Background: Delays in the discharge process of hospitalized patients impact patient flow and lead to increased costs and slower progression of care. As hospitalist work becomes increasingly shift based, there are concerns for proper patient handoffs and hesitancy with clinical progression of care overnight. This leads to daytime patient flow congestion and is a significant [...]

Background: Delays in the discharge process of hospitalized patients impact patient flow and lead to increased costs and slower progression of care. As hospitalist work becomes increasingly shift based, there are concerns for proper patient handoffs and hesitancy with clinical progression of care overnight. This leads to daytime patient flow congestion and is a significant [...]

Background:   Academic medical centers are complex healthcare delivery systems that are quickly adopting electronic health records (EHR) nationwide while still using alpha-numeric paging for physicians-in-training raised with cell phones, texting, messaging, and newer technologies.  Understanding workflow processes for these providers of patient care are key to finding solutions to improve healthcare quality and safety.   [...]

Background: Delays in the discharge of the hospital ward patients cause a backlog for new admissions from the Emergency Department, and transfers from the Intensive Care Units and telemetry units. This bottleneck unnecessarily increases overall resource utilization and also negatively impacts patient care and satisfaction. Therefore, our Internal Medicine Residency Program aimed through this quality [...]

Background: While there are now equal numbers of women and men graduating from medical school, disparities in female representation within academic medicine persist. Gender bias has been cited as one of the main drivers of gender disparity in academic medicine and continues to be a significant barrier for women in the workplace. Grand rounds is [...]

Background: Advanced practice providers (APPs) such as nurse practitioners and physician assistants have become an important addition to the hospital medicine team with the growing demand for physician providers. As APPs experience variable exposure to hospital medicine during training, the Society of Hospital Medicine and other governing bodies such as the American Academy of Physician [...]

Background: Duplicate as-needed (referred to hereafter as “PRN”) orders for common indications such as pain, nausea, insomnia, and constipation are frequent in hospitalized patients. Without explicit instructions for circumstances or order of administration, therapeutic duplication can cause confusion for nurses and violates both Join Commission and the Centers for Medicare & Medicaid Services (CMS) guidelines. [...]

Background: Previous studies have identified racial differences in sepsis incidence and sepsis mortality. Some evidence points towards differential treatment and subsequent sepsis outcomes in Black versus White patients. However, it is unclear to what extent racial differences exist in presentation and subsequent interpretation of complaints in the early phase of sepsis. Using History and Physical [...]

Background: The proportion of high-level bills submitted by our hospital medicine group was lower than national averages as reported by the Clinical Practice Solutions Center (CPSC). This did not seem to align with the complexity of patients at our level 1, safety net hospital in a busy urban location. The purpose of our project was [...]

Background: One year all-cause mortality rates after a fragility fracture are as high as 24%. Treatment of osteoporosis following fracture reduces mortality, recurrent fractures rates, and healthcare costs. Without endocrinology involvement, clinicians often fail to recognize and treat osteoporosis. We aimed to assess the frequency of fragility hip fractures including recurrence rates at our academic [...]