Background: Delirium is a common complication within the hospital setting with nearly one in three older patients experiencing it during hospitalization. Reduction in delirium is associated with decreased falls, decreased distress of patients and caregivers, and decreased length of stay as a result. Identification and reduction of delirium, therefore, is of the utmost importance to [...]

Background: Communication is recognized by the LCME and ACGME as an essential competency with significant patient safety implications; the Joint Commission cites communication errors as a major cause of sentinel events. Consultation is a near-universal method of communication between physicians of all disciplines. However, formal education in requesting a consultation is inconsistent in undergraduate medical education [...]

Background: Delirium is an acute state of brain failure marked by sudden onset of confusion, a fluctuating course, inattention, and often an abnormal level of consciousness. Delirium affects about 11-40% of the hospitalized patient population. In hospital delirium has been associated with 10-fold increased risk for death and a 3-to-5 fold increased risk for nosocomial [...]

Background: There has been relatively little published regarding the transition from residency to faculty appointments. The learning curve during this transition is steep given the sudden increase in responsibility and is fraught with anxiety and trepidation. Given the high burnout and attrition rates within Hospital Medicine divisions, we sought to combat this through a structured [...]

Background: In order to reduce overuse, many hospitals have conducted studies and implemented protocols with the goal of reducing non-indicated telemetry monitoring. A common tool that institutions utilize for these changes are the clinical decision support systems (CDSS). In this report, we will present the telemetry protocol utilized by our hospital and review its effects [...]

Background: The COVID-19 pandemic brought considerable stress to all healthcare providers. The inpatient setting has brought unique challenges to Hospitalists. As we were all adjusting to our new reality both at work and at home, the Division of Hospital Medicine at UC San Diego Health saw the importance of listening in a time of chaos. [...]

Case Presentation: A 56-year-old man presented with one day of high fevers to 104°F, myalgias, and non-productive cough. His past medical history is significant for polycystic liver disease leading to liver transplant, and metastatic neuroendocrine tumor managed with intravenous somatostatin. Two weeks prior to admission, he began a taper of his immunosuppressive medication. On the [...]

Background: PechaKucha, Japanese for “chit chat”, is a presentation format with twenty slides auto advancing after twenty seconds each. The total presentation time is 6 minutes and 40 seconds. Slides rely on pictures and may be modified to include few words summarizing expansive topics. Feedback from our learners has been overall positive, with higher engagement [...]

Background: Mass General Brigham’s Faulkner hospital (BWFH) is a 171 bed community hospital closely affiliated with Brigham and Women’s hospital (BWH), which is located 2.5 miles away. Patient care at BWFH is supported by robust access to consultation and advanced testing from subspecialists located at BWH. To access some advanced diagnostic testing and procedures, patients [...]

Background: The Society of Hospital Medicine’s Choosing Wisely recommendations include avoiding repetitive Complete blood count (CBC) and serum electrolyte panels (SEPs). SEPs include basic and comprehensive metabolic panels (BMP, CMP respectively). Unnecessary routine lab can cause increased costs(1)(2), unnecessary downstream testing and procedures, hospital acquired anemia(2)(3)(4) and patient discomfort. Multiple QI project has been successful [...]