Background: Racism is a public health crisis impacting patients and healthcare workers. Antiracist education is not typical in undergraduate or graduate medical education curriculum. Discriminatory practices in health care result in worse patient outcomes in Black, Indigenous, & People of Color (BIPOC). Committing to antiracist work is the first step in addressing racism and must [...]

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: In 2015, medical students in their clinical clerkships (traditionally known as third year medical students) began rotating directly with hospitalist attendings. As we began crafting the rotation, we sought to provide value that was not leveraged elsewhere in their clerkships. Different organizations, including the Liaison Committee on Medical Education and Association of American Medical [...]

Background: Ensuring hospital-based Patient and Family Advisory Councils (PFACs) include members from diverse, vulnerable and underrepresented communities is important to ensure that all voices are represented and heard when providing input into hospital quality improvement and research efforts. However, ensuring diverse membership of PFACs remains a challenge. This study aims to describe strategies to recruit [...]

Background: Some healthcare organizations struggle to improve quality. Identifying characteristics associated with underperformance may help inform approaches to improvement. Therefore, we sought to: (a) Identify organizational factors associated with low-performing healthcare organizations and (b) propose a conceptual framework with actionable domains, which we present as AMP (The Model to Amplify the Missing Potential), to inform [...]

Background: Clinically stable inpatients may receive potentially unnecessary care, such as overnight vital sign assessment. Nighttime vital signs can disrupt sleep and adversely affect patient satisfaction and contribute to delirium. However, it may be difficult for individual clinicians to determine which patients could safely forego overnight vital signs. Purpose: We developed a predictive algorithm designed [...]

Background: Advance care planning can be challenging for both patients and providers.  Barriers to understanding patients’ goals of care include patient and provider discomfort with the topic, as well as family and cultural dynamics.  The Stanford Letter Advance Directive (LAD) is a simple tool written at a fifth grade reading level in eight different languages [...]

Background: Administrative harm (AH), defined as negative consequences arising from administrative processes and decisions within healthcare, is pervasive in medicine, yet poorly understood and described. Methods: We sought to explore common AHs experienced by hospitalist clinicians, administrative leaders, researchers, and patient and family advisory council members that were part of two national consortiums for hospitalists [...]

Background: Subspecialty consultation among hospitalists varies significantly across and within hospitals. While in many cases consultation is clinically necessary, in other cases it may represent overuse. Recent studies have explored predictors of consultation using observational administrative and EHR data. Qualitative methods may generate knowledge about additional factors and complex processes influencing consultation behavior not ascertainable [...]

Background: In hospital medicine, around 250,000 diagnostic errors occur yearly in American hospitals and a significant proportion are attributed to failures in clinical reasoning. Feedback on the diagnostic process has been proposed as one method of improving clinical reasoning. However, in the current healthcare system barriers to the delivery and receipt of feedback include limited [...]