Background: It is often assumed resident physicians at academic medical centers order more tests for inpatients due to different aspects of the clinical learning environment.  Despite this prevailing notion, there is very little evidence to support this claim. We sought to quantify differences in ordering practices between teaching hospitals and non-teaching hospitals for two common [...]

Background: It is often assumed resident physicians at academic medical centers order more tests for inpatients due to different aspects of the clinical learning environment.  Despite this prevailing notion, there is very little evidence to support this claim. We sought to quantify differences in ordering practices between teaching hospitals and non-teaching hospitals for two common [...]

Background: Assessing severity of illness using available electronic medical record (EMR) data on admission and predicting inpatient mortality is very challenging. Lacking standardized practices around end of life issues, hospitalists use their clinical judgment in making these crucial decisions. Prolonged discussions may be needed in medically complex patients to direct an optimal plan of care [...]

Background: Effective communication between health-care providers, patients and their families is a key aspect of the discussion surrounding a patient’s goals of care.  One crucial part of this process is reaching a shared understanding of how the patient views their own quality of life.   The objective of this study was to characterize factors patients and [...]

Background: Advance care planning is nationally recognized as important for honoring patient wishes at the end of life. Despite this widespread recognition, many patients lack advance care planning and spend their last days in ways not concordant with their values. Moreover, traditional advance directives may provide only a partial context for patients’ belief systems relevant [...]

Background: Dedicated hospitalists are associated with improvements in healthcare quality and patient outcomes, but are not feasible for small-volume critical access hospitals (CAHs). A telemedicine “virtual hospitalist” model may expand the capabilities of a CAH at a fraction of the cost of an on-site provider. Purpose: Our purpose was to provide hospitalist coverage to remote [...]

Background: Hospitalists commonly discuss advance care planning (ACP), which supports patients in understanding and expressing their values for medical care during serious illness. The coronavirus disease of 2019 (COVID-19) pandemic has increased the urgency of these conversations, especially for patients with older age, comorbidities, or an otherwise high risk for complications such as ICU admission, [...]

Background: Hospitalists often care for patients with serious illness and commonly review and discuss advance care planning (ACP). Documented ACP conversations can be difficult to access in the electronic health record (EHR) due to the lack of a centralized location for ACP documentation and individual clinician practice variation leading to ACP documentation existing in multiple [...]

Background: Efforts have been made to increase social determinants of health (SDoH) screening to connect patients and families to community-based organizations (CBOs) and other resources. Tracking closed loop referrals is one potential measure to assist in assessing whether the resulting referrals and interventions have affected the child’s SDoH or improved the family’s well-being. Our team [...]

Background: Conducting early serious illness conversations (SICs) is a high-value intervention that improves the patient and family experience while aligning care with patient preferences. Given the constraints of hospital-based clinicians, using the EHR to identify appropriate patients for SICs remains a key challenge. The aims of this study were to explore whether the EHR’s readmission [...]