Background: Routine laboratory testing is a cornerstone of inpatient care. However, indiscriminate ordering can lead to resource waste, prolonged length of stay, and unnecessary costs. At our community teaching hospital in Queens, New York, we identified high rates of vitamin level testing—specifically vitamin B12, folate, and vitamin D25—which were often ordered without clinical indication. This [...]

Background: Routine laboratory testing is a cornerstone of inpatient care. However, indiscriminate ordering can lead to resource waste, prolonged length of stay, and unnecessary costs. At our community teaching hospital in Queens, New York, we identified high rates of vitamin level testing—specifically vitamin B12, folate, and vitamin D25—which were often ordered without clinical indication. This [...]

Background: Over 32 million patients in the United States have a penicillin (PCN) allergy label in their medical chart.1 Studies have demonstrated that 15-20% of hospitalized patients are labeled PCN allergic. However, IgE-mediated PCN allergy wanes over time and up to 80% of patients with a listed PCN allergy can tolerate PCN after 10 years. [...]

Background: Mortality rates are a critical quality metric for hospitals, influencing both clinical outcomes and institutional reputation. The Centers for Medicare and Medicaid Services (CMS) incorporates 30-day mortality rates into its Value-Based Purchasing (VBP) program and Star Ratings, directly impacting hospital reimbursement and public perception. Similarly, U.S. News & World Report factors 30-day mortality into [...]

Background: Hospitalists vary in their ordering practices related to labs, imaging, and discharge order times. Variations in these practices has been associated with over-utilization of services and inefficient clustering of discharges later in the day. Prior studies suggest that peer comparison can be effective to change provider behavior and reduce unnecessary variation in ordering practices, [...]

Background: Hospital reimbursement for medical necessity is based on the level of care a patient is receiving. In the electronic medical record (EMR), the level of care, inpatient or observation, is determined by a practitioner order or physician certification. The timeliness of this order is of utmost importance, as medical necessity is a dynamic status. [...]

Background: Secure text messaging systems that allow for bidirectional communication between a sender and recipient, instead of relying on unidirectional alphanumeric text or numeric-only messages, have fundamentally changed inpatient communications. At our institution, all clinical team members utilize the same secure messaging platform (Voalte). We aimed to explore physician and nurse overall satisfaction with our [...]

Background: Overdose-related deaths in adolescents have increased, making recognition and treatment of substance use (SU) an issue of critical importance. However, pediatricians are failing to screen and manage SU withdrawal among hospitalized adolescents. Driving factors include no standard process, addiction specialists’ discomfort in treating pediatrics, and discomfort in inpatient providers in managing addiction. Through this [...]

Background: In a technology-driven era, it is no surprise that the majority of learners prefer multimodal resources when learning new material. Patient discharge education is no exception to this, and several studies have demonstrated that providing digital discharge education (DDE) can help with patient comprehension, information retention, and patient self-efficacy with medication (1, 2, 3). [...]

Background: Inpatient utilization of Magnetic Resonance Imaging (MRI) is rapidly expanding, with potential effects on length of stay (LOS). At the same time, current hospital occupancy remains about 10 percentage points higher than before the pandemic and hospitalizations are projected to increase 11% by 2034. Hospital systems are striving to optimize processes to improve bed [...]