Background:   Observation care has evolved significantly since its original inception by the Centers for Medicare and Medicaid Services (CMS).  Originally intended to span less than 48 hours in the majority of cases, the Office of Inspector General (OIG) reported that 11% of all observation stays lasted three or more nights in 2012.[1]Having a higher length [...]

Background: SHM Key Characteristic 9.1 on patient centered care encourages using guidelines/checklists to reinforce effective communication. Focused practice performance evaluations (FPPE) are a required regulatory hospital process for new medical staff members. In cognitive specialties, such as hospital medicine, completing an objective assessment of clinical skills can be difficult, with most initial evaluations based on [...]

Background: Patient-centered communication has been associated with positive patient outcomes such as improved patient understanding and adherence to therapy. Teaching patient-centered care (PCC) and communication throughout a hospital stay, with an emphasis on understanding each patient’s perspective and circumstances, is a focus on one of four general inpatient medicine services at our hospital. We did [...]

Background: Pediatric hospitalists are responsible for educating varying levels of learners while overseeing rounds to deliver high-quality care in an inpatient setting. While many teaching techniques are described, impactful teaching during rounds is a skill not always taught in training. Efficient utilization of teaching techniques is an endeavor that requires tutelage, repetition, and strategic practice. [...]

Background: Peer observation and feedback (POF) is a well-documented tool for faculty development for both medical and non-medical educators. However, in our hospital medicine division of over 150 faculty at an urban academic center, only 16 peer observations were completed in the 2022-2023 academic year as part of our division’s voluntary, formally structured peer observation [...]

Background: Pediatric hospitalists are responsible for educating various levels of learners when overseeing rounds to provide high quality care to patients and families. While many effective teaching techniques are described in the literature, efficient teaching on rounds is a skill not always taught during training. The effective use of these techniques by pediatric hospitalists is [...]

Background: The number of individuals with dementia in the U.S., currently estimated at 5.3 million, is projected to triple by 2050. For patients with cognitive impairment, the unfamiliar and stressful hospital environment often requires constant observation (CO) to ensure patient safety. The use of constant observation (CO) in the hospital setting, while originating in patients [...]

Background: Medicare observation stays are increasing nationally. Beneficiaries frequently hospitalized under observation, as well as those needing post-acute care skilled nursing facility coverage, may face increased financial burdens from these services. Patients living in the most disadvantaged neighborhoods have increased risk of inpatient 30-day re-admissions. It is not known whether neighborhood socioeconomic disadvantage increases 30-day [...]

Background: Patients with undifferentiated but stable clinical presentations may manifest sepsis “time zero” (T-0) or the onset of sepsis-defining conditions while undergoing further evaluation in observation units (OUs). Since these units are often designed to facilitate diagnostic and clinical risk assessments, we hypothesize that patients experiencing T-0 while in OUs will likely experience similar or [...]

Background: Research suggests that COPD patients with low peak inspiratory flow rate (PIFR,