patients can vary during their hospital stay. Decompensation in this population is under recognized and can lead to adverse outcomes. Even when correctly identifying decompensation, unclear lines of escalation, and poor documentation practices [...]

Background: When used optimally, technology should serve as a tool for clinicians, not an obstacle. Yet according to a recent study by the Mayo Clinic, Electronic Health Records (EHR) score in the bottom nineth percentile of technologies when evaluated for usability. This lack of usability can lead to increased documenting times, workflow bottlenecks, and physician [...]

Background: Data dashboards are used in many industries to track performance, however their development and efficacy in hospital medicine has not been well described. Data availability, provider attribution, feedback timeliness, and data accuracy have been cited as barriers to developing and implementing an effective performance dashboard. Purpose: We developed a hospital medicine clinical data dashboard [...]