Background: It is often assumed resident physicians at academic medical centers order more tests for inpatients due to different aspects of the clinical learning environment.  Despite this prevailing notion, there is very little evidence to support this claim. We sought to quantify differences in ordering practices between teaching hospitals and non-teaching hospitals for two common [...]

Background: Structured mortality review can help identify care issues and focus quality efforts, but existing methods have limitations. In the Department of Medicine at UCLA, we developed a novel in-person, near real-time, interdisciplinary rapid mortality review (RMR) process to capture the insight of frontline providers and improve care. In this study, we compare the yield [...]

Background: Advance care planning can be challenging for both patients and providers.  Barriers to understanding patients’ goals of care include patient and provider discomfort with the topic, as well as family and cultural dynamics.  The Stanford Letter Advance Directive (LAD) is a simple tool written at a fifth grade reading level in eight different languages [...]

Background: Although point-of-care ultrasound can improve patient care and reduce unnecessary downstream costs, few economic models exist on hospitalist use and whether remuneration for imaging could offset equipment costs.  As the heart and lungs are commonly examined during admission, we observed the frequency of use and projected fiscal outcomes of point-of-care cardiac ultrasound by an [...]

Background: Most academic general medical services cover patients across several different care units in the hospital. Studies have shown that de-regionalized care leads to a lack of team cohesion and poor communication between healthcare providers. Prior studies have shown that teamwork improves patient outcomes and increases health care worker satisfaction. However, little information using validated [...]

Background: Effective and timely communication among caregivers is one of the 2016 Hospital National Patient Safety Goals set forth by the Joint Commission. The pager messaging system remains predominant in the U.S health care system, but is this one-way pager device falling out of favor over smart phones in the health care setting? There is [...]

Background: SHM Key Characteristic 9.1 on patient centered care encourages using guidelines/checklists to reinforce effective communication. Focused practice performance evaluations (FPPE) are a required regulatory hospital process for new medical staff members. In cognitive specialties, such as hospital medicine, completing an objective assessment of clinical skills can be difficult, with most initial evaluations based on [...]

Background: There is variability in care expectations and perceptions of terminally ill patients who are expected not to benefit from intensive care unit (ICU) level care. This created significant angst amongst members of the health care team, administration, families and patients and contributed to significant waste in our system. While criteria for ICU admission were [...]

Background: Cardiac arrest on the wards may be preceded by unmet palliative care needs, including advance care planning and specialty palliative consultation that can seek to align patients’ prognoses and goals for care. Identification of hospitalized patients with limited life expectancy allows for the delivery of appropriate palliative interventions. However, the prognosis on admission of [...]

Background: Understanding of the Do-Not-Resuscitate (DNR) order varies among different ethnic backgrounds. In Korea, the concept of DNR is not well-known. We therefore conducted a questionnaire-based study to explore and characterize ethnic differences (Korean vs. Non-Korean) in the understanding of DNR.   Methods: Subjects were recruited from the Englewood Hospital and Medical Center where is [...]