Background: Subspecialty consultation among hospitalists varies significantly across and within hospitals. While in many cases consultation is clinically necessary, in other cases it may represent overuse. Recent studies have explored predictors of consultation using observational administrative and EHR data. Qualitative methods may generate knowledge about additional factors and complex processes influencing consultation behavior not ascertainable […]

Background: Subspecialty consultation among hospitalists varies significantly across and within hospitals. While in many cases consultation is clinically necessary, in other cases it may represent overuse. Recent studies have explored predictors of consultation using observational administrative and EHR data. Qualitative methods may generate knowledge about additional factors and complex processes influencing consultation behavior not ascertainable […]

Background: In the acute care environment, healthcare workers interface with patients who have limited access to medical care and a high prevalence of social determinants of health (SDoH) barriers.1 The inpatient setting presents a key intervention point where the social needs of vulnerable populations might be addressed. Standard inpatient medicine care teams, however, lack the […]

Background: “Hospital at Home” (HaH) models of care have existed for over 20 years in the U.S. Demand for healthcare value, advances in relevant technologies, and the ongoing global pandemic have driven renewed attention to HaH models, by way of policy-based and academic pilot programs – and even commercialization attempts. Where studied, these models have […]

Background: Identifying patients who may benefit from a Serious Illness Conversation (SIC) in the hospital is an important step in increasing SIC timeliness. Epic’s Readmission Risk Score (RRS) is an electronic health record integrated composite score (0-100%) that includes diagnostic, laboratory, medication, order, and utilization variables to predict unplanned, 30-day readmission and was found by […]

Background: Professional Advancement Models (PAM) have been researched and implemented at large academic institutions as a solution to provide structure and support for career advancement for Advancement Practice Providers (APPs).1,2 Many of these programs fail to appreciate the nuances of inpatient vs outpatient providers. Given the inherent differences of these practice settings, we aim to investigate […]

Background: An estimated 580,000 individuals were experiencing homelessness during the most recent national point-in-time count. Dialysis requires substantial patient engagement, and not having secure housing impedes medical care and could increase acute care utilization. The prevalence of homelessness and its impact on hospitalizations among patients with ESKD are unknown. This retrospective cohort study examined differences […]

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: 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: Several electronic health record (EHR) mortality prediction models have been developed to promote early goals of care discussions (GOCD) but only a few models were evaluated prospectively. We aimed to implement a real-time 30-day inpatient mortality prediction model previously developed at our facility and evaluate its effect on GOCD in seriously ill transferred patients. […]