Background: The Choosing Wisely campaign aims to engage clinicians and public in addressing overuse in healthcare. Through adoption in 20 countries and 75 organizations, clinician engagement is largely successful. However, patient and public engagement remains a challenge, and there is concern that the impact of Choosing Wisely will be dampened if this is not achieved. [...]

Background: Cardiac telemetry monitoring in hospitalized patients is an often overused resource. In a chart review at our institution, 30% of inpatient days on general medicine services involved telemetry use outside of American Heart Association guidelines. Telemetry overuse is driven both by use outside of accepted indications and by continuing telemetry monitoring longer than clinically [...]

Background: Physician Assistants (PAs) and Nurse Practitioners (NPs) play a growing role within hospital medicine groups. We studied physician perceptions of NPs and PAs in Hospital Medicine and identified factors that impact these perceptions. Methods: Data was collected through a mixed methodology survey with both open and closed-ended questions on a 6 point Likert scale. [...]

Background: Hemorrhagic complications after cardiac catheterization (CC) and percutaneous coronary intervention (PCI) are associated with an increased risk of mortality. In review of a large catheterization registry, blood transfusions were required following 1.4% of radial access and 2.8% of femoral access PCIs, respectively. While there is a standardized protocol for obtaining a blood type and [...]

Background: Cellulitis is a common cause of hospitalization. In the United States there are approximately 650,000 hospitalizations for cellulitis yearly, accounting for 1% of all admissions and approximately $10 billion. Most patients when hospitalized are treated with combinations of antibiotics with broad-spectrum Gram-positive, Gram-negative and anaerobic coverage. The Infectious Disease Society of America recommends hospitalization [...]

Background: Appropriate use of consultation can improve mortality and decrease cost of care. However, inappropriate consultation may carry risks to patients. Little is known about the variability of inpatient consultation. We aim to describe patient-, admission-, and physician- level factors that influence the variability of inpatient consultation. Methods: We conducted a secondary analysis of 2011-2015 [...]

Background: Inadequate access to seven-day inpatient medicine services, particularly at weekends, can lead to poor outcomes. Most evidence in this area is from North America and Europe but there is little or no evidence from the Middle East region. Purpose: We evaluated our practice before and after the introduction of an attending physician hospitalist delivered [...]

Background: Burnout is the syndrome of emotional exhaustion, depersonalization and reduced personal efficacy that occurs in individuals working in the human services field. Recent data suggests that 50% of physicians are experiencing at least one symptom of burnout. Factors that contribute to physician burnout include lack of efficiency and lack of input.There is growing concern [...]

Background: Constipation accounts for approximately 20,000 hospitalizations in the United States per year and contributes to increased length of stay for patients hospitalized with other diagnoses. Docusate is routinely prescribed for inpatient constipation although extensive studies have shown minimal effectiveness. It contributes to increased pill burden and polypharmacy for patients, and adds to unnecessary use [...]

Background: The American healthcare system is focused on promoting value; providing high quality care while paying close attention to associated costs. Studies have shown that admission to a teaching hospital is associated with better outcomes, reduced mortality, compared to nonteaching hospitals. It is not known whether the value proposition at academic hospitals is worthwhile for [...]