Background: Due to the importance of rest for inpatients, the American Academy of Nursing recommends preserving patient sleep by reducing unnecessary nocturnal care as part of their Choosing Wisely® campaign. Prior sleep-promotion interventions often fail due to lack of sustained staff behavior change. We designed and implemented SIESTA, which combined staff education with the behavioral economics [...]

Background: Hospital-associated venous thromboembolism (HA-VTE) is a serious condition with controversy regarding ideal risk assessment and VTE prophylaxis (VTEP), especially in medical patients. We conducted a collaborative VTE quality improvement project, supported by a charitable grant from the Gordon and Betty Moore Foundation, in 35 hospitals across three states and assessed the impact on HA-VTE [...]

Background: Research suggests that high workloads in the inpatient setting (often measured through patient encounters/visits) contribute to increased hospital length of stay, increased costs, and delayed discharges. High workloads also negatively impact our quality improvement efforts and result in a mismatch in job demands and job resources leading to clinician burnout. To date, there is [...]

Background: Although hospitals should be a place of healing and restoration, multiple studies demonstrate that hospitalized patients face acute sleep deprivation due to potentially modifiable disruptions (vitals, medications, tests). Acute inpatient sleep deprivation is also associated with worse health outcomes both in-hospital and post-discharge. While staff-directed sleep interventions show benefits, no study has tested whether [...]

Background: Hospitalizations related to opioid use disorder (OUD) are rising, creating opportunities to initiate medications for opioid use disorder (MOUD) and connect patients with outpatient resources.1,2 Despite evidence that MOUD reduces morbidity and mortality, most patients fail to receive evidence-based treatment during hospitalization.3-6 Addiction consultation services are becoming the standard of care to address this [...]

Background: Across the field of Hospital Medicine, there is a “call to arms” to build robust faculty development programs(1). Medical education and clinical teaching are common career interests for early career hospitalists (ECH), defined as hospitalists ≤5 years since postgraduate training. ECH often pursue academic positions to explore an interest in medical education, but find [...]

Background: Hospitalization is costly, associated with the potential for adverse medical events and may have deleterious health effects.  Hospitalist physicians are uniquely positioned to help patients avoid unnecessary hospitalizations.  Our attending-only hospitalist practice in a tertiary academic center admits approximately 350 patients monthly, the majority of which are referred through the emergency department (ED).  Our [...]

Background: Coordination of inpatient and outpatient care is an important challenge in improving population health but evidence examining the effectiveness of existing care coordination programs is mixed. The Comprehensive Care Physician (CCP) Program at the University of Chicago provides patients at increased risk of hospitalization the opportunity to receive inpatient and outpatient care from the [...]

Background: The transfer of patients between hospitals (interhospital transfer, IHT), exposes patients to risks of discontinuity of care. In this study, we aim to better understand which patients may (or may not) benefit from IHT by evaluating the impact of IHT on clinically important patient outcomes among a variety of patient diagnoses. Methods: We performed [...]

Background: In a previous randomized trial we found that shorter ward rotations reduced attending physician burnout at rotation-end. This improvement was offset, however, by negative education outcomes among trainees. Therefore solutions to burnout other than simply shortening rotations are needed to preserve the educational mission. We examined additional data collected (but not yet presented) to [...]