Background: Inpatient antibiotic stewardship programs often use pre-prescription approval (PPA) or prospective audit and feedback (PAF) to reduce fluoroquinolone prescribing. Whether these stewardship strategies targeting inpatient fluoroquinolone use also influence prescribing at discharge is unknown. Therefore, we aimed to evaluate the effect of fluoroquinolone stewardship on discharge fluoroquinolone use in patients with pneumonia or a [...]

Background: Structured mortality review can help identify care issues and focus quality efforts, but existing methods have limitations. In the Department of Medicine at UCLA, we developed a novel in-person, near real-time, interdisciplinary rapid mortality review (RMR) process to capture the insight of frontline providers and improve care. In this study, we compare the yield [...]

Background: Clinically stable inpatients may receive potentially unnecessary care, such as overnight vital sign assessment. Nighttime vital signs can disrupt sleep and adversely affect patient satisfaction and contribute to delirium. However, it may be difficult for individual clinicians to determine which patients could safely forego overnight vital signs. Purpose: We developed a predictive algorithm designed [...]

Background: Advance care planning can be challenging for both patients and providers.  Barriers to understanding patients’ goals of care include patient and provider discomfort with the topic, as well as family and cultural dynamics.  The Stanford Letter Advance Directive (LAD) is a simple tool written at a fifth grade reading level in eight different languages [...]

Background: Although point-of-care ultrasound can improve patient care and reduce unnecessary downstream costs, few economic models exist on hospitalist use and whether remuneration for imaging could offset equipment costs.  As the heart and lungs are commonly examined during admission, we observed the frequency of use and projected fiscal outcomes of point-of-care cardiac ultrasound by an [...]

Background: Between the United States and Canada, TikTok hosts more than 175.8 million active users. While originally known for entertainment, the platform has rapidly evolved into a major source of education, news, and health-related content. Because of its wide reach and immediate accessibility, it is essential to evaluate the accuracy and quality of medical information [...]

Background: Remote patient monitoring (RPM) is a promising new tool to monitor patients who have historically required observation visits in a hospital, or would have remained hospitalized longer if initiated at hospital discharge, and was widely used in the COVID-19 pandemic. We report the outcomes of hospital admission and urgent/emergent care service utilization in a [...]

Background: Healthcare disparities have existed for decades, yet it took a global pandemic to put this emergency into the spotlight. The Joint Commission states “health related social needs” (HRSN) are the root cause of many disparities. HRSN encompasses a wide spectrum including inability to pay bills, poor access to transportation, and lack of housing. At [...]

Background: The CDC Core Elements of Antibiotic Stewardship recommend that patients initiated on broad-spectrum antibiotics (BSA) undergo antibiotic de-escalation within 48-72 hours based on available culture data. However, adherence with this recommendation in patients with sepsis has not been well studied. We assessed the incidence of, and characteristics associated with, anti-methicillin resistant staphylococcus aureus (MRSA) [...]

Background: Peer consultation – the wisdom from collaborating clinicians – is associated with more accurate diagnosis. Programs that provide second opinions or diagnostic time-outs (also known as cross-checks) are thought to improve diagnosis but have not been applied to hospital medicine services. Data from our multicenter collaborative suggest concerns remain about the time required and [...]