Background: Somatic Symptom and Related Disorders (SSRD) is an umbrella term for a wide variety of disorders commonly encountered in the inpatient pediatric setting, including conversion disorder, amplified pain syndrome, and psychogenic non-epileptiform seizures. These patients can be high utilizers of medical resources. The hospitalist is often charged with ruling out a medical diagnosis and [...]

Background: Failure to thrive and malnutrition continues to be a common diagnosis in pediatrics contributing to a significant number of hospital admissions (1-5). There is no national practice guideline or consensus recommendation for diagnosis and treatment for patients hospitalized with failure to thrive, contributing to significant clinical practice variation. Unnecessary variability in practice has been [...]

Background: Somatic Symptom and Related Disorders (SSRD) is an umbrella term for a wide variety of disorders commonly encountered in the inpatient pediatric setting, including conversion disorder, amplified pain syndrome, and psychogenic non-epileptiform seizures. These patients can be high utilizers of medical resources. The hospitalist is often charged with ruling out a medical diagnosis and [...]

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: Hip fractures are one of the most common causes for surgery in the elderly and the burden of care extends beyond the perioperative period as many are discharged to a long-term facility and have significant morbidity and mortality despite advances in perioperative care. To date, trials of interventions and standardized multidisciplinary hip fracture programs [...]

Background: Stroke is the leading cause of mortality worldwide. However, available treatment options are limited due to the narrow treatment time window and reperfusion injury after revascularization. New treatment modalities to overcome these challenges are in need. Chlorpromazine and promethazine (C+P) have been utilized for cerebral edema, central high fever with restlessness, and delirium [1, [...]

Background: Clinical decision making pathways (pathways) embedded within electronic medical record (EMR) systems are an innovative tool intended to assist providers in diagnosing and managing patient conditions. Pathways provide clinical decision trees with the ability access online risk score calculators and select orders for lab and imaging tests, medications, and consultations. Studies have shown that [...]

Background: The COVID-19 pandemic has required healthcare systems to meet new demands for rapid information dissemination, resource allocation, and patient tracking and reporting. To help address these unique challenges, the University of Chicago Medical Center (UCMC) has leveraged Integrated Clinical Pathways (ICPs), which are flexible decision support tools integrated directly into the electronic health record. [...]

Background: The emergence of hospitalists over the last 25 years as leaders in quality, safety, and value-based care has resulted in improvements in hospital throughput and reduction of in-hospital complications (1). The keys to success are standardizing clinical pathways and interdisciplinary collaboration. At Tampa General Hospital (TGH), our hospitalist team observed significant variability in the [...]

Background: At our urban, academic hospital, use of outdated protocols and unnecessary variations in the care of DKA patients treated with ICU requiring IV insulin protocols have led to multiple safety events, delays in care with associated increased costs, and overtreatment of hyperglycemia with ketosis frequently resulting in unnecessary ICU utilization. After multi-disciplinary stakeholder development [...]