Background: Community acquired severity scores are well known and used routinely in predicting mortality and risk of inpatient and ICU admission in suspected bacterial pneumonia patients. However such scores have not been studied in patients with influenza infection and influenza pneumonia. We attempted to validate one such score, CURB65 and and identify other scores that [...]

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: Several institutions have implemented a medical procedure service (MPS) to improve timeliness of bedside procedures and standardize performance and training of procedures by internal medicine (IM) residents (1-2). A critical barrier to starting an MPS has been a lack of experienced proceduralists (3). In 2011, our IM residency program created an MPS led by [...]

Background: Procedural complications are a common source of adverse events in hospitalized patients(1, 2). In academic centers, bedside procedures have traditionally been performed by trainees, often without experienced proceduralist supervision, or referred to interventional radiology or consultant services, often with an associated delay in procedure performance. Many trainees report discomfort with their skill in performing [...]

Background: Community acquired severity scores are well known and used routinely in predicting mortality and risk of inpatient and ICU admission in suspected bacterial pneumonia patients. However such scores have not been studied in patients with influenza infection and influenza pneumonia. We attempted to validate one such score, CURB65 and and identify other scores that [...]

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: Several institutions have implemented a medical procedure service (MPS) to improve timeliness of bedside procedures and standardize performance and training of procedures by internal medicine (IM) residents (1-2). A critical barrier to starting an MPS has been a lack of experienced proceduralists (3). In 2011, our IM residency program created an MPS led by [...]

Background: Endoscopies are commonly performed in the inpatient setting, and successful completion frequently requires close coordination among nurses, hospitalists, gastroenterologists, and anesthesiologists. Given the complexity of this multidisciplinary involvement, as well as variability in patient factors like clinical stability and presentation, endoscopies are prone to delays. These delays may cause frustration amongst care providers and [...]

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 [...]