Background: The landmark adoption of the 80 hour work week by the Accreditation Council for Graduate Medical Education (ACGME), followed by shift-length restrictions has forced both hospitals and residency programs to restructure who provides acute medical care and in what fashion. Academic Medical Centers have increasingly relied on hospitalists as traditional teaching attendings, in the […]

Background: ST elevation MI is an acute event that mandates immediate intervention. Often, resources play a major role to enable prompt intervention. Our study aims to elaborate any differences that may exist between weekend and weekday outcomes at a national level. Methods: We conducted a retrospective analysis of the Nationwide Inpatient Sample (HCUP-NIS) database. Patients […]

Background: New Mexico has a long-standing history of implementing harm reduction strategies for the prevention of opioid overdose. Most recently, on June 14, 2019, SB221 added language to the New Mexico Pain Relief Act requiring health care providers prescribing opioid analgesics for 5 days or longer to co-prescribe an opioid antagonist along with written information […]

Background: Quality improvement and patient safety (QI/PS) is a major focus for hospitalists in both their day-to-day clinical care. In addition, many hospitalists have educational and administrative QI/PS duties, and salary support for them is highly sought after. As part of an ongoing effort to help identify opportunities to further support members of the Society […]

Background: Rest is critical to healing, yet a child’s sleep during an inpatient hospital admission is often disrupted. One such disruption is oral medication administration, which is commonly scheduled around the clock (q6h, q8h, q12h) by default, despite comparable efficacy during waking hours. Previous studies suggest that flexible medication times help inpatients sleep longer and […]

Background: Time motion studies are often conducted to describe activities of physicians caring for hospitalized patients with the goal of improving efficiency and patient safety. Prior work has mostly focused on trainees at academic medical centers. However, with the growth of hospital systems, most academic hospitals now have a similar number of patients cared for […]

Background: Rural areas are disproportionately affected by physician shortages, and small rural hospitals in particular struggle to staff acute medicine services 24/7. Telehospitalist models are emerging as an alternative to provide inpatient medicine services in rural settings. In a 2018 needs assessment of rural Veterans Health Administration (VHA) hospitals, 60% percent reported being short on […]

Case Presentation: A 14-year-old previously healthy male presented to a community hospital for sudden repeated episodes of initially non-bloody, and then grossly bloody, emesis. He denied sick contacts, travel, significant NSAID use, alcohol consumption, and caustic ingestions. On presentation, he had normal vital signs, mild epigastric tenderness, and heme-positive dark stool. His labs were notable […]

Case Presentation: A 74-year-old female, with no significant past medical or travel history, developed sepsis 2 days after undergoing debulking surgery for stage IIIc ovarian carcinoma. Blood cultures were positive for gram-negative bacilli and the organisms identified as Enterobacter spp. with blaIMP MBL (Verigene). Antimicrobial susceptibility testing demonstrated high-level resistance to all penicillins, ureidopenicillins, cephalosporins, […]

Case Presentation: A 73 year-old man with type 2 diabetes mellitus (hemoglobin A1c 7.5), hypertension, hyperlipidemia, chronic renal failure stage 3a, and a distant 10 pack year smoking history presented with 2 weeks of substernal chest tightness and dyspnea on exertion. He was hemodynamically stable without tachypnea at rest. Examination revealed a grade 2/6 holosystolic […]