Background: In hospital medicine, around 250,000 diagnostic errors occur yearly in American hospitals and a significant proportion are attributed to failures in clinical reasoning. Feedback on the diagnostic process has been proposed as one method of improving clinical reasoning. However, in the current healthcare system barriers to the delivery and receipt of feedback include limited [...]

Background: Complex non-pharmacologic interventions containing multiple, or bundled, components can successfully prevent and treat hospital-acquired delirium in older adults. However consistent implementation, and the measurement of compliance, of these bundled interventions can be challenging to sustain in hospital settings especially in presence of COVID-19. Developing workflows with a smaller sub-set of components that are feasible [...]

Background: Affecting approximately 5.9% of the US population, alcohol use disorder (AUD) has been established as a prevalent disease in this country (1). Through repeated hospital admissions for alcohol use disorder (including alcohol withdrawal syndromes), hospital costs have steadily risen to recent estimates of 7.6 billion dollars in 2017 (2). Without the establishment of outpatient [...]

Background: Post hospital discharge review during the transition from hospital to skilled nursing facility (SNF) is critical to avoid medication errors, improve patient outcomes and reduce hospital readmissions (1-3). Despite increased integration of electronic health records (EHR) across health entities, communication gaps and discharge-related medication errors still persist (2,4). These challenges can be more predominant [...]

Background: The traditional role of hospitalists is to provide care to patients hospitalized with acute medical conditions. Over the past few years, this has evolved to improve care transitions and stewardship of hospital resources. Many hospitals may embed hospitalists in the Emergency Department (ED) to improve patient flow into the hospital; however, there are sparse [...]

Background: Hospitalizations to treat SARS-CoV-2 infected patients have strained health systems worldwide. Monitored outpatient management of select low-risk COVID-19 patients with isolated exertional hypoxia could help preserve hospital resources and reduce costs while aiming to maintain a high standard of care. In this retrospective cohort analysis, we aimed to evaluate the safety and effectiveness of [...]

Background: Clostridioides difficile infection (CDI) is a common, often nosocomial infection associated with substantial morbidity and mortality. Antibiotics are the most important modifiable risk factor, but empiric antibiotics remain appropriate for many patients with severe acute illness. Which antibiotics minimize the risk of CDI remains an important unanswered question. Because protective equipment and isolation were [...]

Background: Early risk stratification scores utilizing data available at the bedside have been used regularly to identify patients at greatest risk of poor outcomes from rapidly evolving conditions like sepsis. Little is known about how point-of-care scores developed for sepsis perform at predicting outcomes in large, heterogeneous cohorts of patients with COVID-19. Our objective was [...]

Background: Prior studies have tested interventions to redesign aspects of the care delivery system for hospitalized medical patients, but the majority have evaluated the effect of single interventions. We sought to implement a set of complementary interventions and evaluate the effect on interprofessional teamwork and patient safety. Methods: The REdesigning SystEms to Improve Teamwork and [...]

Background: Patient portal use has been associated with improved patient experience, safety, and health outcomes.1,2 To keep patients better connected to their providers, our institution aimed to expand MyChart utilization. We piloted a standard operating procedure (SOP) to enhance MyChart education and uptake among those admitted to an inpatient general medicine unit. Purpose: Our intervention [...]