Background: Availability of acute medical services (e.g., emergency department, intensive care unit) has been associated with adverse clinical outcomes. The association between acute psychiatric inpatient beds and suicide has not been well described. In the Veterans Health Administration (VHA), suicide rates among veterans have increased despite mental health care investments. Our objective was to examine […]

Background: Hospital readmissions continue to pose a challenge for many hospitals across the country. With the implementation of financial penalties for high rates of 30‐day readmissions in October 2012, hospitals stand to forfeit more than $280 million in Medicare funds in the next year if rates are not reduced. Despite multiple studies and programs, results […]

Background: Mentoring relationships among physicians in academic medicine have been implemented to facilitate scholarly productivity, faculty development, and retention. Mentorships have been shown to encourage productive activity (e.g., peer‐reviewed publications), drive career advancement (e.g., faculty promotion), and enhance attitudes toward work (e.g., reduced burnout). Yet few studies have examined mentorships' impact at critical points along […]

Background: Between 2007 and 2015, inpatient fluoroquinolone use declined in U.S. Veterans Affairs (VA) hospitals. Whether fluoroquinolone use at discharge has also declined, in particular since antibiotic stewardship programs became mandated at VA hospitals in 2014, is unknown. Methods: In this retrospective cohort study of hospitalizations with infection between January 1, 2014 and December 31, […]

Case Presentation: A previously healthy 49‐year old woman presented for admission after a syncopal episode. She had a 4‐ month history of fever (104°F), sweats, rigors, 40‐pound weight loss, and abdominal pain associated with alternating diarrhea and constipation. Prior workup done at another hospital including pan cultures, HIV and hepatitis testing, upper and lower endoscopy, […]

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 […]