Background: Failure to promptly recognize clinically deteriorating patients in the hospital leads to delays in critical interventions and worse health outcomes. Current standard practice in patient monitoring on most medical-surgical wards involves vital sign assessment at discrete time points, typically every four to eight hours. More frequent or continuous vital sign monitoring has historically been […]

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: One of the challenges in hospital medicine is the care of patients overnight, when the primary team is unavailable, and care is being provided by those who are not as familiar with the patient. This is compounded by the high volume of pages at night. At UNC Rex Hospital, these factors resulted in delays […]

Background: Observation status was designed to reduce health care costs for patients in need of short hospital stays. CMS suggests that observation care should typically require less than 24 hours, and only rarely last more than 48 hours. However, studies suggest that length of stay for observation patients is often longer than CMS guidance.[1,2] An […]

Background: There are no guidelines for designing or evaluating fixed-content signs or electronic displays used to communicate patient-related information in hospital rooms. Accordingly, there is the potential for the displayed information to be ignored, misinterpreted, or distracting in the complex hospital room environment where patients, nurses, and physicians change frequently. Purpose: To address this shortcoming, […]

Background: POCUS is increasingly being used across medical specialties, and adds value to diagnostic accuracy for numerous pathologies and levels of acuity. Emergency Medicine providers were early adapters, providing examples of how POCUS increases patient satisfaction and diagnostic clarity (1, 2). Internal Medicine and Family Medicine have been slower to adopt this technology; however, general […]

Background: Uncontrolled asthma leading to emergency department (ED) visits and hospitalization causes suffering, disproportionately among underserved patients, and are costly to healthcare systems. Timely treatment and adherence to clinical guidelines via serial monitoring of patients’ reported symptoms, offers the opportunity to improve health outcomes that are important to patients, clinicians, and accountable care organizations (ACO). […]