Case Presentation: A 31-year-old man with past medical history of secondary syphilis and HIV/AIDS (CD4 47) intermittently on ART presented with worsening rectal pain and recurrent rectal abscesses. He endorsed rectal pruritis, nausea, weight loss, and lower extremity pain. He denied fevers, night sweats, abdominal pain, or diarrhea. Last year, he had a prior rectal […]

Background: Advanced Practice Providers (APP) are an expanding workforce within hospital medicine. Training and onboarding APPs is essential for developing a confident and competent workforce. However, onboarding options for APP training in hospital-based medicine have been limited due to the breadth and complexity of knowledge required to practice. Purpose: To develop an inpatient hospital medicine […]

Background: An increasing amount of literature demonstrates the detrimental impact of discrimination and microaggressions at personal and institutional levels in the healthcare workplace (1-5). Confronting these displays of bias involves a multifaceted approach across professional disciplines and hierarchies. Residency is a time when physicians experience and learn to navigate bias (6). To address this, we […]

Background: Enhanced physician-nurse collaboration improves patient outcomes. Current interprofessional clinical learning environments, however, rarely engage physicians with nurses and are not based on high-performance team frameworks. Therefore, leaders at the University of Chicago Medicine developed the Improving GME Nursing Interprofessional Team Experiences (IGNITE) program to engage interprofessional healthcare teams, with hospitalist coaches, in institutional performance […]

Background: Pain is assessed by nurses through either reported or observed intensity. Self-reported assessments, specifically a numeric score, are the gold standard and preferred to behavioral assessments. Disparities in the assessment and management of pain across race, ethnicity, and language status are prevalent, but we do not know how actual numeric pain scores vary and […]

Background: Assessing and treating pain in older adults is challenging. Although having patients self-report pain on a numeric scale is the recommended approach, age-associated conditions such as dementia, delirium, and impaired vision or hearing can prevent patients from effectively communicating their symptoms. Older patients are also at risk of adverse effects from commonly used analgesics […]

Background: Physical restraint use among patients hospitalized with dementia and behavioral disturbances has not been studied on a national level in the United States. We aimed to determine rates of physical restraint use among hospitalized patients with dementia and behavioral disturbances and to characterize associations with mortality and utilization metrics. Methods: National Inpatient Sample database […]

Background: Hospitals increasingly face capacity strain and challenges with patient flow, leading to emergency department (ED) crowding, ED boarding, and threats to patient safety and quality of care. ED boarding occurs from the time of the decision to admit until the patient arrives in an inpatient bed and is affected by many factors including discharge […]

Background: It is universal practice to restrain incarcerated patients – regardless of age, illness, mobility, or pretrial status – with metal shackles during hospital stays without consideration for less restrictive alternatives. Globally, human rights and legal groups have voiced opposition to this shackling, citing numerous justice, ethics, and medical concerns relating to the practice. Healthcare […]

Background: Hospitalist-run Medical Procedure Services (MPS) have been shown to decrease time-to-procedure, overall length of stay, and interventional subspecialty consults for bedside procedures while increasing revenue for hospitalist groups [1,2,3,4]. However, significant challenges remain in the deployment of a financially sustainable MPS, and there is interest in identifying and deploying strategies to improve sustainability. Two […]