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: Accurate attribution of quality metrics to individual hospitalists is crucial for quality improvement and value-based care initiatives. However, the collaborative nature of inpatient care with frequent patient handoffs makes fair attribution challenging. The current understanding of variation in hospitalist quality metrics comes primarily from studies using attribution methods based on who oversaw the majority [...]

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: 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: 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: Hospital length of stay (LOS) is an important metric for evaluating a healthcare system’s quality of patient care, patient experience and outcomes, efficiency of practice, and resource management. The COVID-19 pandemic led to a significant increase in the average hospital LOS in the United States. Hospital LOS has continued to remain high due to [...]

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: Multi-visit patients (MVP) tend to represent a small portion (< 5%) of all admitted patients, yet account for more than 40% of 30-day readmissions based on prior literature (1-2). Among our institution’s MVPs, Heart failure (HF) exacerbations are one of the top disease presentations accounting for 40% of 30-day readmissions in 2022. These patients [...]