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: 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: Approximately 1.6 million patients are transferred between hospitals yearly, with disproportionately high cost and mortality. Despite the risk associated with inter-hospital transition of care, there is no established best practice in coordinating and triaging transfers. This gap in knowledge is partly driven by a dearth of studies which integrate clinical data before and after […]

Background: In many teaching hospitals, internal medicine residents participate in a majority of patient interactions. However, the impact of trainees on patient satisfaction and the care experience is unknown. We sought to determine how resident providers impact inpatient ratings of doctor communication and global satisfaction via the Healthcare Consumer Assessment of Healthcare Providers and Systems […]

Background: Since the “birth” of hospitalist in mid-nineties, it took 20 years to grow from zero to 50,000 physicians in 2016. In the U.S, internal medicine (IM) services are covered by different models, including teaching IM services and non-teaching services. Non-teaching services are attended by hospitalists or outpatient-practicing internists. Methods: We conducted a classical prospective […]

Background: Ultrasound guidance is an invaluable technique for obtaining vascular access. The Agency for Healthcare Research and Quality (AHRQ) determined that this is required for patient safety during all central line placements. The need for peripheral access in anatomically challenging patients is also becoming a more commonly encountered clinical problem. However, support for the placement […]

Background: Our previous research has confirmed that bleeding from paracenteses is unrelated to coagulation parameters or the presence of blood‐thinning/antiplatelet medications. However, despite this and the routine use of ultrasound, we have consistently witnessed a postprocedure intra‐abdominal bleeding rate of 0.3% (unpublished internal quality data). Given our annual volume of 1200 paracenteses, this translates into […]

Background: In 2016, around 94% of healthcare facility managers used locum tenens physicians in the previous 12 months. One-quarter of them were locum hospitalists, making hospitalists as the second most common service in demand for locum physicians. There are no prospective studies comparing the care of locum to non-locum hospitalists. Methods: We conducted a classical […]

Background: Hospital at home (HaH) programs have shown efficacy as substitutes for high-cost, traditional hospitalization in patients who are primarily low-acuity and with a range of medical conditions, including community-acquired pneumonia (CAP) and urinary tract infection (UTI). However, wide-spread adoption is minimal as providers and patients are challenged to consider HaH at the time of […]

Background: Documentation of in‐hospital cardiac arrest commonly consists of a paper transcript of the interventions provided during a resuscitation. However, this method of documentation is notoriously unreliable, often lacking the accuracy that is necessary for recording a fast‐paced resuscitation. Quality improvement of resuscitation practices requires precise and uniform documentation of interventions, including exact time of […]