Background: Despite medical advancements for organic and structural diseases, effectively managing acute and chronic functional pain syndromes remains a daunting challenge for hospitalists. Standard inpatient treatments frequently fail to adequately control symptoms, often compelling hospitalists to shift from diagnostics to the contentious task of tapering opioids in patients with legitimate pain. This pivot can lead [...]

Background: Despite medical advancements for organic and structural diseases, effectively managing acute and chronic functional pain syndromes remains a daunting challenge for hospitalists. Standard inpatient treatments frequently fail to adequately control symptoms, often compelling hospitalists to shift from diagnostics to the contentious task of tapering opioids in patients with legitimate pain. This pivot can lead [...]

Background: Pain is a frequent symptom in patients who require inpatient rehabilitation. For example, 40-50% of patients hospitalized for stroke rehabilitation report pain. Further, 82% of those hospitalized for postsurgical orthopedic rehabilitation complain of at least moderate pain, and among those hospitalized for rehabilitation after acute traumatic spinal cord injury, 97% report pain at least once [...]

Background: Disruptions in normal life routines (such as sleep, function, nutrition, etc.) that commonly occur as part of routine hospital care may be traumatic for acutely ill patients and lead to a generalized condition of high risk after discharge that has been described as “post-hospitalization syndrome.” We created the ARCHES cohort study to measure these [...]

Background: Survivors of critical illness, such as acute respiratory distress syndrome (ARDS) requiring invasive mechanical ventilatory support in an intensive care unit (ICU), commonly experience prolonged morbidity in multiple health domains: psychological distress, functional debility, cognitive impairment, and poorer quality of life. This resulting morbidity is now recognized broadly as post-intensive care syndrome (PICS). COVID-19 ICU survivors are at [...]

Background: Functional decline during hospitalization of older adults is well-recognized and potentially preventable.  Recent studies have suggested that clinically significant functional decline also affects hospitalized adults under 65 years of age, and that physical function is an important predictor of hospital readmissions. Despite the importance of function, we lack simple, efficient, and standardized measures to [...]

Background: Patients spend about 95% of their hospitalization in bed, increasing the risk of functional decline associated with adverse events and readmissions. Some hospitals track patients’ functional mobility trends using Activity Measure for Post-Acute Care 6-Clicks Inpatient Short Form (AM-PAC). We aim to understand the associations between functional mobility loss from hospital admission to discharge, [...]

Background: Black patients have been shown to have worse physical function, higher likelihood of developing mobility limitations and higher rates of mobility loss and functional decline. Despite these functional disadvantages, Black patients are less likely to receive acute and post-acute rehabilitation services. These disparities have been described in community-dwelling, ambulatory, and surgical populations, and social [...]

Background: Sickle cell disease (SCD) is characterized by lifelong, recurrent episodes of vaso-occlusive pain that often require inpatient hospitalization. Readiness for discharge is dictated by the patient’s pain intensity rated on the Numeric Rating Scale (0-10). Pain is an individualized multidimensional experience and a pain intensity score only measures one facet. Physical function is another [...]

Background: Immobility in the hospital setting is associated with persistent inability to perform activities of daily living, increased length of stay, and decreased return to independent living; this loss of function is identified by patients as a commonly unaddressed barrier to discharge. The reasons for immobility are multifactorial; however, lack of provider interest or value [...]