Background: There were approximately 46,000 opioid overdose deaths in 2017. It is known that opioid overdose risk is increased in patients with a diagnosis of substance use disorder, prior opioid overdose, and high suspicion of risk as assessed by clinical teams. The Risk Index for Overdose or Serious Opioid-Induced Respiratory Depression (RIOSORD) is a validated [...]

Background: Delirium is a common complication within the hospital setting with nearly one in three older patients experiencing it during hospitalization. Reduction in delirium is associated with decreased falls, decreased distress of patients and caregivers, and decreased length of stay as a result. Identification and reduction of delirium, therefore, is of the utmost importance to [...]

Background: Trauma co-management is a growing field within hospital medicine. While improvements in quality metrics have been documented in other co-management services, the impact of co-management of trauma patients is uncertain. This study aimed to determine whether a hospitalist trauma co-management program improves clinical outcomes. Methods: This was a pre- and post-implementation study comparing trauma [...]

Background: Procedural complications are a common source of adverse events in hospitalized patients(1, 2). In academic centers, bedside procedures have traditionally been performed by trainees, often without experienced proceduralist supervision, or referred to interventional radiology or consultant services, often with an associated delay in procedure performance. Many trainees report discomfort with their skill in performing [...]

Background: Sepsis is a common and life-threatening complication of infection that disproportionately affects patients with chronic comorbidities. Timely fluid resuscitation is a key initial management strategy for reducing sepsis mortality; however, patients with serious comorbidities are often excluded from clinical trials. The Surviving Sepsis guidelines suggest that patients meeting severe sepsis criteria should be administered [...]

Background: The Choosing Wisely Campaign started in 2012 with the aim of promoting high-value care. On its Choosing Wisely List, the Society of Hospital Medicine cited daily basic metabolic panel (BMP) and complete blood count (CBC) testing in the absence of clinical suspicion as unnecessary practice. Since the implementation of Choosing Wisely, there have been [...]

Background: High levels of interprofessional collaboration and communication have been shown to lead to better patient safety outcomes, improved patients’ satisfaction and quality of care, as well as higher job satisfaction for doctors and nurses alike. Yet, challenges to nurse-doctor collaborations exist. One way of improving interprofessional collaboration may be through structured co-teaching by nurses [...]

Background: As a result of COVID-19, clinical care across the U.S. has changed with virtual services becoming the new normal in many clinics.1-5 How these changes impact patient care following hospitalization is unclear as data are limited.6 We report on characteristics and rates of clinic follow up and satisfaction with care in patients discharged during [...]

Background: Literature on the prognostic value of laboratory tests on patients hospitalized with COVID-19 is sparse.1-4 Based on available evidence our institution developed a protocol for care of patients admitted with COVID-19. In addition to routine labs (complete blood count, complete metabolic panel, venous lactate, etc.), the protocol recommends a set of COVID-specific daily lab [...]

Background: Prior studies have found racial disparities in how patients are assessed for pain and prescribed opioids from emergency department and surgical settings. However, we do not know whether similar disparities exist among general medicine inpatients. We examined opioid prescriptions at discharge among adults admitted to the general medicine service at our medical center, with [...]