Background: Hospital-associated venous thromboembolism (HA-VTE) is a serious condition with controversy regarding ideal risk assessment and VTE prophylaxis (VTEP), especially in medical patients. We conducted a collaborative VTE quality improvement project, supported by a charitable grant from the Gordon and Betty Moore Foundation, in 35 hospitals across three states and assessed the impact on HA-VTE [...]

Background: Hospital-associated venous thromboembolism (HA-VTE) is a serious condition with controversy regarding ideal risk assessment and VTE prophylaxis (VTEP), especially in medical patients. We conducted a collaborative VTE quality improvement project, supported by a charitable grant from the Gordon and Betty Moore Foundation, in 35 hospitals across three states and assessed the impact on HA-VTE [...]

Background: Hospital-acquired delirium is serious, leading to increased falls, pressure ulcers, length of stay (LOS), cost, patient institutionalization, and patient and caregiver distress. In addition, it is associated with mortality rates as high as 35-40% within one year in older patients who develop delirium. Because hospital-acquired delirium is often under-recognized and prevention and treatment involves [...]

Background: Urinary tract infection (UTI) and community acquired pneumonia (CAP) are the two most common infections treated in hospitalized patients and are often inappropriately diagnosed. Due to myriad factors—including diagnostic uncertainty—patients are commonly inappropriately diagnosed with UTI or CAP in the emergency department (ED). Antibiotics may be continued throughout the hospitalization even if new information [...]

Background: Digital bedside information displays can alert clinicians about patient safety hazards, but the unintended consequences of these interventions are not well understood. Introducing new digital interventions may have implications for clinician satisfaction with the electronic environment, clinical team communication, and patient-centered care. Toward greater understanding of these unintended consequences, we described the content, form, [...]

Background: Hospital-acquired disability (HAD) is common, and a key contributor to this process is low hospital physical activity. This study examines whether objective measures of hospital physical activity from wearable accelerometers can be used to predict HAD. Methods: Prospective observational study of community-dwelling older adults aged ≥ 60 years, admitted to an academic hospital’s general [...]

Background: With standard diagnostic methods, the etiologic pathogen of community acquired pneumonia (CAP) is detected in ≤ 50% hospitalized CAP patients. In our previous studies using a diagnostic “bundle”, we were able to detect etiologic pathogens in ≥ 70 % of the patients. Our bundle consisted of a nasopharyngeal swab for Biofire film array, that [...]

Background: Patients with undifferentiated but stable clinical presentations may manifest sepsis “time zero” (T-0) or the onset of sepsis-defining conditions while undergoing further evaluation in observation units (OUs). Since these units are often designed to facilitate diagnostic and clinical risk assessments, we hypothesize that patients experiencing T-0 while in OUs will likely experience similar or [...]

Background: For most infections, shorter antibiotic durations are similarly effective to longer durations but have lower risk for side effects and antibiotic resistance.1-9 Since 2019, community-acquired pneumonia (CAP) guidelines have recommended hospitalized patients with CAP be treated until clinical “stability and for no less than a total of 5 days.”10 However, randomized clinical trials have [...]

Background:   In line with the American Board of Internal Medicine’s (ABIM) Choosing Wisely® initiative, the Society of Hospital Medicine (SHM) recommends not performing repetitive complete blood count (CBC) and chemistry (CHEM7) testing in the face of clinical and lab stability.  In addition to decreasing the risk of hospital acquired anemia (HAA), reducing unnecessary routine blood work can ultimately result in significant [...]