Background: Assessing severity of illness using available electronic medical record (EMR) data on admission and predicting inpatient mortality is very challenging. Lacking standardized practices around end of life issues, hospitalists use their clinical judgment in making these crucial decisions. Prolonged discussions may be needed in medically complex patients to direct an optimal plan of care […]

Background: Hospitalists often care for patients with serious illness and commonly review and discuss advance care planning (ACP). Documented ACP conversations can be difficult to access in the electronic health record (EHR) due to the lack of a centralized location for ACP documentation and individual clinician practice variation leading to ACP documentation existing in multiple […]

Background: Hospitalists often care for patients with serious illness and commonly review and discuss advance care planning (ACP). Documented ACP conversations can be difficult to access in the electronic health record (EHR) due to the lack of a centralized location for ACP documentation and individual clinician practice variation leading to ACP documentation existing in multiple […]

Background: Patients admitted to the hospital without a documented code status specifying what, if any, heroic measures they would consent to in the event of an emergency are at risk for receiving medical interventions that are not goal concordant with their wishes1. This invites patient harm, patient and family dissatisfaction, and may increase hospital length […]

Case Presentation: A 49‐year‐old man presents with acute‐onset fever and confusion for one day. He has a history of type 2 diabetes mellitus and polycythemia vera complicated by myelofibrosis, and he underwent bone marrow transplant 3 months prior to admission. He is maintained on weekly chemotherapy via a mediport. His medications included cyclosporine, prednisone, voriconazole, […]

Case Presentation: A 67‐year‐old man with long‐standing bipolar disorder presented with acute psychosis. Two weeks after initiation of clozapine, the patient began to experience lethargy, vomiting, diarrhea, low‐grade fevers, and tachycardia. Physical exam revealed a new late‐systolic murmur that was loudest at the left lower sternal border. Labs revealed an elevated white blood cell count […]

Background: Although the vast majority of adult patients in the United States prefer to die at home, most patients die in acute care settings. Barriers include advanced care planning, communication between inpatient and outpatient providers, and delivery of medical equipment. In 2018, our General Medicine Service Line ranked 73rd out of 98 Academic Medical Centers […]