Background: Half of US hospitalists have contracts with pay-for-performance incentives based on quality outcomes such as length of stay (LOS) and readmission according to the 2023 State of Hospital Medicine Report. Traditionally, these measures have been linked to the discharging provider. However, as the length of a patient’s stay increases, the influence of the discharging [...]

Background: Efforts have been made to increase social determinants of health (SDoH) screening to connect patients and families to community-based organizations (CBOs) and other resources. Tracking closed loop referrals is one potential measure to assist in assessing whether the resulting referrals and interventions have affected the child’s SDoH or improved the family’s well-being. Our team [...]

Background: Inpatient stewardship has appropriately become a large focus of acute inpatient care. The Vizient™ Clinical Data Base contains hospital discharge data used for benchmarking, and we observed significantly elevated cardiac MRI (cMRI) use at our tertiary hospital, relative to other tertiary academic medical centers, with resource utilization percentile averaging in the top decile (figure [...]

Background: The leadership of our academic hospital medicine group designed a geographic rounding intervention with the goal of improving patient-nursing communication, decreasing hurdles in discharging patients and eventually leading to reducing patient length of stay and increasing discharge rate. Our quantitative analysis compared the pre-intervention and post-intervention time periods with regard to observed to expected [...]

Background: At our multi-hospital system, our utilization management (UM) program found that the length of stay (LOS) for observation patients in one hospital was, on average, 10 hours longer than the rest of the hospital system. There was a challenge of having better observation management, but there was no space or staffing to create a [...]

Case Presentation: A 28-year-old Middle Eastern male, previously diagnosed with Systemic Lupus Erythematosus (SLE) and biopsy-proven Lupus Nephritis at the age of 18 in Egypt, had been managing his condition with a daily dose of mycophenolate mofetil at 250 mg. During a routine clinic follow-up, laboratory tests were conducted, revealing concerning results. His 24-hour urine [...]

Case Presentation: A 29-year-old African American male with chronic intermittent low back pain of several weeks presented with sudden-onset severe low back pain and inability to bear weight or ambulate. Prior to his hospitalization, he had a few urgent care visits, where he was diagnosed with back pain of muscular origin and was discharged home [...]

Case Presentation: A 43-year-old male from Guatemala with a history of alcohol abuse, brief incarceration and nephrolithiasis presented to the emergency room with abdominal pain and bloody diarrhea. He was found to have a psoas abscess and subsequently underwent radiologic aspiration and drainage of the lesion. Given the unusual intraosseous features on imaging, the patient [...]

Case Presentation: A 57-year-old Honduran male with no past medical history presented with two weeks of recurrent fevers, dyspnea, bilateral blurred vision, and pain in his low back, flank, and abdomen. Chest X-ray revealed a round opacity over the right lower lung. CT chest, abdomen, and pelvis showed patchy consolidation in the right lower lobe [...]

Case Presentation: An 80-year-old female was admitted with sudden right-sided weakness, expressive aphasia and left partial loss of vision. She denied preceding temporal tenderness, jaw claudication, headaches, history of tick bites, and new rashes. While her weakness and aphasia resolved within an hour, her vision impairment persisted. Initial CT and MRI scans showed no acute [...]