Background: People experiencing homelessness (PEH) face barriers to accessing regular ambulatory care, which increases their risk of having poorly controlled chronic medical conditions and contributes to high acute care utilization. The role of field-based homeless healthcare teams in improving hypertension and diabetes control and reducing acute care utilization (e.g., emergency department [ED] visits, inpatient hospitalizations) [...]

Background: We have previously showed how implementing the Michigan Appropriateness Guide for Intravenous Catheters (MAGIC) to inform peripherally inserted central catheter (PICC) use can lead to more appropriate device use. In this analysis, we assessed the association between appropriateness and PICC-related complications. We hypothesized that improved PICC appropriateness is associated with reduced major PICC complications [...]

Background: Ultrasonography is a safe, non-invasive bedside tool used by providers to obtain real-time, dynamic images to support diagnostic guidance, therapeutic decisions, and procedural success. Point-of-care ultrasonography (POCUS) has demonstrated improved outcomes in states of critical illness such as trauma or shock and enhanced the command and accuracy of procedural skills. Despite these important measures, [...]

Background: A substantial proportion of peripherally inserted central catheters (PICCs) are placed for inappropriate indications. We performed a multi-hospital intervention to improve the appropriateness of PICC use. Methods: We conducted a collaborative cohort study of hospitals participating in the Hospital Medicine Safety Consortium. An evidence-based intervention centered on the Michigan Appropriateness Guide for Intravenous Catheters [...]

Background: The Pediatric Hospital Medicine (PHM) Core Competencies define the expertise required of practitioners in the field and provide a framework for graduate and continuing medical education activities. Since their initial publication in 2010, the scope of practice among pediatric hospitalists has matured. Pediatric hospitalists lead or participate in institutional and national efforts that emphasize [...]

Case Presentation: Patient is a 45-year-old female with a history of esophageal reflux and dysmotility, asthma, depression/anxiety, and recent SARS-2-CoV infection (COVID-19) who presented to our hospital 9 months after initial and 3 months after recurrent COVID-19 with headache, dyspnea, and home blood pressures (BP) > 180/100. Patient reported intermittent symptoms for the last 3 [...]

Background: Hospitalists nationwide are faced with complex patient and family behaviors that interfere with medical care. In the acute inpatient setting, few resources are available for physicians to address maladaptive behaviors and many physicians report significant discomfort managing these disruptive behaviors. We implemented a Nurse Practitioner-Led Psychiatric Consult Service to provide education and recommendations for [...]

Background: Point-of-care ultrasound (POCUS) is a diagnostic modality that can improve diagnosis, reduce cost, and increase patient satisfaction. POCUS is being increasingly utilized in internal medicine (IM), and IM residents desire training in POCUS. A such, residency programs across the country have implemented various strategies to teach POCUS, though the impact of these interventions is [...]

Case Presentation: A 66-year-old Hispanic male with a history of primary hypertension and type 2 diabetes mellitus presents to hospital with 3 months of progressive fatigue, poor appetite, watery diarrhea, dizziness, and vomiting. Vital signs were notable for postural hypotension (BP 146/84 sitting, BP 118/72 standing). Physical examination was normal with no skin or mucous [...]