Background: Cross-cover, or care for hospitalized patients when the primary team is absent, is a ubiquitous yet understudied aspect of inpatient care marked by cognitive complexity. Trainees confront challenges when performing cross-cover care (1) which may be viewed through the lens of Cognitive Load (CL) Theory (CLT) (2,3). CLT is an established learning theory accounting [...]

Background: It is challenging for care teams to learn about hospitalized older adults with Alzheimer’s Disease and other related dementias (ADRD). Life stories – interventions that collect patient’s personal narratives, histories, likes and dislikes and share them with care teams – are one innovation developed to enhance person-centered care. Few studies have explored the implementation [...]

Background: Accurate attribution of quality metrics to individual hospitalists is crucial for quality improvement and value-based care initiatives. However, the collaborative nature of inpatient care with frequent patient handoffs makes fair attribution challenging. The current understanding of variation in hospitalist quality metrics comes primarily from studies using attribution methods based on who oversaw the majority [...]

Background: Screening and treatment for unhealthy alcohol use (UAU) and alcohol use disorder (AUD) is recommended but underutilized, particularly in inpatient settings. Initiating interventions during hospitalization can reduce UAU and may improve clinical outcomes. Methods: We implemented screening and treatment for UAU at a safety-net hospital in Austin, Texas. Nurses screen admitted patients with the [...]

Background: In 2023, the Accreditation Council for Graduate Medical Education (ACGME) proposed changes to Pediatric Residency programs allowing for greater individualization of resident experiences and increased ambulatory care time. The ACGME changes may lead some institutions to expand pediatric hospital medicine (PHM) services to provide coverage of hospitalized children previously cared for by residents. We [...]

Background: Community acquired pneumonia (CAP) is commonly treated in hospitals and frequently results in antibiotic overuse. Important areas of overuse for CAP include excess treatment duration and unnecessary fluoroquinolone use. Smaller hospitals, including critical access hospitals (CAHs), often have limited resources for antibiotic stewardship compared to larger institutions which impedes stewardship efforts. After 2 years [...]

Background: Over 32 million patients in the United States have a penicillin (PCN) allergy label in their medical chart.1 Studies have demonstrated that 15-20% of hospitalized patients are labeled PCN allergic. However, IgE-mediated PCN allergy wanes over time and up to 80% of patients with a listed PCN allergy can tolerate PCN after 10 years. [...]

Background: Hospital scheduling and structure has the potential to smooth the flow and impact quality outcomes. The most predominant hospitalist schedule follows the seven-on/seven-off scheduling where hospitalists would switch off service after the 7th day, also known as switch day, to the next incoming provider. However, there is limited data on which hospitalist switch day [...]

Background: Sepsis is a life-threatening condition involving organ dysfunction caused by a dysregulated response to infection [1]. Sepsis is the leading cause of 30-day unplanned readmissions nationwide [2]. At UF Health Shands Hospital, the 30-day readmission rate for sepsis patients is 17% compared to 13% for all adult patients. Of those readmitted for sepsis, 38% [...]

Background: An estimated 20-30% of inpatient standing labs are medically unnecessary1, contributing to iatrogenic anemia2, sleep disruption3, and increased healthcare costs. The Society of Hospital Medicine identified routine repetitive complete blood count (CBC) and chemistry (BMP) as a common wasteful inpatient practice4. At our institution, repetitive inpatient CBC, BMP, magnesium, and phosphorus account for 500,000 [...]