Background: Medication reconciliation (MR) is critical for patient safety during hospital admissions and transitions, though MR completion may be complicated by factors such as lack of familiarity with the electronic medical record (EHR) or missing information at admission. Over the past three years, our urban academic quaternary care hospital has led a successful MR improvement [...]

Background: Routine laboratory testing is a cornerstone of inpatient care. However, indiscriminate ordering can lead to resource waste, prolonged length of stay, and unnecessary costs. At our community teaching hospital in Queens, New York, we identified high rates of vitamin level testing—specifically vitamin B12, folate, and vitamin D25—which were often ordered without clinical indication. This [...]

Background: Hospital at Home (HaH) provides inpatient level of care to patients within their homes and replaces the brick and mortar inpatient experience. Our institution’s HaH program has had incredible success and has enrolled over 2000 patients to date and continues to expand. The growth of our program has allowed us to accept more complex [...]

Background: Evaluating a patient’s post-hospitalization course is critical feedback for refining future diagnostic and therapeutic decisions, yet it rarely happens formally during residency. The Out of Sight, Out of Mind (OOSOOM, pronounced like “awesome”) conference addresses this gap. Purpose: To provide a structured forum for residents to review post-discharge outcomes of the patients they managed [...]

Background: Nocturnists often start their positions immediately after residency. It has been shown that early career hospitalists benefit from mentorship for scholarly productivity, academic promotion and personal career satisfaction (1,2). However, as nocturnists typically work at different hours than senior clinicians and service leaders, there are decreased opportunities for informal mentorship, modelling, and visibility. Purpose: [...]

Background: Increased Emergency Department (ED) boarding times have been associated with delays in care, longer length of stay, lower patient satisfaction, increased adverse events, and increased mortality. Kobayashi et. al., coined the term “dead time” to describe the time spent awaiting admission during which meaningful contribution to the advancement of care is limited. In the [...]

Background: Penicillin is the most commonly documented drug “allergy” on hospital admission. Patients with listed penicillin allergies have higher rates of treatment failures, antibiotic resistance, and average length of stay. This has downstream implications impacting healthcare utilization, infection prevalence, and cost. However, the majority of these reported allergies are inaccurate, and over 90% of these [...]

Background: Mortality rates are a critical quality metric for hospitals, influencing both clinical outcomes and institutional reputation. The Centers for Medicare and Medicaid Services (CMS) incorporates 30-day mortality rates into its Value-Based Purchasing (VBP) program and Star Ratings, directly impacting hospital reimbursement and public perception. Similarly, U.S. News & World Report factors 30-day mortality into [...]

Background: We created a generative artificial intelligence chatbot (“VLRChat”) that draws from a comprehensive curricular resource (the 480-page Vanderbilt Housestaff Handbook) to answer point-of-care clinical questions by hospitalists and inpatient clinical teams. Time constraints and cognitive overload frequently prevent hospitalist faculty and learners from determining the optimal, most current answers to clinical questions: as many [...]

Background: Hospitalists vary in their ordering practices related to labs, imaging, and discharge order times. Variations in these practices has been associated with over-utilization of services and inefficient clustering of discharges later in the day. Prior studies suggest that peer comparison can be effective to change provider behavior and reduce unnecessary variation in ordering practices, [...]