Background: Many end stage renal disease (ESRD) patients present with complaints related to missed or incomplete hemodialysis (HD). Inpatient HD units often are not credentialed for outpatient use which results in extra cost and consumes additional resources for a standard outpatient procedure. Delays in patient throughput in emergency departments (ED) can cause boarding in the [...]

Background: Hospital medicine is a growing field, including the subset of academic hospital medicine. Little is known about the characteristics of academic hospitalist programs, leadership, structure and faculty. Methods: A multifaceted survey was developed, piloted and refined to explore and define characteristics of academic hospital medicine. It was sent electronically, with follow up email and [...]

Background: Residents in Internal Medicine have traditionally taken electives that prepare or position them well for fellowships. Another purpose of elective time during residency is to expose the learner to career opportunities. As Hospital Medicine grows as a specialty, more training programs are offering electives for residents in this field. However, most elective descriptions that [...]

Background: The care of surgical patients is becoming more complex as patients with increasing comorbidities require surgical procedures. In adult hospital medicine, co-management of complex medical patients by hospital medicine and surgery has been shown to decrease length of stay and readmission for many procedures. It remains unclear, however, which patients are most likely to [...]

Background: Each year 45 million procedures are performed in the United States. For elective procedures, the preoperative evaluation is an opportunity to identify and manage risk factors that may contribute to post -operative morbidity and mortality. Increasingly thispre-operative visit has come under the purview of hospital medicine. While studies have demonstrated that pre-operative evaluations reduce [...]

Background: Hospital Medicine is a relatively new medical speciality that dedicates to the care of hospitalized patients and experienced an exponential growth in the United States (US) during the last years. Nowadays there are more than 50.000 american hospitalists according to the Society of Hospital Medicine. Outside the US it is still brand new and [...]

Background: Respiratory rate (RR) is a predictor of adverse outcomes and an integral component of many risk prediction scores for hospitalized adults. Despite its clinical value, RRs are often inaccurate and may lead to misclassification of disease severity, potentially jeopardizing patient safety. Purpose: We sought to improve inpatient RR measurement by patient care assistants (PCAs) [...]

Background: Emergency Department (ED) boarding, which occurs when admitted patients do not have an available bed in the hospital, has been associated with adverse patient outcomes. In 2014, 13,109 patients waited greater than 2 hours for a medicine inpatient bed at our large urban academic center. In July 2016, we deployed a 24-hour hospital medicine [...]

Background: Hospitalists have an increasing role in caring for patients with advanced illness. Due to time constraints, lack of experience and the sensitivity of the topic, it is challenging for Hospitalists to engage in adequate conversations regarding advanced care planning. Moreover, when these conversations do occur, documentation of Advanced Directives and Code Status is frequently [...]

Background: The Joint Commission (TJC) included medication reconciliation (MedRec) as a 2005 National Patient Safety Goal to reduce errors related to medication omissions, duplications and interactions. Medication errors and harms continue to be one of the most widely reported healthcare problems. TJC’s sentinel event database includes > 350 medication errors resulting in death or major [...]