Background: Patients hospitalized with COVID-19 can clinically deteriorate in the second week of illness after a period of initial stability. Thus, an important clinical question is determining when it is safe to discharge these patients from the hospital without overwhelming hospitals’ capacities. Unfortunately, discharge criteria for COVID-19 patients are often based on expert opinion, with […]

Background: Early risk stratification scores utilizing data available at the bedside have been used regularly to identify patients at greatest risk of poor outcomes from rapidly evolving conditions like sepsis. Little is known about how point-of-care scores developed for sepsis perform at predicting outcomes in large, heterogeneous cohorts of patients with COVID-19. Our objective was […]

Background: To evaluate prevalence of non-adherence to breast cancer screening guidelines after bedside educational intervention and informed individualized risk assessment score during an inpatient stay. Methods: A prospective intervention study was conducted among 507 cancer-free (except skin cancer) women aged 50-75 years hospitalized to a general medicine service. Study intervention included one-on-one bedside education via […]

Background: Serious Illness Conversations (SICs) lead to a better understanding of patient values and preferences, improved patient and family satisfaction, and other benefits. Prognostic awareness and early identification of patients who may benefit from an SIC remains a challenge. Epic’s Risk of Unplanned Readmission (Readmission Risk Score), a composite score (0-100) that includes clinical factors […]

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: A 34-year-old female with a history of hypertension, hyperlipidemia, and SLE presented with acute substernal tightness associated with nausea and vomiting. She denied fever, chills, diaphoresis, or palpitations. Her EKG showed sinus rhythm with new T wave inversions in anterior leads. Troponin elevation was noted with a peak of 4.48. Echocardiogram showed normal […]

Background: Hospital-at-Home (HaH) is a safe and effective alternative to high-cost, traditional hospitalization in patients with a range of medical conditions, such as non-severe community-acquired pneumonia (CAP). The COVID-19 pandemic created a unique situation with favorable policy changes, hospital resource constraints, and a clearly defined patient population that helped to increase HaH program deployment and […]

Background: An estimated 1 in 5 patients are at risk for being readmitted to the hospital within 30 days of discharge. Readmissions put a large financial strain on the United States healthcare system and increase risk for poor patient care outcomes. The Centers for Medicare/Medicaid Services publicly report readmission data and have financial penalties for […]

Case Presentation: A 54-year-old man with a past medical history of intravenous drug use and morbid obesity presented with worsening bilateral lower leg pain and swelling. The patient reported chronic bilateral leg edema after a car accident a year before and started noticing skin changes with multiple bumps on his legs for several months. He […]

Case Presentation: A 37-year-old female with Systemic Sclerosis (SSc) presented with new-onset elevated blood pressure. She was on medium to high dose Corticosteroids (CS) a month prior to admission. Her significant vitals on admission included a heart rate of 103 and blood pressure of 193/97. Labs showed hemoglobin 9.6, sodium 130, BUN 63, creatinine (Cr) […]