Background: Oncology comanagement of hospitalized cancer patients is increasingly common. We (1) and others (2-4) have previously demonstrated that when compared with traditional oncologist-only staffing, hospitalist co-management can improve on well-recognized quality outcomes including length of stay, early discharge rates and 30-day readmission rates. Yet, the composition of an oncology hospitalist practice is incompletely understood [...]

Background: Overuse of daily labs (DL), especially CBC and BMPs in hospitalized patients leads to increased costs and utilization of resources, iatrogenic anemia, and patient discomfort. Prior quality improvement (QI) efforts in hospital medicine have worked to reduce excessive lab utilization, but few have focused on labs ordered on the day of discharge (LOD) . [...]

Background: Accountable Care Units (ACUs) with Structured Interdisciplinary Bedside Rounds (SIBR® rounds) have shown significant improvements in throughput, clinical outcomes, and satisfaction. Yet, prior studies have noted difficulties achieving such improvements or sustaining them. Interdisciplinary rounds are a predominantly physician-led teamwork process with efficacy vulnerable to inconsistent physician leadership and engagement. Our hospital had previously [...]

Background: Multiple organizations have published clinical guidelines on hyperglycemia management in the acute care setting in non-critically ill patients [1–3], and the Society of Hospital Medicine offers additional support through its Glycemic Control program [4]. However, there remains little consensus regarding specific dosing regimens when designing insulin protocols in the inpatient setting. At our institution, [...]

Background: Hospital crowding and subsequent resource strain have been associated with worse patient outcomes and increased length of stay (1–3). As pediatric hospitals face an overwhelming respiratory illness surge in the wake of the COVID pandemic (4–6), improving hospital patient flow is all the more critical. Nonetheless, a substantial proportion of patients, nearly 1 in [...]

Background: Hospitalists have been at the frontlines of caring for hospitalized patients with COVID-19, placing unusually high stress on hospital-based providers. Attention to hospitalist well-being and resiliency has been essential. We have engaged in a quality improvement project seeking to measure and, more importantly, improve the well-being of hospitalists at a single, large academic hospital. [...]

Background: Sepsis is a major cause of hospital mortality. Moreover, patients who survive sepsis have increased risk for morbidity, rehospitalization, and death in the months after sepsis. To address this, the 2021 Surviving Sepsis Campaign now provides recommendations addressing recovery and longer-term outcomes. We were interested in whether Michigan hospitals are consistently incorporating key elements [...]

Background: National guidelines recommend hospitals implement standardized approaches to handoffs, and recent quantitative research has indicated that standardized approaches such as the I-PASS tool can lead to sustained improvements in patient safety and provider communication in a diverse array of settings.1 Our hospital medicine group piloted a formal written handoffs process based on the I-PASS [...]

Background: More than 71,000 people are non-fatally injured by firearms annually in the US and forced to deal with the aftermath and sequela of surviving a gunshot wound (GSW). The social determinants of health (SDOH) needs in this vulnerable population are poorly understood, particularly at the time of discharge. Following up with healthcare providers after [...]

Background: Over 50% of practicing physicians in the United States report burnout with internal medicine having some of the highest rates. The aim of our study is to identify factors that contribute to burnout in academic hospitalists and the impact that COVID-19 has had on this phenomenon. Methods: 19 academic hospitalists at Froedtert Hospital & [...]