Background: The American Academy of Pediatrics (AAP) publishes core pediatric clinical practice guidelines advising pediatricians on evidence-based management of common diagnoses. However, multiple studies demonstrate poor guideline compliance by pediatricians. There is no published curriculum on how to teach these guidelines, and on a national survey we conducted of pediatric residency training programs, only two [...]

Background: The “10 commandments of consultation” were published in 1983 and revised in 2007. Since then, academic medical centers have grown significantly, expanding the number of non-teaching teams. This rapid growth risks straining the current subspecialty consultation services’ teaching and educational models. Overuse of consultations and lack of clarity in the consulting question may increase [...]

Background: In hospitalized patients with anemia, the AABB recommends that transfusion of red blood cells occur when a patient’s hemoglobin (Hb) drops below a restrictive transfusion threshold, either at 7 or 8g/dL1. These transfusion guidelines are the result of a growing body of clinical trial evidence showing that transfusion at lower or restrictive Hb thresholds [...]

Background: Addressing the needs of the geriatric population is critical, as “baby boomers” comprise a larger proportion of hospitalized patients. Hospitalists increasingly care for these complex geriatric patients. The “BEERS Criteria” are evidence-based guidelines that encourage medication safety by describing potentially inappropriate and harmful medications (PIMS) among geriatric patients. BEERS guidelines recommend that with a [...]

Background: Choice of agent for venous thromboembolism prophylaxis (VTEP) after joint arthroplasty is a complex decision, the difficulty of which has been compounded by divergent guidelines. Specifically, the adequacy of aspirin monotherapy (ASA) for VTEP has long been debated between the American Academy of Orthopaedic Surgeons (AAOS) and the American College of Chest Physicians (ACCP). [...]

Background: Email represents an administrative burden which contributes to overall burnout. While general strategies to mitigate burnout related to email have been published (Armstrong 2017), formal clinical workplace guidelines and specifically their impact have not been described in the literature. The University of Michigan (UM) Division of Hospital Medicine (HM) developed and distributed email management [...]

Background: Inappropriate telemetry use has been associated with increased health care cost and unnecessary diagnostic procedures. For these reasons, the Society of Hospital Medicine’s Choosing Wisely campaign promoted use of both American Heart Association (AHA) telemetry guidelines and protocol-driven discontinuation of telemetry. Despite these measures, an estimated 59% of patients are placed on telemetry due [...]

Background: Podcasts geared towards clinicians are increasing in popularity. While there are several podcasts that garner a high listenership the general internal medicine community , few podcasts are tailored specifically to hospitalists. Purpose: Our overall goal was to develop and launch a new podcast designed for hospitalists to provide clinical updates as well as interviews [...]

Background: As hospital medicine looks to the future, we carry forward achievements and lessons learned from the past three years. In our large and diverse health system (with 14 acute care hospitals that serve adult inpatients from a populous catchment area, ranging in type from quaternary/academic to community based) we found we can best support [...]

Background: A vaso-occlusive episode (VOE) is a common complication of sickle cell disease (SCD). The most common presentation of VOE is pain that, if undertreated, can lead to life-threatening complications. Nearly all persons with SCD will have a VOE, however, data show that patients frequently receive inadequate analgesia when being treated for acute pain related [...]