Background: Pain management is complex, and multiple variables may affect pain relief for patients. It is estimated that roughly 40% of hospitalized patients experience moderate to severe pain. Because hospitalists now care for an increasing number of inpatients across the United States, developing hospitalist‐based quality improvement for pain is essential, both for improving patient care […]

Background: Central line-associated bloodstream infection (CLABSI) is a morbid and potentially lethal complication. National policies related to CLABSI mandate public reporting of this adverse event, with hospitals receiving penalties based on their CLABSI rates. Contemporary data suggest that peripherally inserted central catheters (PICCs) placed outside critical care settings are a large contributor to hospital CLABSI […]

Case Presentation: A 62‐year‐old woman with no medical history presented with 1 month of recurrent palpitations and near‐syncope. Two weeks previously she had a normal EKG and exercise stress echocardiogram. The patient's symptoms continued to worsen, and on re‐presentation, she was found to have multiple episodes of wide‐complex tachycardia at 150 beats/minute. EKG (Figure) revealed […]

Background: Hospitals are nationally ranked on the basis of comparisons of quality of care, mortality, readmissions and health care associated infections.1 Center for Medicare and Medicaid Services (CMS) looks at these top 6 illnesses; stroke, pneumonia, heart failure, chronic obstructive pulmonary disease, acute myocardial infarction and coronary artery bypass graft (CABG) to compare hospital’s specific […]

Background: Code status discussions and documentation are a key part of inpatient care for hospital medicine providers as they become more involved in caring for those with advanced illness. Hospitalists are challenged both with efficiently addressing a complicated subject due to time constraints and by a lack of established patient relationships. If it is not […]

Case Presentation: This 34‐year‐old woman presented with an 8‐month history of frequent emergency department visits related to episodically severe and progressively frequent nausea, vomiting, and abdominal pain. She had no neurological symptoms at the time. Despite of extensive diagnostic tests and procedures, the etiology of the bouts remained elusive. She was treated empirically for gastritis […]

Case Presentation: A 62‐year‐old man with diabetes and recent subdural hematoma presented from another hospital with lethargy. At transfer, he was afebrile, hypertensive, disoriented to time and place but able to follow instructions. He had a sixth cranial nerve palsy and anasarca. White blood cell count was 7500, urea nitrogen 48, creatinine 2.1, and albumin […]

Background: Clinical reasoning is a core component of medical training yet learners receive very little formative feedback on their clinical reasoning documentation. We hypothesize that this is related to the lack of a shared assessment rubric and faculty time constraints. Purpose: Here we describe the process of developing a machine learning algorithm for feedback on […]

Background: For academic hospital medicine groups to thrive and be partners with their hospital systems, physicians must document and bill appropriately as a means of demonstrating their clinical value. Yet, many major academic hospital medicine groups may be unaware or receive little training for this very important skill set. Based on data from the Society […]

Case Presentation: A 65‐year‐old man with a medical history of hypertension, tobacco use, a recent L3–L5 laminectomy, and posterior spinal fusion was hospitalized with fever, dyspnea, and pleuritic chest pain of 2 days' duration. A month prior to this admission he had q laminectomy with spinal fusion that was later complicated by MRSA wound infection. […]