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: The age‐old practice of writing a doctor's letter of condolence provides a way for physicians to share the grief of losing their patients while communicating the impact of a therapeutic doctor–patient relationship. Studies show that house staff and hospitalists rarely write letters of condolence, citing lack of time, uncertainty of the appropriate expression of […]

Background: There is a significant impact of influenza on the individuals, families, and societies, both economically and clinically, in terms of hospital admissions, medication expenses and side effects, secondary bacterial infections and more days off from work or other forms of reduced productivity for the patients or their caretakers. Our objective is to present the […]

Background: Persons with opioid use disorders (OUD) represent a disproportionately high percentage of hospitalized patients, have greater lengths of stay and readmissions, can incur higher costs, and are at greater risk of drug-related death immediately post-discharge. Further, despite the availability of effective medications for OUD, patients often are not offered treatment during the inpatient encounter. […]

Background: Transition from an acute care setting to a skilled nursing facility (SNF) or home is ripe with opportunities for poor communication. Changes in medications, lack of understanding about disease processes, and inadequate discharge teaching make patients vulnerable. Misunderstanding or lack of recognition can result in a readmission. Thus, 30‐day readmissions to the hospital are […]

Background: Mitochondrial disease (MD) refers to a group of clinically heterogeneous disorders that result from dysfunctional oxidative phosphorylation and subsequent cellular incapability to meet energy demands. Mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes (MELAS), myoclonus, epilepsy, ataxia with ragged red fibers (MERRFs), chronic progressive ophthalmoplegia, Kearns–Sayre syndrome, and sensory ataxia neuropathy dysarthria ophthalmoplegia are among […]

Background: As hospitals work to reduce avoidable hospital readmission rates, health care delivery systems more broadly have been working to develop efficient, effective health care delivery models under the rubric of accountable care organizations (ACOs). As the principal providers of inpatient‐based care, hospitalists can build on their quality improvement experience in transitions of care to […]

Background: ACGME Milestones and Entrustable Professional Activities (EPA) have emerged as benchmarks for the professional development of house staff. Residents must demonstrate expertise in these patient care activities in order to progress in training, and thus, programs will require tools for direct observation in order to evaluate these skills. These tools must evaluate milestone‐specific performance […]

Background: Postmyocardial Infarction Syndrome (PMIS), also called Dressler syndrome or Post-pericardiotomy Syndrome, refers to a heterogeneous group of autoimmune-mediated conditions of pericardial, epicardial and myocardial inflammation following myocardial infarction. Generally considered to be rare in the reperfusion era, the features and risk factors of PMIS are less well characterized in the contemporary era. This study […]

Background: The 2016 Surviving Sepsis Campaign guidelines recommend antibiotic administration within 1 hour of emergency department (ED) presentation for patients with sepsis. While early antibiotics are associated with reduced mortality, the 1 hr policy has been criticized for its one-size-fits-all approach and risk for over-diagnosis and treatment. Clinicians and quality leaders have called, instead, for […]