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: 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 [...]

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: 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 [...]

Background: Research suggests that ambulation in hospital settings can help prevent functional decline in patients. Early ambulation also contributes to better patient outcomes and decreased length of stay. The purpose of this study is to investigate patient perspectives to learn about factors that influence early ambulation and recommended amount of ambulation while in the hospital. [...]

Background: In 2016, there were more than 50,000 hospitalists working in the United States. The Society of Hospital Medicine (SHM) published ‘The Core Competencies in Hospital Medicine’ as a blueprint to standardize expectations of practicing hospitalists and to inform continuing medical education (CME) programs. We conducted a qualitative study to discover elements judged to be [...]

Background: Physician burnout impacts job satisfaction and turnover with significant financial and operational costs in addition to the negative impact on patient care. Organizations are increasingly focused on methods to improve physician resilience. Our study aims to explore the impact of difficult patient encounters on hospitalist resilience to inform future individual and organizational efforts to [...]

Background: Point-of-care ultrasound (POCUS) training is rapidly expanding across all levels of internal medical education (1), but lack of trained faculty has been a persistent barrier to program expansion (2,3). POCUS faculty development is a complicated endeavor that must take into account mastery of a complex psychomotor skill-set, integration within existing practice habits, and adherence [...]