Background: We have markedly expanded Point-of-Care Ultrasound (PoCUS) education within our Internal Medicine residency program through multifaceted instructional interventions. But despite an increasing number of trainees familiar with PoCUS, there remained insufficient real-time clinical use and supervision due to a lack of formal PoCUS training and experience among attending faculty. Traditional PoCUS faculty development programs [...]

Background: Hospital at home is a novel healthcare delivery model offering acute inpatient care outside hospital walls. In the United States, hospital at home programs are almost exclusively offered in urban settings. Many rural regions of the United States have difficulty with adequate healthcare access, and there is little data on rural hospital at home [...]

Background: The occurrence of adverse events due to unsafe health care is thought to be one of the 10 leading causes of death and disability in the world. The harm can be caused by a range of adverse events, with nearly 50% of them preventable. Broad adoption of electronic health records (EHR) should ideally harness [...]

Background: An innovative team of practicing physician leaders launched a Physician on Duty (POD) program in order to provide daily, pro-active clinical leadership to our Mission Control center. Our Mission Control includes, in addition to the physician team, a clinical team performing centralized staffing, bed placement, transfer center, RN care expediting, and ambulance dispatch services [...]

Background: Medical errors and adverse events are leading causes of morbidity and mortality in the United States. Reporting errors – both those that do and do not cause harm to patients – is paramount to preventing recurrences within the medical system and, therefore, reducing future harm. However, physicians may be reluctant to disclose errors due [...]

Background: As COVID-19 spread across the globe, hospitals restricted visitors in an attempt to protect patients and healthcare providers. The absence of in-person visitors and loved ones, who play a central role in clinical decision-making by clarifying medical histories, elucidating patients’ baseline status, and bridging linguistic and cultural divides, left patients vulnerable to social isolation, [...]

Background: At our 583-bed tertiary care nonprofit teaching hospital serving the greater metropolitan New York area, ESRD (End-Stage Renal Disease) patients on hemodialysis presenting with complaints like chest pain, shortness of breath, hypertensive urgency, pulmonary edema, would sometimes wait for more than 6 hours to get dialysis started. While they were “waiting” to get admitted [...]

Background: Heart failure (HF) is a major contributor to hospitalizations. At our institution, we determined that the average length of stay (LOS) for HF admissions was 0.54 days longer than expected compared to similar hospitals nationwide based on a risk-adjusted methodology. A chart review (n=25 patients) revealed that LOS was often extended due to ongoing [...]

Background: Hospitalists encounter problems daily in their clinical practice but do not routinely engage in problem solving independently. Problems are often brought to the attention of hospital medicine leadership, but this does not support hospitalist engagement in process analysis and implementation of solutions. A reason for hospitalist disengagement is a lack of a standardized and [...]

Background: Advance care planning (ACP) is an underutilized aspect of patient care due to clinician time constraints, inadequate care processes, and poor clinician prognostication. Consequently, hospitalized patients with a high risk of mortality and readmission often do not have clearly defined goals of care, and their families may not be prepared to discuss end-of-life decisions. [...]