Background: Clostridioides difficile infection (CDI) is a common, often nosocomial infection associated with substantial morbidity and mortality. Antibiotics are the most important modifiable risk factor, but empiric antibiotics remain appropriate for many patients with severe acute illness. Which antibiotics minimize the risk of CDI remains an important unanswered question. Because protective equipment and isolation were [...]

Background: Rising inpatient census, limited physical space and unpredictable admission rates introduce communication inefficiencies among doctors, nurses and patients. Purpose: At UC San Diego Health System, we aimed to streamline communication among physicians, patients and other care team members. Description: Two operational changes were made: 1) establishment of team-based geographic cohorting and 2) segregation of [...]

Background: Inpatient admissions for Congestive Heart Failure (CHF) represent a substantial economic burden within the US healthcare system with patients experiencing high rates of 30-day readmission and mortality. To more efficiently and effectively serve complex cardiovascular (CV) patients at a major cardiac care center, Intermountain Health created a dedicated CV hospitalist service which has expanded [...]

Background: Background: Geographic cohorting (GCh) of clinicians to a single unit may improve teamwork and improve outcomes. The physical proximity between the care team is purported to mediate these positive effects. We conducted an exploratory time-and-motion study of physicians to assess differences in daily activities between GCh and traditionally dispersed or ‘At-Large’ (AL) physicians. We [...]

Background: The global impact of the COVID-19 pandemic has been profound, with significant disparities in infection and mortality rates, particularly in high-risk populations. Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that complicates patient management in the context of COVID-19, given the increased risk of infections and limited guidance on pharmacological management. Methods: This [...]

Background: One year all-cause mortality rates after a fragility fracture are as high as 24%. Treatment of osteoporosis following fracture reduces mortality, recurrent fractures rates, and healthcare costs. Without endocrinology involvement, clinicians often fail to recognize and treat osteoporosis. We aimed to assess the frequency of fragility hip fractures including recurrence rates at our academic [...]

Background: Geographic co-location, the practice of cohorting a panel of patients on the same hospital unit for a single provider or team, is increasingly popular, with 36.4% of adult hospitalist groups reporting unit-based assignments [1]. Benefits include increased hospitalist-patient interaction time, increased odds of multiple same-day patient visits, improved productivity, and greater interdisciplinary communication [2-4]. [...]

Background: Admitted Hematologic and Oncologic patients are often complex and have a unique set of challenges. Balancing outpatient care plans with inpatient medical and psychosocial issues can lead to long lengths of stay, patient dissatisfaction, and provider burnout. Hospitalists offer an expertise in managing complex medical problems along with an adept ability to integrate and [...]

Background: For hospitalist sections that cover a variety of inpatient services from general medicine to oncology, geographic cohorting of patients may be difficult to execute and maintain. The varying influx of admissions and discharges can result in mismatches in available beds and services. Successful implementation of geographic assignment may require considerable costs including institutional support, [...]

Background: Lung transplant recipients are a unique cohort of patients who require a multidisciplinary approach to management when hospitalized due to their higher rate of comorbidities, use of immunosuppression medications, and increased risk of complications. As of April 2023, over 12,000 total transplants have been performed in our institution, of which, 538 (4.5%) have been [...]