Background: Risk assessment for venous thromboembolism (VTE) is a part of every hospital admission. The workflow of who completes the assessment varies between hospitals, but often it is carried out by trainees. VTE risk assessment is further complicated by the variety of methods to identify those patients who are appropriate for chemoprophylaxis, mechanical prophylaxis, or [...]

Background: Hematopoietic stem cell transplantation (HSCT) can be a life-saving and curative therapy in hematological malignancies. Pre-transplant evaluation for HSCT is a multidisciplinary process that can be complicated, time-consuming, and expensive for patients to navigate. The process requires coordination between several medical subspecialties including pulmonary, cardiology, and mental health, in addition to social workers and [...]

Background: Hospital medicine groups endeavor to avoid excessive workloads which can contribute to burnout. 1,2,3,4Groups vary in how new patients are distributed, but larger groups often assign a single hospitalist to carry an admitting pager and distribute new patients among several colleagues. This “admitting pager” role combines high volume with frequent interruptions and multitasking as [...]

Background: Hospitalists, rather than primary oncologists, are increasingly caring for hospitalized patients with cancer. High medical acuity, complex psycho-social issues, rapidly evolving cancer treatments, advanced care planning, and end-of-life care make management of this patient population especially challenging. The impact of the oncology hospitalist model of care delivery on clinical quality and oncologists’ work satisfaction [...]

Background: Spontaneous bacterial peritonitis (SBP) is a commonly encountered complication of end stage liver disease that carries a high morbidity and mortality. Risk factors for SBP are defined by the American Association for the Study of Liver Diseases (AASLD) as a prior history of SBP, active gastrointestinal bleeding, and low ascites total protein (< 1.5 [...]

Background: Up to 12% of hospitalized patients require high dose parenteral thiamine treatment to prevent Wernicke’s Encephalopathy, a devastating and easily preventable neurologic disorder that can lead to death. Despite the fact that it is as simple and relatively inexpensive therapy with no known side effects, high dose thiamine continues to be underutilized. Attempts to [...]

Background: Agency of Healthcare Research and Quality reported an increase in Opioid-related hospitalizations from 2005 to 2014. Previous studies in patients undergoing surgery have shown an increased risk of readmission with opioid dependence. This study was intended to identify the all-cause 7 and 30-day readmission rates of hospitalizations with opioid-related disorders, and potential predictors of [...]

Background: Until the advent of novel oral anticoagulants (NOACs), Warfarin was the only oral agent available for the treatment of deep venous thrombosis (DVT) and Pulmonary embolism (PE). Bridging with parenteral anticoagulation until warfarin reaches a full therapeutic level often results in prolonged hospitalization. Rivaroxaban, Dabigatran, Apixaban, Edoxaban were approved by the FDA for DVT [...]

Background: Recent literature supports risk stratifying patients presenting to the Emergency Department (ED) with undifferentiated chest pain based upon the HEART score. Our institution utilizes the HEART score in a chest pain pathway. Patients with scores of 0 to 3 are typically discharged home after two negative troponins while those with intermediate scores of 4 [...]

Background: Length of stay (LOS) is a key metric that hospitals follow closely for quality and operational purposes. Hospital Medicine groups frequently use LOS to evaluate their providers and to identify opportunities for improvement; however, the most appropriate methods to apply specific hospital encounters to individual providers is debated. Complex schemes of weighted Observed to [...]