Background: Understanding a patient’s goals of care (GOC) during hospitalization is vital to provide patient centered care. Despite the known importance, little is known about the quality of GOC conversation documentation. The aim of this study is to examine discussion documentation in hospitalized general medicine (GM) patients prior to intensive care unit (ICU) transfer and [...]

Background: Up to 18% of clinic patients are considered difficult by their providers. (1,2) Common characteristics of difficult outpatients are the presence of personality disorders, depression, anxiety, somatization and requesting pain medications. (1,2, 5) Two qualitative studies suggest that inpatient medicine providers also regularly experience hospitalized patients as difficult. (3,4) However, there have been no [...]

Background: Hospitalized patients who are at high-risk for mortality and readmission represent a unique population requiring tailored interventions to improve care outcomes. Advance care planning (ACP) conversations in the inpatient setting can help align care goals with patient preferences, yet their influence on measurable clinical outcomes in this vulnerable population is not well understood. Methods: [...]

Background: The benefits of palliative care for hospitalized cancer patients are well known and have become a hallmark of high-quality oncologic care. This evolution in cancer treatment has led to a growing demand for palliative care services, and to questions about how to most effectively integrate this specialty into patient care. Furthermore, the field of [...]

Background: There is some observational evidence for the benefit of having an infectious diseases (ID) physician provide consultative support in the care of patients with Staphylococcus aureus bacteremia (SAB). A recent randomized trial was unable to document a similar benefit, although the control group received a concurrent stewardship intervention. We wanted to determine the effect [...]

Background: UC Davis Medical Center is a 646-bed tertiary care center and level 1 pediatric and adult trauma center, serving over 33 counties. Most inpatient internal medicine consultations originate from orthopedic and trauma services, with a significant subset of fragility fractures and geriatric patients. We established a co-management service to provide additional assistance for the [...]

Background: Patients with substance use disorders (SUD) are frequently cared for by hospitalists and admission presents an opportunity to engage patients in SUD treatment. Currently, patients with SUD are undertreated with medications to treat SUD, despite proven reduction in mortality. Addiction consult services are increasingly seen as an intervention to improve the quality of care [...]

Background: In hospital medicine, uncertainty [the subjective perception of ignorance(1)] is an inescapable challenge that impacts both patient care and physician well-being (2). There is a gap in our understanding of what hospital medicine physicians are uncertain about and how they manage their uncertainties. We aimed to learn more about how hospitalists experience and manage [...]

Background: Graduate medical education programs often use anonymous virtual comment boxes to elicit feedback from residents, fostering a culture of openness and aligning with ACGME standards.(1,2) These platforms allow residents to express concerns safely and anonymously, promoting trust and transparency. While previous studies highlight their positive impact on wellness, no comprehensive analysis exists regarding their [...]

Background: Nationally, inpatient medical oncology services are transitioning from services led by oncologists to hospitalist led with a consultant medical oncology team. There is national literature surrounding inpatient medical oncology services being poorly received by residents for a variety of reasons. Inpatient medical oncology is generally limited to medical complications and challenging goals of care [...]