Background: Inequitable healthcare is delivered to those who are incarcerated and have a history of incarceration. Incarceration has a significant multiplicative impact on the health of those who experience it – worsening outcomes related to chronic illness and shortening life expectancy. Hospital based providers tend to interact sporadically with individuals who are incarcerated, limiting the [...]

Background: Mortality risk assessment is crucial for predicting patient outcomes, assessing patient care delivery, and improving healthcare quality. Although high-quality medical documentation is critical for mortality risk assessment tools, provider documentation may be inconsistent, relies on coding teams for support, and may not directly reflect provider orders. Complete and precise documentation and coding can improve [...]

Background: The under-reporting of adverse events has been a significant issue in patient and healthcare staff safety, and prevents improvement of individual and systemic errors in healthcare. As champions for quality and safety in their institutions, it is essential hospitalists who work with housestaff  serve as role models to encourage trainees to report safety issues. [...]

Background: Obtaining timely intravenous (IV) access can be challenging for pediatric patients due to physiological and behavioral differences. Many pediatric patients experience multiple needlesticks, leading to trauma and delays in medical interventions. Prior investigators have attempted to implement standardized IV access algorithms, ultrasound-guided IV placement, and stratification of IV placement difficulty using the Difficult Intravenous [...]

Background: Point-of-care ultrasound (POCUS) is an invaluable clinical tool gaining traction as more physicians recognize its utility. However, pediatric residency programs lag behind internal medicine (IM) and emergency medicine in incorporating formal POCUS training. A survey of 90 programs found that 37.5% of IM and 43.5% of medicine-pediatrics (MP) programs offered formal curricula, compared to [...]

Background: Internal Medicine physicians are increasingly involved in Perioperative care. Medicare claims data in colectomy & total hip arthroplasty patients shows >50% had a medicine consult (1) Surgeons, when surveyed, felt Internist’s role in preoperative risk stratification and medication management were vital (2).In one study, 82.2% of medical consultations came from surgical services commonly from [...]

Background: Addiction medicine services are a critical component of care for patients suffering from opioid use disorder. Previous research has indicated that opioid use disorder patients have higher lengths of stay (LOS) and higher hospital readmission rates than patients admitted for a different medical condition. Even though the presence of a specialized team of addiction [...]

Background: At the time of hospitalization, a physician must place an admission status order designating inpatient, outpatient, or observation care. If a patient requires medically necessary hospital care for at least 2 midnights, an inpatient admission order is appropriate. If care is expected to last fewer than 2 midnights or if there is uncertainty about [...]

Background: Blood gas analysis should be performed within 30 minutes of collection to ensure accurate results. Venous blood gas (VBG) data can help evaluate critically ill patients, but it has little role in routine use in non-critically ill hospitalized patients. Nonetheless, we noted that at our urban safety-net hospital, many general medicine patients had VBGs [...]

Background: Hospital-at-Home (HaH) is a novel care model providing inpatient care for patients in their home through a combination of home visits and virtual care. Advanced Care at Home (ACH), UNC Health’s HaH program, launched in 2021, has facilitated over 2,000 admissions to date. The majority of HaH care is provided under the terms of [...]