Background: Obesity is an important risk factor for common chronic conditions, such as diabetes and heart disease. However, obesity has been associated with better outcomes for patients with sepsis. The underlying pathophysiologic basis for this obesity paradox is unclear. We sought to assess patient characteristics, quality of care, and clinical outcomes of patients with obesity [...]

Background: UNC’s hospitalist service admits on average 9 patients per week with alcohol use disorder (AUD). UNC does not have a standardized inpatient screening tool for assessing risk of Alcohol Withdrawal Syndrome (AWS) nor standardized treatment protocol for AWS. In the 6 months prior to our study, 30% of inpatients at UNC with AUD in [...]

Background: Hospital-at-home programs deliver hospital-level care in the comfort of patients’ homes, offering an innovative alternative to traditional hospitalization. These programs have gained traction since the COVID-19 pandemic and Medicare’s expanded reimbursements for virtual visits. Studies have demonstrated that they effectively manage heart failure with outcomes comparable to traditional hospital care. In 2020, Kaiser Permanente [...]

Background: Glycemic control is crucial in the intensive care setting to reduce morbidity and adverse outcomes.1 The debate over methods for achieving this control highlights the risks of hypoglycemia and unclear management parameters.2 Continuous glucose monitoring software, like Glucommander, helps manage blood sugar safely and prevents hypoglycemic events.3,4 Generally, maintaining euglycemia with insulin improves outcomes [...]

Background: Since the pilot program for the hospitalist system was initiated in September 2016 in South Korea, hospitalists have provided specialized care to hospitalized patients and played a crucial role as experts in inpatient care. It is essential to analyze patient perceptions of hospitalist services to identify areas for improvement, as well as to study [...]

Background: Capturing appropriate clinical documentation allows providers to best approach treating patients and can also be utilized for quality monitoring of outcomes within health systems. Mortality measures are used by the Centers for Medicare and Medicaid Services (CMS) for reimbursement and payment. (1) Observed mortality includes all deaths which occur in the hospital during a [...]

Background: Effective discharge instructions are critical for safe patient transitions to outpatient care. However, patients may misunderstand the information they receive, particularly those with complex plans and limited English proficiency. The Institute for Healthcare Improvement and Solutions for Patient Safety recommend discharge instructions that outline the patient’s primary issue, care steps, signs of worsening, where [...]

Background: Totally implantable venous access ports (“ports”) are a cornerstone of the treatment and survival of highly vulnerable patients, particularly those requiring chemotherapy for cancer. Because they are a lifeline for such patients, the ability to use ports for indications other than their primary use (e.g., chemotherapy) is often restricted. We sought to describe current [...]

Background: “Geographic rounding” describes physicians focusing on patient care in a single hospital unit. Studies have suggested that geographic rounding may improve efficiency and communication. Prior to our pilot, physicians at EUHM were seeing patients distributed across 13 units making rounding inefficient and care coordination challenging. Methods: We designed a geographic-based rounding system on unit [...]

Background: Self-directed discharges, also referred to as discharge “against medical advice” (AMA), comprise 1–2% of hospital discharges. Practice guidelines suggest avoiding the designation of “AMA” discharge as this is associated with adverse outcomes. The term “AMA discharge” persists, however, and characteristics of clinician documentation of self-directed discharges remain underexplored. We used retrospective chart review at [...]