Background: Hospital Medicine groups are often called upon to lead initiatives that require access to high-quality data from their local health system. These include quality and value improvement (QI) efforts as well as health services and outcomes research. Although these efforts can be important for clinical operations as well as academic advancement, clear mechanisms to [...]

Background: Malnutrition, defined as deficiencies or excesses in nutrient intake, is associated with worse short and long-term outcomes compared to similar people without the diagnosis. The ASPEN or GLIM criteria are used to diagnose malnutrition, but these criteria are somewhat vague and measurement standards are typically not objective. The Inpatient Prospective Payment System considers severe [...]

Background: Specialty wards (e.g., cardiology or oncology wards) group clinically similar hospitalized patients in efforts to improve outcomes and costs. When these wards exceed capacity, subsequent patients overflow to “geographically dispersed” alternate wards. Geographic dispersion has been associated with care inefficiency and worse outcomes on specialty wards, but has not been studied in a large, [...]

Background: Sepsis is a significant cause of morbidity and mortality in hospitalized patients . Early and appropriate therapy has been shown to improve outcomes, making early diagnosis and intervention critical . However, recognition and treatment of sepsis remains a challenge . In order to understand how to best deliver sepsis treatment in different hospitals within [...]

Background: One in three heavy drinkers experience acute alcohol-associated hepatitis (AAH). AAH is defined as acute liver injury with elevated bilirubin and AST/ALT ratio >1.5 in the setting of heavy alcohol use. AAH has a high mortality rate and is associated with development of chronic liver disease; thus, it is crucial to correctly identify patients [...]

Background: The Atlanta Medical Center (AMC) closure in fall 2022 resulted in diversion of its patients to Grady Memorial Hospital, Emory University Hospital-Midtown (EUHM), Emory Decatur Hospital, and Emory Hillandale Hospital. The impact on Emory has not been examined; this reflects a gap in the literature. There are many studies of negative impacts of rural [...]

Background: Suicide attempt and self-injury (SA/SI) are frequent reasons for medical hospitalizations, yet little is known about length of stay (LOS) among youth hospitalized for SA/SI. LOS is commonly used to measure quality of patient care and resource use within hospitals, and a comprehensive understanding of factors associated with LOS among youth admitted for SA/SI [...]

Background: As the day progresses, clinicians may experience decision fatigue that impairs clinical reasoning. Such impairment may exert its greatest effects on clinicians’ abilities to identify and effectively treat heterogeneous clinical syndromes with high diagnostic uncertainty, including sepsis. We therefore examined the association of time of day with antibiotic initiation among hospitalized ward patients with [...]