Background: The availability of beds within healthcare systems has been stressed during each wave of the COVID-19 pandemic. Healthcare systems with tertiary hospitals have had increasing patient volumes and face limitations of specialized urgent (e.g., ECMO) and routine (e.g., Percutaneous Coronary Intervention) functions during critical inpatient surge volumes. Reserving the limited capacity at a tertiary […]

Background: Evidence-based COVID-19 management has evolved with unprecedented speed; however, the rate and fidelity with which institutions have adopted new evidence into practice is unknown. Methods: We surveyed members of the Hospital Medicine Reengineering Network (HOMERuN) from 12/17/20-2/10/21 and compared their institutional COVID-19 management recommendations to available evidence from pivotal randomized controlled trials (RCTs) and […]

Background: Acknowledging that a successful career in hospital medicine (HM) may require specialized skills, residency programs have developed hospital medicine-focused education (HMFE) programs. Surveys of internal medicine residency leaders have described HMFE curricula but are limited to that specialty and lack input from early career hospitalists (ECHs) who recently completed this training. Therefore, we surveyed […]

Background: Scholarly productivity is critical for academic fulfilment and promotion in hospital medicine (HM), but many hospitalists struggle to achieve scholarly success. Protected time (PT) (i.e., non-clinical time that can be dedicated to scholarly activities) is a key facilitator of academic productivity in HM. However, little is known about how PT for scholarship is managed […]

Background: As the COVID-19 pandemic continues, the hospitalist workforce, which has been at the forefront, has been further stretched in both clinical and non-clinical domains. Hospitalists have faced increased clinical workloads due to inpatient volume surges, have been asked to lead hospital administrative pandemic responses, and have had to quickly adapt research to the context […]

Background: Community-acquired pneumonia (CAP) is the most common infectious diagnosis necessitating adult hospitalization in the United States (US). Timely diagnosis of CAP is important to improve patient outcomes. However, overdiagnosis of CAP, or treatment of CAP despite inadequate signs or symptoms of CAP, may also pose a significant threat to patient safety. Potential harm of […]

Background: Confidentiality within adolescent medicine is imperative in establishing a trusting patient-physician relationship. In April 2021, the 21st Century Cures Act granted patients’ guardians immediate access to select patient electronic medical records. Whereas Pediatric Hospital Medicine (PHM) history and physical (H&P) notes are visible to guardians, adolescent sensitive notes (ASN) remain confidential. At our institution, […]

Background: Fewer hospitalized patients are discharged per day on weekends as compared to weekdays.1 Hospital medicine groups have implemented quality improvement (QI) initiatives to increase weekend discharges, however, the factors contributing to lower rates of weekend discharges are not well-described.2 To better understand contributors to missed opportunities for weekend discharge, we analyzed patients discharged on […]

Background: The management of patients with COVID-19 is challenging for front-line healthcare providers given limited validated, evidence-based clinical decision support. Determining patient mortality risk is critical for effective triage, management, and discharge decision making. Numerous COVID-19 risk prediction models have been created, though the robustness of these models varies. The 4C Mortality Score, created by […]

Case Presentation: This is a case of a 68-year-old female with a history of a recent cryptogenic stroke and atrial fibrillation who presented for an elective TEE for patent foramen ovale (PFO) evaluation and possible closure. TEE revealed a PFO with evidence of a right-to-left shunt. After completion, the patient reported exquisite neck tenderness, severe […]