Background: We have previously showed how implementing the Michigan Appropriateness Guide for Intravenous Catheters (MAGIC) to inform peripherally inserted central catheter (PICC) use can lead to more appropriate device use. In this analysis, we assessed the association between appropriateness and PICC-related complications. We hypothesized that improved PICC appropriateness is associated with reduced major PICC complications [...]

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: Like all large academic medical centers (AMCs), we face capacity challenges. On most days, bed occupancy is often greater than 90% and long boarding times in the Emergency Department (ED) leads to poor patient experience, care delays and risk for adverse outcomes. While many AMCs have approached this problem by acquiring new facilities or [...]

Background: It is often assumed resident physicians at academic medical centers order more tests for inpatients due to different aspects of the clinical learning environment.  Despite this prevailing notion, there is very little evidence to support this claim. We sought to quantify differences in ordering practices between teaching hospitals and non-teaching hospitals for two common [...]

Background: At all academic medical centers, nurses and resident physicians are two prominent front-line contributors to the care of patients. During a patient’s hospital stay, they receive communication regarding their diagnosis, test results, management, and plan of care from both the resident physicians and the nursing staff. Therefore, it is critical to have effective communication [...]

Background: The traditional role of hospitalists is to provide care to patients hospitalized with acute medical conditions. Over the past few years, this has evolved to improve care transitions and stewardship of hospital resources. Many hospitals may embed hospitalists in the Emergency Department (ED) to improve patient flow into the hospital; however, there are sparse [...]

Background: Clinicians face an overwhelming volume of communication through various channels, including phone calls, text messages, emails, in-person interruptions, and secure messaging systems. This information overload is increasing[1] and poses significant challenges. Despite the availability of communication tools, failures in communication remain the leading cause of preventable medical errors [2]. Secure messaging systems, while essential, [...]

Background: Routine laboratory testing is a cornerstone of inpatient care. However, indiscriminate ordering can lead to resource waste, prolonged length of stay, and unnecessary costs. At our community teaching hospital in Queens, New York, we identified high rates of vitamin level testing—specifically vitamin B12, folate, and vitamin D25—which were often ordered without clinical indication. This [...]

Background: The Choosing Wisely Campaign started in 2012 with the aim of promoting high-value care. On its Choosing Wisely List, the Society of Hospital Medicine cited daily basic metabolic panel (BMP) and complete blood count (CBC) testing in the absence of clinical suspicion as unnecessary practice. Since the implementation of Choosing Wisely, there have been [...]

Background: High levels of interprofessional collaboration and communication have been shown to lead to better patient safety outcomes, improved patients’ satisfaction and quality of care, as well as higher job satisfaction for doctors and nurses alike. Yet, challenges to nurse-doctor collaborations exist. One way of improving interprofessional collaboration may be through structured co-teaching by nurses [...]