Background: Microaggressions (adapted from Sue et al. 2007) are “brief and commonplace verbal, behavioral, or environmental indignities, whether intentional or unintentional, that communicate hostile, derogatory, or negative slights and insults with regards to race, gender, religion, or sexual orientation that target a person or group”. In healthcare, studies have examined microaggressions’ effect on trainee experience, […]

Background: Medicare patients account for over 50% of hospital days and over 30% of all hospital discharges in the United States. The number of healthcare providers with specialized geriatric training dedicated to the care of hospitalized vulnerable older adults is currently insufficient. The growth of the hospitalist movement has become the key strategy for providing […]

Background: Communication failures amongst interdisciplinary internal medicine (IM) teams occur often in the inpatient setting, which can inhibit mutual understanding of care plans, increase the potential for medical error, and contribute to patient dissatisfaction. Efforts to enhance interdisciplinary collaborative teamwork within inpatient IM teams highlighted a critical need to address concerns related to communication. Methods: […]

Background: Press–Ganey survey data suggest that low self‐assessment of discharge preparedness is associated with hospital readmission. However, Press–Ganey data are collected after hospitalization, limiting the ability to respond to concerns. The intent of this project was to implement a predischarge patient satisfaction survey to determine if there was an association between low self‐assessed discharge readiness […]

Background: Multidisciplinary rounding (MDR) is a necessary component to safe and effective patient care and discharge during hospitalization. However, there are many barriers to daily MDR that can limit the effectiveness of the team. An interdisciplinary needs assessment of MDR at our institution revealed poor communication on plan of care and limited understanding of interdisciplinary […]

Case Presentation: This is a 53‐year‐old African American woman with a history of hypothyroidism and active cocaine and alcohol abuse who presented to the emergency department with acute‐onset altered mental status, hypotension, and tachycardia. She appeared pale and disheveled, was confused, and had poor attention span. Her examination was otherwise unremarkable. Admission labs revealed profound […]

Background: There is a paucity of literature examining length of stay for medical patients requiring discharge to subacute rehabilitation facilities (SAR). At our institution, this subset of patients had an average length of stay (ALOS) of 8.2 days while medical patients being discharged to home had ALOS of 4.2 days during the first half of […]

Background: Late afternoon hospital discharges contribute to admission delays, leading to occupancy increase and increased length of stay. However, prominent workplace barriers often exist towards improvement initiatives that target early discharge. Team members cite timing of rounds, absence of early discharge support resources, communication breakdowns, and increased daytime admission volume as barriers to change. Furthermore, […]

Case Presentation: A previously healthy 41‐year‐old man presented to the emergency department (ED) with right‐sided pleuritic chest pain of 1‐week duration. He was diagnosed with right lower lobe pulmonary embolism (PE) on CTA of the chest, attributed to recent prolonged travel history, and the patient was subsequently discharged home on warfarin. After 2 weeks, patient […]

Case Presentation: A 70‐year‐old man with biliary cancer was treated with a 5‐fluorouracil (5‐FU)–containing regimen. Three days after his first cycle, the patient presented with chemotherapy‐induced nausea and vomiting. Over the next week, he developed mucositis, diffuse maculopapular rash, pancytopenia, and fever. Infectious workup was negative . He was treated supportively with growth factors and […]