Case Presentation: We present a 41-year-old female with a past medical history of hypertension and ESRD status post deceased donor kidney transplant in 2018, on treatment with tacrolimus and Mycophenolate Mofetil.She presented to an urgent care 4 days prior, where she tested positive for symptomatic COVID-19 infection and was prescribed a 5-day course of nirmatrelvir-ritonavir. [...]

Case Presentation: Spontaneous spinal epidural hematoma (SSEH) is a hematoma that happens without an insult. Although a rare entity, it can result in spinal cord compression. Etiologies include anticoagulant therapies, coagulopathies, blood dyscrasias, pregnancy, and vascular malformations (1). We present a case of SSEH in the setting of heparin and clopidogrel use during a vascular [...]

Background: Intimate partner violence (IPV) is a serious and prevalent public health issue associated with increased healthcare utilization and worse healthcare outcomes. The majority of IPV outcomes research is conducted in emergency and outpatient populations. Our study aims to investigate how IPV exposure affects hospitalization rates and outcomes in adult patients. Methods: We performed a [...]

Background: Unconscious bias within the U.S. health care system has been linked with disparities in the treatment of patients by age, gender, and race (1). While many factors contribute to these disparities, implicit bias may play a significant role. Stigmatizing language often reflects the implicit bias that healthcare providers possess toward patients (2). Recent research [...]

Background: It is well established that there is a persistent gender gap in promotion in academic medicine despite an equal number of male and female medical students for the past 20 years. Possible mediators of this gender gap include differences between men and women in years on faculty, measures of productivity such as number of [...]

Background: Stigmatizing language in clinical notes can negatively impact physician attitudes, propagate bias, affect prescribing behaviors, and exacerbate healthcare disparities, yet remains prevalent even in the Open Notes era. Prior analyses of stigmatizing terms in clinical notes are limited by the lack of context in which terms are used and multiple meanings of certain words [...]

Background: As hospitalists often serve marginalized patients and have system-wide influence, hospital medicine is well positioned for promoting diversity, equity, inclusion, and justice (DEIJ). While representational diversity may be tracked, inclusion can be harder to assess. As hospitalists engage in DEIJ efforts, it is important to understand what ‘success’ in inclusion looks like. We sought [...]

Background: Attention to the quality of glycemic management during the hospital stay, including care transitions, has grown with increasing evidence linking inpatient and post-discharge glycemic control to clinical outcomes, widespread use of glucometric benchmarking, and impending pay-for-performance measures. Clinical inertia (nonadherence to guidelines) and therapeutic inertia (failure to adjust medications as indicated) or CTI among [...]

Background: Hypoglycemia is common and potentially life-threatening for diabetic patients, often iatrogenic from diabetes treatments. It is important to be able to accurately study rates of hypoglycemia when evaluating the inpatient treatment of diabetes at a systems-level. Discharge diagnosis codes show promise as a tool in the surveillance of hypoglycemic events in large administrative databases [...]

Background: Asymptomatic bacteriuria (ASB), or bacterial growth on urine culture without localizing urinary symptoms, is common in hospitalized patients.1,2 ASB is often misdiagnosed as urinary tract infection (UTI) and treated with antibiotics3 despite no improvement in mortality1 and multiple harms associated with antibiotic overuse.4,5 To reduce treatment of ASB, many hospitals set urinalysis parameters (e.g. [...]