Background: Nationally, internal medicine (IM) residency programs have been struggling with the balance of protecting residents from exposure to COVID-19, ensuring they are sufficiently trained in general medicine while still teaching them about a new disease process and preparing them to help fight the pandemic (1). Anxiety is common amongst providers in a pandemic, especially [...]

Background: In 2016, the Sepsis-3 taskforce posited that acute organ failure is the defining feature of sepsis. Accordingly, they recommended that an acute rise in the Sequential Organ Failure Assessment (SOFA) score by 2 points over baseline should replace the Systemic Inflammatory Response Syndrome (SIRS) score as the sepsis criteria (1). As a justification, they [...]

Background: Patient experience is increasingly recognized as a measure of healthcare quality and patient-centered care. However, there is insufficient understanding of patient expectations during hospitalization, and of how these are perceived by physicians, nurses, and administrators. The best way to apply the HCAHPS ratings remain elusive due to variability in practice environments, patient and clinician [...]

Background: In 2013, the American Academy of Pediatrics’ position statement, “Guiding Principles for Pediatric Hospital Medicine (PHM) Programs,” emphasized the importance of professional development for each PHM physician. However, little is published about PHM physicians’ perspectives on professional development. The objectives of this study were to explore pediatric hospitalists’ perceptions of professional development needs, desired [...]

Background: Hospitalists increasingly confront patient care and policy dilemmas due to financial incentives created by bundled payments, single payments that “bundle” acute and post-acute care for specific diagnoses. The most common and most successful bundled payment has been for total joint replacement, where cost savings have been achieved through discharging patients to home rather than [...]

Background: Rich sources of data are available in hospitals, but are often housed in different systems. These include electronic health records (EHRs), physician scheduling software, and existing tools that can be used to electronically contact clinicians. Developing a streamlined way to integrate and connect disparate data has enormous potential for clinical care, operations, and research. [...]

Background: On a daily basis, hospitalists prescribe Venous Thromboembolism (VTE) prophylaxis. While of benefit to certain populations, VTE prophylaxis has not been proven to benefit medical patients at low risk for VTE. Pharmacologic prophylaxis may increase the risk of serious bleeding, mechanical prophylaxis is associated with an increased risk of delirium, and both methods are [...]

Background: Unit-based care teams offer inherent benefits to hospitalist services, including opportunity for improved efficiency, interdisciplinary collaboration, and enhanced patient experience. However, many barriers exist to creation of these care teams such as high occupancy rates and conflicting interests among stakeholders.  Failure to account for such barriers has led to unsuccessful initiatives to achieve regionalization, [...]

Case Presentation: We report the case of a 69-year-old Honduran male with a long history of non-valvular atrial fibrillation with a CHA2DS2-VASc Score= 2 (Age > 65 and Hypertension) anticoagulated with Rivaroxaban 20 mg po daily since 2013.  He presented with sudden onset of excruciating upper and lower back pain while seated at his cardiologist’s [...]

Case Presentation: A 44-year-old female with end-stage renal disease on hemodialysis presented to the hospital with progressive nausea, vomiting and abdominal pain. The etiology of her renal disease was unknown. She had received a renal transplant 17 years ago, which then failed. She was maintained on peritoneal dialysis (PD) for 12 years until she was [...]