Background: Pharmacist-led peri-discharge interventions reduce adverse drug events. However, evidence is lacking as to whether there is a business case to fund these non-billable interventions. To test whether such interventions could drive reductions in post-discharge health care utilization to help build a business case, we conducted a pragmatic randomized controlled trial (RCT). Methods: The PHARMacist [...]

Background: People experiencing homelessness (PEH) face barriers to accessing regular ambulatory care, which increases their risk of having poorly controlled chronic medical conditions and contributes to high acute care utilization. The role of field-based homeless healthcare teams in improving hypertension and diabetes control and reducing acute care utilization (e.g., emergency department [ED] visits, inpatient hospitalizations) [...]

Background: Hospitalizations related to opioid use disorder (OUD) are rising, creating opportunities to initiate medications for opioid use disorder (MOUD) and connect patients with outpatient resources.1,2 Despite evidence that MOUD reduces morbidity and mortality, most patients fail to receive evidence-based treatment during hospitalization.3-6 Addiction consultation services are becoming the standard of care to address this [...]

Background: Fracture Liaison Services (FLS) are traditionally outpatient-based and led by orthopedists or endocrinologists. In the United States, over 1 million patients are hospitalized yearly with osteoporotic fractures and internal medicine hospitalists are frequently involved in their co-management. Purpose: Internal medicine hospitalists have an integral role in the prompt recognition and early treatment of patients [...]

Background: Overnight vital sign assessment can disrupt sleep in the hospital and may be unnecessary in clinically stable patients. However, providers may not feel comfortable determining which patients can safely forego overnight vitals. We studied the effect of a clinical decision support (CDS) tool embedded in the electronic health record (EHR) that automatically identified clinically [...]

Background: We have previously showed how implementing the Michigan Appropriateness Guide for Intravenous Catheters (MAGIC) to inform peripherally inserted central catheter (PICC) use can lead to more appropriate device use. In this analysis, we assessed the association between appropriateness and PICC-related complications. We hypothesized that improved PICC appropriateness is associated with reduced major PICC complications [...]

Background: Antibiotics targeted against C. difficile bacteria are necessary, but insufficient, to achieve a durable clinical response because they have no effect on C. difficile spores that germinate within a disrupted microbiome. ECOSPOR-III evaluated SER-109, an investigational, biologically-derived microbiome therapeutic of purified Firmicute spores for treatment of recurrent CDI. Methods: Adults ≥18 years with recurrent [...]

Background: Survivors of hospitalization for COVID-19 are potentially at high risk for subsequent psychiatric morbidity due to medical trauma, systemic inflammation, and potential neurotropism of SARS-CoV-2(1). In addition, social isolation during the hospital stay due to restrictive visitor policies and after discharge due to fears of contagion or stay-at-home orders could further increase psychiatric vulnerability [...]

Background: Across the field of Hospital Medicine, there is a “call to arms” to build robust faculty development programs(1). Medical education and clinical teaching are common career interests for early career hospitalists (ECH), defined as hospitalists ≤5 years since postgraduate training. ECH often pursue academic positions to explore an interest in medical education, but find [...]

Background: Sleep disruptions for routine care, such as vital sign assessments, are common during hospitalization and are associated with negative health outcomes and patient satisfaction. While higher risk patients may benefit from increased monitoring at night, the tradeoff is less obvious for lower risk patients. We hypothesized that assigning overnight vital sign assessment based on [...]