Background: While many Hospital Medicine groups employ overnight providers to exclusively care for previously admitted patients (cross-coverage), little data exists regarding factors contributing to the perceived workload of this role. The NASA-Task Load Index (NASA-TLX) is a validated questionnaire used to quantify perceived workload. Methods: Overnight providers completed the NASA-TLX at the end of each [...]

Background: Racism is a public health crisis impacting patients and healthcare workers. Antiracist education is not typical in undergraduate or graduate medical education curriculum. Discriminatory practices in health care result in worse patient outcomes in Black, Indigenous, & People of Color (BIPOC). Committing to antiracist work is the first step in addressing racism and must [...]

Background: Hospitalizations related to opioid use disorder (OUD) are rising, creating opportunities to initiate medications for opioid use disorder (MOUD) and connect patients with outpatient resources.1,2 Despite evidence that MOUD reduces morbidity and mortality, most patients fail to receive evidence-based treatment during hospitalization.3-6 Addiction consultation services are becoming the standard of care to address this [...]

Background: Co-management across service lines has become increasingly common in hospital medicine. While debate continues over clinical outcomes, some co-management arrangements have led to enhanced provider satisfaction, which may have implications for burnout. We have established successful co-management services with orthopedics, urology (GU), otorhinolaryngology (ENT), trauma and neurosurgery (NS). We are a large urban/suburban academic [...]

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: Clinicians face an overwhelming volume of communication through various channels, including phone calls, text messages, emails, in-person interruptions, and secure messaging systems. This information overload is increasing[1] and poses significant challenges. Despite the availability of communication tools, failures in communication remain the leading cause of preventable medical errors [2]. Secure messaging systems, while essential, [...]

Background: Work engagement has been an ongoing subject of interest within many organizations as it reflects employee well-being and can affect productivity, work outcomes, emotional health, and physical health (1). Stress levels in the work environment can lead to deterioration of sleep and work engagement and increase burnout (2). Heartfulness meditation is a simple heart-based [...]

Background: Frailty is linked to poor outcomes in older patients, especially those with multiple conditions. The electronic frailty index (eFI) is a validated tool based on the cumulative deficit model used to screen hospitalized patients at risk for poor outcomes1. The eFI relies on 35 ICD-10 codes associated with encounters across four domains (morbidity, sensory, [...]

Background: Trauma co-management is a growing field within hospital medicine. While improvements in quality metrics have been documented in other co-management services, the impact of co-management of trauma patients is uncertain. This study aimed to determine whether a hospitalist trauma co-management program improves clinical outcomes. Methods: This was a pre- and post-implementation study comparing trauma [...]

Case Presentation: A 62-year-old male with a history of paroxysmal atrial fibrillation presented with hypotension and 2 week history of chest pain after an ablation with pulmonary vein isolation. Transthoracic echocardiography demonstrated a pericardial effusion. Pericardial fluid sampling revealed an elevated leukocyte count of 130,000 cells per cubic millimeter and culture grew rare strep mitis/oralis [...]