Background: Evidence-Based Medicine (EBM) improves physicians’ clinical decision-making through refining the skills of asking a clinical question, searching for and appraising the literature and then properly applying it to patient care. While EBM has been implemented as an essential module across medical schools worldwide, most graduates are not well versed in the fundamentals of effectively [...]

Background: Evidence-based COVID-19 management has evolved with unprecedented speed; however, the rate and fidelity with which institutions have adopted new evidence into practice is unknown. Methods: We surveyed members of the Hospital Medicine Reengineering Network (HOMERuN) from 12/17/20-2/10/21 and compared their institutional COVID-19 management recommendations to available evidence from pivotal randomized controlled trials (RCTs) and [...]

Background: Morbidity and Mortality (M&M) Conference is a traditional forum that provides residents with an opportunity to discuss medical errors, adverse events and near misses. Conventionally, most of the allotted time is spent on case presentation, unexpected outcomes and therapeutic debates. We demonstrate a unique approach to M&M, where we refocused the content by emphasizing [...]

Background: Pediatric venous thromboembolism (VTE), although less common than in adults, is increasingly recognized as a significant and preventable cause of morbidity and mortality. There are no universal pediatric VTE guidelines, although the American College of Chest Physicians (ACCP) limits prophylaxis recommendations to a limited set of risk factors. Multiple centers have published institutional guidelines [...]

Background: Routine patient care including vital signs checks, lab draws, medication administration, during the night contributes to the already disturbed sleep of inpatients. This study aimed to assess the performance of automated risk scores to stratify the risk of an overnight deterioration to better inform letting low-risk patients sleep and more intensively monitoring and/or intervening [...]

Background: Inpatient telemetry monitoring began over 4 decades ago. However, recently hospitals have started to implement programs that aim to improve the appropriateness of telemetry use. Quality initiatives take the American Heart Association (AHA) guidelines for practice standards for EKG monitoring in hospital settings to reduce the numbers of patients on telemetry inappropriately.  Our residency [...]

Background: Evidence-based guidelines/protocols for electrolyte replacement that safely encourage oral (PO) and/or intravenous (IV) dosing attain goal levels more successfully than standard care.1-17 PO is generally more comfortable and less dangerous than IV. Between 5/2017-11/2017, Jefferson dosed ~300,000 doses of potassium (K) and magnesium (Mg), with 30% and 19% of doses being PO, respectively. Guiding [...]

Background: In the early stages of the COVID-19 pandemic, there was a lack of knowledge about this new disease. Keeping up to date with new, rapidly expanding literature was demanding. Evidence-Based Medicine (EBM) practices were ambiguous and critical evaluation of scientific articles was challenging. Management of patients with COVID-19 was often isolating for providers and [...]

Background: Telemetry utilization for a long time has been dependent on individual physician experiences, preference as there were no good randomized controlled trails or guidelines from any scientific organization. American Heart Association has released the guidelines for appropriate use of telemetry in Oct 2004. Even more than a decade of these guidelines been available there [...]

Background: Misdiagnosis of catheter associated asymptomatic bacteriuria as CAUTI leads to inappropriate use of antibiotics and related consequences, including medication side effects, antibiotic resistance, C. difficile infection, and potential financial penalties to hospitals. Purpose: To develop and implement an evidence-based pathway to improve evaluation of CAUTI in our academic health system. Description: Health system leadership [...]