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: Failure to thrive and malnutrition continues to be a common diagnosis in pediatrics contributing to a significant number of hospital admissions (1-5). There is no national practice guideline or consensus recommendation for diagnosis and treatment for patients hospitalized with failure to thrive, contributing to significant clinical practice variation. Unnecessary variability in practice has been […]

Background: The advent of internal medicine procedure services within academic medical centers has had a profoundly positive impact on patient care, patient safety, and resident training (1-4). In general, these teams focus on performing invasive bedside procedures, including paracenteses, lumbar punctures, central venous catheter placements, thoracenteses, and ultrasound-guided peripheral intravenous catheter placements. Recently, the procedure service at […]

Background: Food insecurity (FI), the lack of access to nutritious food to maintain an active lifestyle, is associated with poor health outcomes and morbidities in both children and adults. COVID-19 has exacerbated FI and disproportionately impacts communities of color and low-income households. Hospitalization can be an important time to address FI as a social determinant […]

Background: Every year, as many as 98,000 people die from medical errors within the hospital, making medical errors one of the top 10 leading causes of death in the United States(1). While the Accreditation Council for Graduate Medical Education (ACGME) has incorporated healthcare quality and patient safety into the Clinical Learning Environment Review (CLER) program […]

Background: Bone marrow biopsies (BMB) are a relatively frequent procedure needed in the inpatient setting, especially in a tertiary care center. BMB are a straightforward procedure with a generally low complication rate. In lieu of using specialists (eg, oncologists) or computed tomography (CT) guidance with radiology, procedure-focused hospitalists can provide an excellent option for doing […]

Background: Central venous catheters (CVC), including temporary dialysis catheters, are a relatively frequent procedure needed in the inpatient setting. Historically in our institution, CVC have been placed in the intensive care unit (ICU) by critical care staff or in the radiology suite by interventional radiology staff. The reasons for this placement preference have included the […]

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: Central line associated bloodstream infection (CLABSI) is the 8th leading cause of death in the United States, causing 100,000 deaths annually. Each CLABSI costs about $56,000 per patient and increases length of hospital stay by an average of 3 weeks. Femoral lines have been shown to have the highest risk of infection compared to […]

Background: The AHRQ-funded REdesigning SystEms to Improve Teamwork and Quality for Hospitalized Patients (RESET) study was designed to improve teamwork and quality for hospitalized patients by providing mentorship and resources to hospitals as they implemented 5 interventions, which included (1) Unit-based Physician Teams, (2) Unit Nurse-Physician Co-leadership, (3) Enhanced Interprofessional Rounds, (4) Unit-level Performance Reports, […]