Background: Chest pain and related symptoms are the number two reason patients visit emergency departments in the United States, often leading to routine hospitalization or observation. Improving utilization management of patients presenting to the emergency department with chest pain is an important goal for hospitals. Use of 5th generation troponins and risk stratifying tools can [...]

Background: Stress is prevalent in healthcare where a certain level of stress is constant. Healthcare workers face higher rates of burnout that could be characterized by emotional exhaustion, depersonalization and could make it difficult to connect with patients in meaningful ways. Yogic Lifestyle brings into account the different variations of a healthy lifestyle combined into [...]

Background: The latest guidelines on parapneumonic effusion (PPE) management1 recommend immediate evaluation of PPE with ultrasound. Recognizing that bedside procedure services (BPSs) staffed with procedural hospitalists (proceduralists) are becoming the first point of ultrasound contact for many patients admitted with PPE our study sought to demonstrate that proceduralists can reliably agree with radiologists (viewed as [...]

Background: Staffing of inpatient medicine services with Advanced Practice Providers (APPs), including physician assistants and nurse practitioners, is becoming increasingly common at academic medical centers across the United States. The various roles filled by APPs have not been well-described in the literature. The purpose of this study is to better characterize how APPs are utilized [...]

Background: Depression is considered an independent risk factor for coronary artery disease. Post-myocardial infarction (PMI) depression, is an increasingly recognized clinical entity with a prevalence of 10%. Compared with other ethnic groups, African Americans (AA) are more likely to be depressed and have higher coronary artery disease (CAD) burden. Few studies have evaluated the implications of [...]

Background: Antipsychotics are frequently used in the hospital setting for managing both acute and chronic neuropsychiatric disorders. However, antipsychotics have been associated with higher rates of adverse events, including mortality, due to their association with QT prolongation, which can lead to fatal cardiac arrhythmias such as torsade de pointes, earning a black box warning for use in dementia related psychosis. Yet, [...]

Background: Since the “birth” of hospitalist in mid-nineties, it took 20 years to grow from zero to 50,000 physicians in 2016. In the U.S, internal medicine (IM) services are covered by different models, including teaching IM services and non-teaching services. Non-teaching services are attended by hospitalists or outpatient-practicing internists. Methods: We conducted a classical prospective [...]

Background: In 2016, around 94% of healthcare facility managers used locum tenens physicians in the previous 12 months. One-quarter of them were locum hospitalists, making hospitalists as the second most common service in demand for locum physicians. There are no prospective studies comparing the care of locum to non-locum hospitalists. Methods: We conducted a classical [...]

Background: Alcoholic hepatitis (AH) related admissions have been increasing, and severe AH (as defined by a discriminant function [DF] > 32) can carry a one-month mortality rate of up to 50% (Crabb et al). With rising mortality from alcoholic liver disease, early detection of alcohol use disorder to achieve cessation and prevent progression to alcoholic [...]

Background: Hospital at home (HaH) programs have shown efficacy as substitutes for high-cost, traditional hospitalization in patients who are primarily low-acuity and with a range of medical conditions, including community-acquired pneumonia (CAP) and urinary tract infection (UTI). However, wide-spread adoption is minimal as providers and patients are challenged to consider HaH at the time of [...]