Background: Urinary tract infections (UTIs) are a common bacterial infection in infants, with potentially serious consequences. Even though urinalysis (UA) is a commonly used screening test for UTI, there is a lack of consensus on its accuracy in well-appearing febrile infants below 28 days old. This study aims to evaluate the accuracy of UA, both [...]

Background: Syphilis cases in the United States increased by 28.6% between 2020 and 2021. San Francisco was the highest-risk county for early syphilis in 2017, and between 2017 and 2021, syphilis diagnoses further increased by 12%, with a 200% increase in syphilis cases among women and a 333% increase in congenital syphilis cases compared to [...]

Background: Patients with cancer diagnoses are known to have the highest likelihood of readmission to the hospital based on nationally available data. Reducing readmissions to the hospital has remained a national priority in healthcare quality, however it can be challenging to identify patients who are at highest risk for readmission to the hospital. Currently, our [...]

Background: Facing challenges of capacity strain, many hospitals have implemented programs to prioritize discharges in the morning as a strategy to improve patient throughput, decrease emergency room boarding, and improve patient satisfaction/experience. (1) However, evaluations of these practices have had mixed results. (2) Like many other complex health interventions, priority discharge interventions may fail to [...]

Background: Email represents an administrative burden which contributes to overall burnout. While general strategies to mitigate burnout related to email have been published (Armstrong 2017), formal clinical workplace guidelines and specifically their impact have not been described in the literature. The University of Michigan (UM) Division of Hospital Medicine (HM) developed and distributed email management [...]

Background: Advance Care Planning (ACP), palliative care (PC), and enrolling inpatients near end of life into hospice are known methods to improve patient experience and reduce inappropriate use of inpatient (IP) resources. We sought to increase ACP, PC, and hospice referral by proactively identifying patients near end of life. Methods: In 2020 we introduced the [...]

Background: There is little data on the relative prevalence of different causes of care delays that contribute to prolonged length of stay. Unnecessary delays in the care of hospitalized patients increase the risk of hospital-related complications and drive up healthcare costs. Prior observational studies have suggested that a reduction in hospital length-of-stay is possible without [...]

Background: Hospitalized patients are often cohorted on specific inpatient wards in an effort to improve outcomes and provider satisfaction. When hospitalist beds are fully occupied, patients may be admitted to off-service inpatient units. Dispersion to multiple units has the potential to affect multiple outcomes. Hospitalist groups may develop cohorting programs, either in the form of [...]

Background: Alcohol use disorder (AUD) is a pervasive disease affecting 28.6 million (11.3%) American adults in 2021.1 Medications for AUD (MAUD), including naltrexone, acamprosate, and disulfiram, are effective, yet less than 5% of these patients received treatment.1,2    Inpatient encounters of patients with AUD present a crucial opportunity to initiate MAUD, prompting this quality improvement [...]

Background: Social determinants of health (SDOH) are thought to account for up to half of modifiable outcomes related to health. Children from minority groups and/or lower socioeconomic backgrounds are at higher risk for hospitalization. Efforts have been made to screen for social risk factors in the outpatient setting. However, few studies describe inpatient SDOH screening [...]