Background: Residents identify formal didactic teaching (FDT) as a critical component of learning on the medical wards on annual residency surveys. Similarly, faculty express a desire to incorporate FDT into the daily inpatient rotation experience. However, both residents and faculty note multiple barriers to its consistent implementation. We aim to study the impact of various [...]

Background: Throughout the COVID-19 pandemic, the practice of intubation for hypoxemic respiratory failure secondary to presumed COVID ARDS has shifted from earlier to later intubation at our hospital. Patients are now intubated for respiratory fatigue rather than for only hypoxemia. Timing of intubation has not been associated with change in mortality based on one recent [...]

Background: On March 7, New York was declared in “State of Emergency”; all Emergency Room and hospital facilities in NYC were overwhelmed by the rapid and high influx of patients with COVID-19 infection. At least 20% of patients with criteria for hospitalization received mechanical ventilation, and the Mortality reached 80% in a time when the [...]

Background: ARDS incidence in patients with COVID-19 pneumonia varies from 15-42%; between 5-20% of patients with hospitalization criteria received mechanical ventilation (1-3). Prone positioning demonstrated mortality benefits for patients with Severe ARDS (sARDS) with lung injury, but its use in patient COVID-19 is not clear (4-6). ARDS protocol (ARDSp) is recommended by ATS and The [...]

Background: Acute otitis media (AOM) is a commonly overtreated pediatric diagnosis. Since 2014, the American Academy of Pediatrics (AAP) has recommended a ‘wait-and-see’ strategy and shorter antibiotic courses for mild or moderate AOM in qualifying patients. While this strategy has been successfully implemented in some pediatric emergency units (EUs), studies have shown that 30-90% of [...]

Background: The management of cellulitis in young infants has not been well-studied and appears to be largely variable. Infants with cellulitis often present without fever and only skin findings, with only a small minority having invasive infection. There is no consensus on the need for admission and further workup, such as a lumbar puncture. The [...]

Background: Community acquired pneumonia (CAP) is one of the leading causes of hospitalization in the United States.[1] In an effort to improve the quality of care for this resource-intensive disease, our institution implemented a clinical decision support (CDS) pathway for CAP comprised of three phases: (1) education on best practices, (2) education and a CDS [...]

Background: Geographic decentralization of inpatient teaching teams has been shown to impair physician-nurse communication and efficiency of care. Reliance upon paging or messaging increases probability of miscommunication. Importantly, the inclusion of nurses as integral members of the care team cannot be fully realized in the absence of consistent provider presence on the unit. Purpose: Prior [...]