Background: Migraine headache (MHA) is a common pediatric disorder, which frequently leads to hospital admission. Inpatient MHA treatment involves ever-increasingly complex treatment plans, including fluid resuscitation and a variety of medications. Severe Migraine headache may require more aggressive therapy such as dihydroergotamine (DHE) and sphenopalatine ganglion (SPG) block that may prolong hospital stay and increase [...]

Background: Family centered rounds (FCR) is an important approach in patient care that allows for multi-disciplinary collaboration and active involvement of patients and families in shared medical decision making. FCR has been recognized by the American Academy of Pediatrics (AAP) as a standard of care but the definition and implementation of FCR can be highly [...]

Background: Despite the benefits of electronic health records, they have propagated lengthy and redundant notes. At our tertiary care pediatric hospital with a high degree of trainee turnover we identified high variability in documentation in our pediatric hospital medicine (PHM) progress notes with significant note bloat. We aimed to standardize and shorten the length of [...]

Background: Each year, 14 million Americans are diagnosed with HPV and 33,700 Americans are diagnosed with a cancer caused by HPV. The HPV vaccination can prevent 92% of these cancers. In 2018 only 42.74% of adolescents in Wisconsin ages 13-18 had completed the HPV series and only 56.47% had received the first dose. Hospitalization represents [...]

Background: Nosocomial infections contribute significantly to morbidity and increase health care costs for both pediatric and adult patients in the United States.(1) Intravenous access remains a main source of nosocomial infections from environmental and (non-intentional) aseptic technique violations by healthcare providers via contact with stopcocks, IV tubing, and syringes.(2,3) Stopcock contamination and repeated syringe strokes [...]

Background: Family-centered rounds on our pediatric hospital medicine teaching service, which cares for patients in multiple units throughout the hospital, are often prolonged with unpredictable progression. This contributes to inconsistent nursing participation, inefficiencies in patient care, and variable end times. Through the implementation of scheduled-based rounding, our aims were to: 1) start 90% of rounds [...]

Background: Delirium is a well know post-operative complication that has been shown to increase mortality, length of stay, and post-operative complications. Despite extensive study, there is limited treatment for delirium once it occurs. Emphasis on preventing delirium and identifying patients at risk is an important part of reducing its impact on the individual and the [...]

Background: Intravenous (IV) low molecular weight iron dextran is a safe and effective treatment for iron deficiency anemia (1). However, oral (PO) iron supplementation remains a preferred mode of iron repletion due to low cost and ease of administration. Unfortunately, the efficacy of PO iron varies due to differences in drug absorption and patient adherence. [...]

Background: The Society of Hospital Medicine (SHM) is the academic professional home for more than 16,000 hospitalists around the world [1]. The SHM Quality Improvement (QI) Special Interest Group (SIG), which currently has 813 members including residents and medical students, known as QI enthusiasts, uses an online platform, Hospital Medicine Exchange (HMX), to share project [...]

Background: Despite the consistently proven benefits of cardioprotective medications, medication adherence (MA) remains a challenge in coronary artery disease (CAD) patients. Studies suggest that up to 50% of patients with CAD are nonadherent to medications, with patient knowledge, beliefs, and expectations playing a vital role. We aimed to assess patient-related medication non-adherence (MNA) factors in [...]