Background: Lack of urgency indicators and receipt confirmation are two of several known alphanumeric paging limitations. To address absence of urgency indicators, a Priority Structured Paging (PSP) system that allowed nurses to communicate priority was adopted at an academic medical institution across multiple nursing units caring for a mixed patient type and acuity. Data recorded [...]

Background: Residents are frequently the first physicians notified when acute changes occur in patient conditions.   Delays in appropriate diagnostic testing or treatment can adversely affect patients if residents are unfamiliar with certain clinical situations and fail to escalate to an attending physician.  Our hospital had no written guidelines on when internal medicine residents should escalate [...]

Background: Effective communication between health-care providers, patients and their families is a key aspect of the discussion surrounding a patient’s goals of care.  One crucial part of this process is reaching a shared understanding of how the patient views their own quality of life.   The objective of this study was to characterize factors patients and [...]

Background: Patient evaluation of satisfaction with their physician has been utilized for several years and is now being included as a parameter utilized to calculate reimbursement. Despite the routine use of these evaluations by most hospitals and agencies, little research has been done to evaluate the metrics of patient evaluations. We sought to assess whether [...]

Background: Patient evaluation of satisfaction with their physician has been utilized for several years and is now being included as a parameter utilized to calculate reimbursement. Despite the routine use of these evaluations by most hospitals and agencies, little research has been done to evaluate the metrics of patient evaluations. We sought to assess whether [...]

Background: Advance care planning is nationally recognized as important for honoring patient wishes at the end of life. Despite this widespread recognition, many patients lack advance care planning and spend their last days in ways not concordant with their values. Moreover, traditional advance directives may provide only a partial context for patients’ belief systems relevant [...]

Background: Surgical co-management is an up-and-coming field within Hospital Medicine, with great successes documented in the improvement in quality metrics and patient satisfaction owing to the involvement of hospitalists in peri-operative inpatient care. Currently, orthopedic and neurosurgical co-management programs are the most commonly developed partnerships. Our institution is a Level 1 regional trauma center with [...]

Background: Previous studies have shown reduced costs and length of hospital with surgical comanagement performed by hospitalists. In Latin America, however, this practice of comanagement is still not standard among surgeons. The Hospital Nossa Senhora da Conceição, localized in Southern Brazil, was the pioneer of Hospital Medicine in our country. It is a public, tertiary, [...]

Background: Consultation in hospital is an important tool for acquiring subspecialty support when managing patients with acute congestive heart failure (CHF). The effect of consult utilization on hospital outcomes and resource utilization of acute CHF is unknown.   Methods: Discharge data was obtained for patients discharged with a principal diagnosis of acute CHF over 3 [...]

Background: Hospitalists nationwide are faced with complex patient and family behaviors that interfere with medical care. In the acute inpatient setting, few resources are available for physicians to address maladaptive behaviors and many physicians report significant discomfort managing these disruptive behaviors. We implemented a Nurse Practitioner-Led Psychiatric Consult Service to provide education and recommendations for [...]