Background: Pain management is complex, and multiple variables may affect pain relief for patients. It is estimated that roughly 40% of hospitalized patients experience moderate to severe pain. Because hospitalists now care for an increasing number of inpatients across the United States, developing hospitalist‐based quality improvement for pain is essential, both for improving patient care […]

Background: Central line-associated bloodstream infection (CLABSI) is a morbid and potentially lethal complication. National policies related to CLABSI mandate public reporting of this adverse event, with hospitals receiving penalties based on their CLABSI rates. Contemporary data suggest that peripherally inserted central catheters (PICCs) placed outside critical care settings are a large contributor to hospital CLABSI […]

Background: Despite the benefits of electronic health records, they have propagated lengthy and redundant notes. At our tertiary care pediatric hospital with a high degree of trainee turnover we identified high variability in documentation in our pediatric hospital medicine (PHM) progress notes with significant note bloat. We aimed to standardize and shorten the length of […]

Case Presentation: A 44‐year‐old man was reported to be wandering naked in the streets of his town and behaving erratically. Police were summoned. He was evasive and combative when officers attempted to apprehend him, leading to the use of an electronic control device (ECD) with which he was shocked 3 times. It was reported by […]

Background: Spontaneous bacterial peritonitis (SBP) is a commonly encountered complication of end stage liver disease that carries a high morbidity and mortality. Risk factors for SBP are defined by the American Association for the Study of Liver Diseases (AASLD) as a prior history of SBP, active gastrointestinal bleeding, and low ascites total protein (< 1.5 […]

Case Presentation: A 58‐year‐old African American man presented to our hospital with confusion, diffuse morbiliform rash, facial edema, fever to 41.1°C, leukocytosis with eosinophilia, acute kidney injury, transaminitis, and elevated creatinine kinase. Extensive evaluation for possible infection, including urine, blood, and CSF cultures, was negative. Six weeks prior to admission the patient had been started […]

Background: It has been reported that vaccination rates with pneumococcal vaccine are low in elderly persons in Japan. The primary aim of this study was to examine whether introduction of a vaccination status checkbox in electronic medical records increased the vaccination rates. Methods: Subjects were inpatients and outpatients in the Department of General Medicine at […]

Case Presentation: A 47‐year‐old female smoker presented to the emergency department for right rib pain for 4 days. She had nausea, nonbloody and nonbilious emesis, nonproductive cough, and sore throat. She denied fever, headaches, dizziness, chest pain, palpitations, shortness of breath, or dysuria. In the emergency department, a computed tomography scan showed consolidation in the […]

Case Presentation: An 88‐year‐old man with a medical history of atrial fibrillation presented with dyspnea for 1 week. He endorsed bilateral leg edema, orthopnea, and productive cough of pinkish sputum. He denied fevers, chest pain, and palpitations and had no recent travel history, prolonged period of immobility, or reported history of congestive heart failure. He […]

Background: Physicians increasingly utilize electronic health records (EHR) to deliver healthcare, and the EHR has been identified as leading source of physician burnout and frustration [Shanafelt et al]. Studies report up to 52.6% of hospitalists exhibit symptoms of burnout [Roberts et al]. However, there is no data to inform how hospital medicine physicians spend their […]