Background: Hospitalized patients are often kept fasting for various reasons, including clinical conditions, procedures and imaging, or dysphagia (1). Studies have demonstrated the harm of excessive fasting, including increased post-operative delirium (2), thirst and hunger, and patient dissatisfaction. Accordingly, recent guidelines have promoted a more liberal preoperative fasting strategy, namely, allowing clear liquids up to [...]

Background: Diabetes is a chronic disease that has turned into a global healthcare epidemic. With time, the focus in diabetes care has shifted to patient education and empowerment. Diabetes educators are professionals who focus on educating individuals with and at risk for diabetes to become effective self-managers. Diabetes educators do not only provide information and [...]

Background: Observation status was designed to reduce health care costs for patients in need of short hospital stays. CMS suggests that observation care should typically require less than 24 hours, and only rarely last more than 48 hours. However, studies suggest that length of stay for observation patients is often longer than CMS guidance.[1,2] An [...]

Background: Bed-rest is considered essential to recovery. Functional decline in older patients is an often-overlooked riskfactor during hospitalizations. Older patients have higher 30-day readmission rates, more complications,and longer lengths of stay. Increasing the amount of walking in the hospital has been identified as a potentialsolution, with 900 steps per day identified as a target to [...]

Background: The hospital discharge process is challenging and opportune for human error. Medication discrepancies continue to be a patient-safety problem, exacerbated with the multiple sources of discharge medication documentation. Medication discrepancies may lead to medication errors and may contribute to adverse drug events with potential subsequent healthcare utilization and cost. Discharge medications can be listed [...]

Background: Deep Vein Thrombosis (DVT) is a pathology characterized by the formation of a blood clot inside the venous system. It comprises either distal vein thrombosis, but also proximal vein thrombosis (i.e. Femoral, Popliteal and Iliacal veins), which leads to a significant increase in complications of the disease, such as pulmonary thromboembolism (PE) and even [...]

Background: Physicians increasingly utilize electronic health records (EHR) to deliver healthcare, and the EHR has been identified as leading source of physician burnout and frustration [Shanafelt et al]. Studies report up to 52.6% of hospitalists exhibit symptoms of burnout [Roberts et al]. However, there is no data to inform how hospital medicine physicians spend their [...]

Background: The transitioning from pediatric to adult care has been correlated with worsened outcomes including increased mortality [1]. Improving patient experience (PEX) has been correlated to improved adherence and lower inpatient mortality rates [2] as well as lower 30-day readmission rates for patients with heart failure, acute MI and pneumonia [3]. Young adults transiting from [...]

Background: Despite system-level focus on avoidance of potentially preventable hospitalizations, the decision to admit a patient with low medical acuity has been understudied. Our study sought to identify factors associated with admission versus discharge from the Emergency Department (ED) for patients considered unlikely to be medically appropriate for admission. Methods: We conducted a retrospective cross-sectional [...]

Background: Hospitalists have increasingly engaged in admission decision-making for acute care medical patients. The role, duties, and impact of a Hospital Medicine Triage Attending (“triagist”) are emerging yet ill-defined. To our knowledge, no study thus far has catalogued the activities of these physicians in a comprehensive way. Our objectives were to 1) characterize the demands [...]