Background: Catheter occlusion is one of the most common complications associated with Peripherally Inserted Central Catheter (PICC) insertion, affecting 1 in every 8 PICCs placed. Occlusion may have important consequences for patients including inability to use the device, delays in tests or treatment, or if irreversible the need to remove and replace the device. Based [...]

Background: Heart Failure (HF) is an important health care issue given its high prevalence, mortality, and cost of care. By 2030, greater than 8 million Americans will be living with HF. The projected cost will increase to close to 70 billion with the majority of the cost attributed to hospitalization. Despite numerous evidence-based strategies in [...]

Background: Social isolation (SI) is a largely silent and unrecognized social determinant of health that has negative health outcomes, including increased mortality, depression, hospital readmissions, and emergency room visits. In addition, a recent study revealed that SI and loneliness (L) are self-reported as often as food and housing insecurity. While hospitals readily work on food [...]

Background: In the quest to improve patient satisfaction scores, providers and health systems alike are frustrated with the inability to obtain real-time satisfaction data. Indeed, HCAHPS data lags by six months, and makes it exceedingly difficult to provide real-time feedback to physicians on their communication with patients. As a result, we developed a patient-centered audit [...]

Background: There are no guidelines for designing or evaluating fixed-content signs or electronic displays used to communicate patient-related information in hospital rooms. Accordingly, there is the potential for the displayed information to be ignored, misinterpreted, or distracting in the complex hospital room environment where patients, nurses, and physicians change frequently. Purpose: To address this shortcoming, [...]

Background: The electronic health record (EHR) is a major focus of a hospitalist’s daily work but is also often a frustration. Organizations offer providers the chance to recommend improvements to the system, but frequently there are significant delays in implementation or the request does not even cross the threshold for institutional action. Additionally, of those [...]

Background: As inpatient medical care has increased in complexity and fragmentation, rounding has become siloed away from patients and by discipline, resulting in disjointed and inefficient care models. In response, hospitalist groups across the country have been implementing unit-based rounding programs to centralize communication and align work-flow of health care team members. At UC San [...]

Background: POCUS is increasingly being used across medical specialties, and adds value to diagnostic accuracy for numerous pathologies and levels of acuity. Emergency Medicine providers were early adapters, providing examples of how POCUS increases patient satisfaction and diagnostic clarity (1, 2). Internal Medicine and Family Medicine have been slower to adopt this technology; however, general [...]

Background: The Department of Veterans Affairs (VA) originally released the Computerized Patient Record System (CPRS) in 1997. While revolutionary for its time, there has been limited substantial update in the last twenty years. Customization opportunities and ease of acquiring data are limited compared with newer, widely adopted electronic health record (EHR) systems. Purpose: To develop [...]

Background: Rural areas are disproportionately affected by physician shortages, and small rural hospitals in particular struggle to staff acute medicine services 24/7. Telehospitalist models are emerging as an alternative to provide inpatient medicine services in rural settings. In a 2018 needs assessment of rural Veterans Health Administration (VHA) hospitals, 60% percent reported being short on [...]