Background: Frequently hospitalized patients face unique challenges in navigating health care systems. Although practice-, hospital-, and accountable care organization-level programs to address the needs of these patients exist, interventions have had mixed results, with only some demonstrating reduction in hospitalizations or costs. To best serve frequently hospitalized patients and improve future interventions, clinicians, leaders, and [...]

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: Long-term central venous access devices (CVADs) are integral to cancer care provision. Despite the high prevalence of CVAD occlusion in children with cancer, strategies to prevent occlusive events are understudied. We aimed to test the safety and feasibility of conducting a randomized controlled trial (RCT) comparing heparinised saline, with normal saline (0.9% sodium chloride) [...]

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: While the electronic health record (EHR) provides many benefits, its use can easily allow for incomplete documentation of relevant historical information. The EHR is designed to store documentation of a patient’s past medical history (PMH), surgical history (PSH), family history (FH), and active hospital problems in the History tab. When the information is in [...]

Background: Evidence-based guidelines/protocols for electrolyte replacement that safely encourage oral (PO) and/or intravenous (IV) dosing attain goal levels more successfully than standard care. PO is generally more comfortable and less dangerous than IV. Between 5/2017-11/2017, our institution dosed ~300,000 doses of potassium (K) and magnesium (Mg), with 30% and 19% of doses being PO, respectively. [...]

Background: A growing area within medical literature focuses on clinical prediction and decision tools that use variables from patient history, examination, or diagnostic tests to generate outcome-based risk stratification and/or intervention recommendations. Demonstration of appropriate methodologic quality and clinical applicability remains a need. Here we explore tools that advise a complicated, multifaceted phenomenon – the [...]