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: 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: With over 50% of hospitalists affected by burnout cited in the literature, it is imperative to evaluate tools and techniques to abate the downstream consequences. Recent work on resiliency has focused on how to decrease emotional exhaustion through exercises that can reframe a negative outlook into a positive perspective. Employing the “three good things” [...]

Background: On the 2016 ACGME survey, our Internal Medicine residents indicated that our service vs. education rating was at 47% compared to the national average of 69%. Purpose: To decrease resident physician workload to improve our education on inpatient wards, decrease the amount of non-physician level tasks to improve efficiency and to improve patient communication. [...]

Background: The Advanced Practice Fellowship at the University of Colorado Hospital is a 13-month post-graduate program designed to provide Nurse Practitioners and Physician Assistants with the medical knowledge and clinical skills necessary to practice hospital based medicine. As part of the program, Advanced practice fellows (APFs) have historically attended the internal medicine case conference, which [...]

Background: Millions of patients with cancer are hospitalized each year in the US for treatment or complications of their disease. Increasing numbers are cared for by hospitalists on services dedicated to patients with cancer. Little is known about the practice characteristics or working environment of this expanding pool of oncology hospitalists. Methods: Using a modified [...]

Background: Mortality is the first quality metric reported by CMS, and historically a key measure for evidence based medicine since the 1800’s. THINK:  John Snow removing the handle from the Broad street well pump to reduce cholera deaths  Ignaz Semmelweis demonstrating washing hands reduced puerperal fever and death. Mortality rates are risk adjusted [...]

Background: Peripherally inserted central catheters (PICCs) are an increasingly popular choice in the acute care setting for intravenous therapy. However, compared to other catheters, PICCs are associated with a higher risk for venous thromboembolism and blood stream infection, with multi-lumen PICCs having higher complication rates than single lumen. Midline catheters are associated with a much [...]

Background: Evidence-based medicine and research are the backdrops to our everyday practice of medicine. Although there are defined steps in carrying research project to publication, there is paucity in the translation of research to practice.(1,2) Over 45% hospitalized patients report poor sleep during their most vulnerable time citing the hospital environment and sleep disruptions from [...]

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 [...]