Background: Research suggests that high workloads in the inpatient setting (often measured through patient encounters/visits) contribute to increased hospital length of stay, increased costs, and delayed discharges. High workloads also negatively impact our quality improvement efforts and result in a mismatch in job demands and job resources leading to clinician burnout. To date, there is [...]

Background: A growing body of evidence supports the use of point of care ultrasound increasingly as augmentation of the physical exam and clinical decision making. The literature also supports that trainees, both medical students and residents, can acquire these skills. However, there is no consensus on the training approach and development of competency for hospitalists [...]

Background: Inpatient margins and hospital reimbursement have become increasingly dependent upon improving key metrics, such as length of stay and 30-day readmissions. Hospitalists typically lack access to credible, timely, and insightful metrics that inform their practice. In addition, individualized metrics, when available, struggle to properly normalize for patient complexity, warranted variations in care, shared decision-making, [...]

Background: Failure to promptly recognize clinically deteriorating patients in the hospital leads to delays in critical interventions and worse health outcomes. Current standard practice in patient monitoring on most medical-surgical wards involves vital sign assessment at discrete time points, typically every four to eight hours. More frequent or continuous vital sign monitoring has historically been [...]

Background: A growing body of evidence supports the use of point of care ultrasound increasingly as augmentation of the physical exam and clinical decision making. The literature also supports that trainees, both medical students and residents, can acquire these skills. However, there is no consensus on the training approach and development of competency for hospitalists [...]

Background: Inpatient margins and hospital reimbursement have become increasingly dependent upon improving key metrics, such as length of stay and 30-day readmissions. Hospitalists typically lack access to credible, timely, and insightful metrics that inform their practice. In addition, individualized metrics, when available, struggle to properly normalize for patient complexity, warranted variations in care, shared decision-making, [...]

Background: Research suggests that high workloads in the inpatient setting (often measured through patient encounters/visits) contribute to increased hospital length of stay, increased costs, and delayed discharges. High workloads also negatively impact our quality improvement efforts and result in a mismatch in job demands and job resources leading to clinician burnout. To date, there is [...]

Background: Hospitalists often care for patients with serious illness and commonly review and discuss advance care planning (ACP). Documented ACP conversations can be difficult to access in the electronic health record (EHR) due to the lack of a centralized location for ACP documentation and individual clinician practice variation leading to ACP documentation existing in multiple [...]

Background: Rounds are critical for facilitating patient care, supporting interprofessional communication and providing education for trainees (1,2). Social distancing requirements in the era of COVID led to significant changes to the traditional rounding structure (3). The impact of these changes on patient care, interprofessional communication and education remain unknown. Methods: An interprofessional needs assessment was [...]

Background: One of the challenges in hospital medicine is the care of patients overnight, when the primary team is unavailable, and care is being provided by those who are not as familiar with the patient. This is compounded by the high volume of pages at night. At UNC Rex Hospital, these factors resulted in delays [...]