Background: Patients with delirium are at risk for increased mortality, length of hospital stay, and cognitive impairments for up to one year. In addition, it is estimated that healthcare costs are 2.5 times higher in patients with delirium than in those without. Purpose: Our quality improvement project aims to reduce the incidence of delirium. We [...]

Background: Patients undergoing induction chemotherapy for acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL) often experience prolonged hospital stays due to the length of induction therapy, follow-up bone marrow biopsies, and count recovery. While the average length of stay (LOS) for these patients may exceed 30 days, most diagnosis-related groups (DRGs) assign a LOS [...]

Background: Stepdown units were introduced to provide an alternative for patients with needs not met by a general ward unit but did not require an intensive care unit. Current research indicates that these beds promote greater flexibility in patient triage, increase accessibility to limited intensive care resources, and provide a cost-effective alternative for patients. The [...]

Background: POCUS is rapidly becoming an important tool in Hospital Medicine (HM) and is endorsed by the Society of Hospital Medicine (SHM).​Many medical schools and physician residency programs have recognized the clinical value of POCUS and subsequently come to incorporate competency as a core clinical skill for graduation.APP programs, however, have lagged behind with only [...]

Background: Electronic medical record (EMR) chart notes are primary tool through which providers communicate their thought processes, clinical decision making and care plans. Our health system consists of 11 hospitals ranging from large academic medical center to small hospitals in Minnesota and Western Wisconsin. Hospital Medicine team represent over 250 providers across all the sites. [...]

Background: The patient population at tertiary hospitals is increasingly complex due to advancements in healthcare and more aggressive management of comorbidities. This complexity is particularly evident in the patients on medicine services that have a tracheostomy. Patients with tracheostomies on general medical floors often experience prolonged lengths of stay and multiple inpatient complications, such as [...]

Background: Sodium-glucose transport protein 2 inhibitors (SGLT-2i) are antidiabetic drugs that have shown to aid in all-cause/cardiovascular mortality along with progression of renal disease. ​Though SGLT2i have many benefits, there are many instances where these medications need to be held or discontinued; preoperatively (72h-92h prior to surgery), hypotension, reduced oral intake, decrease in eGFR, urinary [...]

Background: Since 2020, UNC Hospitals has increasing numbers of patients who no longer require acute level of care. A portion of these patients have longer length of stay exceeding 30 days while awaiting disposition. This is noticeable in our percentage of long length of stay patients hospitalized 31-60 days (6.8% in 2022 vs 6.0% in [...]

Background: Chronic obstructive pulmonary disease (COPD) is a leading cause of hospital readmissions, with national 30-day readmission rates reaching as high as 22.6% [1]. These readmissions place a significant financial burden on healthcare systems, with one study showing that the cost of a COPD readmission can exceed that of the initial admission by 18% [2]. [...]

Background: Quality incentive programs are increasingly used in hospitalist groups and can drive improvement in focus metrics (1,2). Due to the nature of hospitalist work including frequent signout and handoffs, group rather than individual metric attribution can be considered for certain metrics and incentive targets set for either individual or group performance. Purpose: We investigated [...]