Background: Point-of-Care Ultrasound (POCUS) is becoming an increasingly valuable tool in Internal Medicine. With the proper training, POCUS can provide insight into diagnostic dilemmas, resulting in expedited management and enhancing patient care. However, the ability to effectively utilize POCUS is directly related to the extent of each individual’s training. It is therefore critical to implement [...]

Background: Understanding communication between providers and patients is key to providing patient-centered care. We sought to determine if patient’s perception of time spent by physician at bedside is associated with patient satisfaction with physician communication. Methods: We conducted a cross-sectional survey of patients admitted to the hospital medicine service. The survey included questions about patient’s [...]

Background: Hospital Medicine is a growing field and integral part of the evolving healthcare system. Hospitalists are challenged to provide high-quality, effective, and efficient care to complex hospitalized patients, which requires medical knowledge in evidence-based practices, the attitudes to work in interdisciplinary healthcare teams, and skills to perform safe transitions in care. Given the rapid [...]

Background: In the primary care setting, up to one third of patients are categorized as complex, while this proportion is not well known in the hospital setting. By definition, complex patients demand more effort and/or resources and required care processes are not routine or standard. The treating physician’s complexity assessment is the gold standard, which [...]

Background: Issues with the quality and safety of hospital care have been well-documented, and serve as the basis for improvement strategies and research. However, what is less understood are the perspectives of patients, families, caregivers, and other stakeholders regarding what they feel are the most important targets of improvement research. We systematically engaged a broad [...]

Background: Medical Emergency Teams (METs) are utilized in an inpatient setting to identify patients who exhibit signs of clinical deterioration. Patients, family, or staff activate the team by calling a Code MET when there is a change in clinical status. Patients with End-Stage Renal Disease (ESRD) fare worse than age-, gender-, and race-matched populations. We [...]

Background: Single-center studies have reported low yield of blood culture for skin and soft tissue infections (SSTIs) in children. Blood cultures are commonly obtained in cases of SSTI, though the degree of practice variation is uncertain. Study objectives include: 1) assess the degree of variation in rate of blood culture for SSTIs among children’s hospitals [...]

Background: Infants ≤ 60 days of age with a urinary tract infection (UTI) represent a challenging population without clear guidelines for diagnostic evaluation or antibiotic therapy. UTI represents a significant percentage of serious bacterial infection in this age group and is a common management dilemma for pediatricians. Our study examined patterns of UTI management in [...]

Background: First year hospitalists have higher inpatient and 30 day post discharge mortality than hospitalists with at least a year of experience. The Joint Commission found that improper orientation and training is the second leading cause of sentinel events in hospitals. There is neither literature nor guidelines to inform best practices for Hospital Medicine (HM) [...]

Background: The use of maintenance fluids (MF, continuous intravenous fluid (IVF)) to prevent dehydration is common, yet highly variable in practice. Unnecessary MF can cause patient harm including fluid overload, sleep disruption (associated alarms), and increase falls risks. In 2017, Hurricane Maria destroyed Puerto Rican facilities that were critical in producing IVF, exacerbating an existing [...]