Background: Septic shock is a significant burden: average length of stay (LOS) for sepsis patients in US hospitals is 75% greater than most other conditions. Mean LOS dramatically increases with sepsis severity: 4.5 days for sepsis, 6.5 for severe sepsis, and 16.5 for septic shock. Administration of antibiotics in < 1 hour after presentation at [...]

Background: Diabetes Mellitus is a growing concern in the USA, affecting around 10.5% of the population or approximately 34.2 million people. West Virginia has the highest prevalence of adult diabetes, with 16.2% of the population diagnosed in 2018. In noncritical care hospitalized patients, new-onset hyperglycemia and patient with diabetes make up 25-30% of the census. [...]

Background: Behavioral emergencies in the hospital are on the rise, leading to increased workplace violence. A small body of evidence recommends an inpatient Behavioral Emergency Response Team (BERT), a multi-disciplinary team to de-escalate behavioral emergencies that can be harmful to the patient or staff. Observational studies have reported that BERT can reduce workplace violence, use [...]

Background: Studies show that nurses and physicians often have different perceptions of the quality of interprofessional communication. An important part of daily communication between physicians and nurses involves patients’ clinical plan of care for each day (‘care plan’). We conducted a study examining hospitalist and nurse perceptions of communication of shared patient care plans. Methods: [...]

Background: Hospitals across the country employ a readmission risk assessment tool such as the LACE score (L- length of stay, A–acuity, C- Comorbidity, E- Emergency department use) to pinpoint patients at heightened risk of potentially avoidable readmissions. However, at our institution, the LACE score proved inadequate in identifying individuals with mid to late-stage chronic illnesses [...]

Background: Constipation is commonly encountered in patients admitted to the hospital, with a variety of possible treatments to choose from. Docusate is often prescribed to treat constipation, though evidence suggests it is ineffective. Utilizing an ineffective medication adds to patients’ pill burden, health care costs, and may delay the use of effective medications with downstream [...]

Background: Tobacco cessation is the most effective intervention for reducing the progression of disease in COPD patients and reducing mortality. Varenicline is the most effective drug to treat tobacco use disorder. The American Thoracic Society strongly recommends initiation of Varenicline for smoking cessation, even in patients who are not ready to quit. Hospitalist initiation of [...]

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.1-17 PO is generally more comfortable and less dangerous than IV. Between 5/2017-11/2017, Jefferson dosed ~300,000 doses of potassium (K) and magnesium (Mg), with 30% and 19% of doses being PO, respectively. Guiding [...]

Background: Project Caring for Patients with Opioid Misuse through Evidence-Based Treatment (COMET) launched in 2019 to provide patients with opioid use disorders (OUD) individualized and evidence-based care at Duke University Hospital (DUH). Patients with OUD have higher rates of self-directed discharge (SDD) which is associated with higher healthcare utilization costs, hospital readmissions, and adverse health [...]

Background: Inpatient phlebotomy-associated-anemia (PAA) has garnered significant attention in recent years, with numerous studies delving into this common and preventable condition’s implications for patient outcomes. During hospitalization, it is estimated that about 18% of patients develop anemia associated with phlebotomy. We evaluated the prevalence and impact of PAA at Grady Memorial, a public safety-net hospital. [...]