Background: Clinical decision support tools based on predictive analytics can provide actionable information and improve clinical outcomes for patients at risk of developing sepsis. Scoring systems such as Systemic Inflammatory Response Syndrome (SIRS) and National Early Warning Score (NEWS) that were not specifically trained to detect sepsis tend to have high false alarm rates, leading [...]

Background: Handoff miscommunications are a leading source of medical errors. Medical error and adverse event rates decreased following implementation of the I-PASS handoff program (a bundled intervention using a structured mnemonic, I-PASS, and other initiatives to sustain implementation) in a pediatric research trial. Whether I-PASS can be implemented in settings outside academic pediatric institutions is [...]

Background: Sleep deprivation has deleterious effects on immune function, wound healing, insulin resistance, pain, and even mortality. Patients in hospitals often suffer from sleep deprivation due to environmental noise and interruptions from staff. The American Academy of Nursing Choosing Wisely guidelines recommend not to “wake the patient for routine care unless the patient’s condition or [...]

Background: In the dawning era of precision medicine, increasingly sophisticated tools are becoming available to diagnose and investigate rare and unexplained diseases. The application of these tools to clinical practice will require new models of collaboration between clinicians, tool developers, and laboratory investigators. Many structural barriers to such collaboration exist in our current healthcare delivery [...]

Background: Community acquired severity scores are well known and used routinely in predicting mortality and risk of inpatient and ICU admission in suspected bacterial pneumonia patients. However such scores have not been studied in patients with influenza infection and influenza pneumonia. We attempted to validate one such score, CURB65 and and identify other scores that [...]

Background: In 2015, medical students in their clinical clerkships (traditionally known as third year medical students) began rotating directly with hospitalist attendings. As we began crafting the rotation, we sought to provide value that was not leveraged elsewhere in their clerkships. Different organizations, including the Liaison Committee on Medical Education and Association of American Medical [...]

Background: Inpatient margins and hospital reimbursement have become increasingly dependent upon improving key metrics, such as length of stay and 30-day readmissions. Hospitalists typically lack access to credible, timely, and insightful metrics that inform their practice. In addition, individualized metrics, when available, struggle to properly normalize for patient complexity, warranted variations in care, shared decision-making, [...]

Background: The transfer of patients between hospitals (interhospital transfer, IHT), exposes patients to risks of discontinuity of care. In this study, we aim to better understand which patients may (or may not) benefit from IHT by evaluating the impact of IHT on clinically important patient outcomes among a variety of patient diagnoses. Methods: We performed [...]

Background: Ensuring hospital-based Patient and Family Advisory Councils (PFACs) include members from diverse, vulnerable and underrepresented communities is important to ensure that all voices are represented and heard when providing input into hospital quality improvement and research efforts. However, ensuring diverse membership of PFACs remains a challenge. This study aims to describe strategies to recruit [...]

Background: In a previous randomized trial we found that shorter ward rotations reduced attending physician burnout at rotation-end. This improvement was offset, however, by negative education outcomes among trainees. Therefore solutions to burnout other than simply shortening rotations are needed to preserve the educational mission. We examined additional data collected (but not yet presented) to [...]