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: Treating alcohol withdrawal in the inpatient medical setting requires timely identification of the severity of alcohol withdrawal so appropriate treatment can be administered. Delayed or missed diagnosis can lead to increased morbidity and mortality, increased cost and length of stay, and ICU admissions. CIWA-Ar is the most commonly used scale, but it is lengthy [...]

Background: CMS and other entities have focused on reduction of readmissions as a national quality improvement goal. The 30-day risk standardized readmission rate is derived from administrative data and requires the accurate coding of a principal diagnosis. We sought to validate the coded principal diagnosis for patients admitted with pneumonia and to determine if local [...]

Background: Inappropriate utilization of daily labs—complete blood counts (CBC) and serum electrolyte panels (SEP)—is an important cause of increased costs in the hospital setting. The Minnesota Lab Appropriateness (MLAB) criteria were previously developed to facilitate assessment of CBC and SEP appropriateness (1). A combination of clinical judgment and common healthcare data, including recent vital signs [...]

Background: The Accreditation Council for Graduate Medical Education (ACGME) requires residency programs to collect work hour data from trainees, with strict policies that no trainee should exceed an 80-hour work week (on average). Evaluating efforts to reduce work hours frequently relies on self-reported hours from trainees, which is subject to recall bias, inconsistency, and variable [...]

Background: Accurate attribution of quality metrics to individual hospitalists is crucial for quality improvement and value-based care initiatives. However, the collaborative nature of inpatient care with frequent patient handoffs makes fair attribution challenging. The current understanding of variation in hospitalist quality metrics comes primarily from studies using attribution methods based on who oversaw the majority [...]

Background: Left atrial enlargement (LAE) is a common disorder that is associated with cardiovascular morbidity and mortality. Cardiac point-of-care ultrasound (POCUS) is frequently used to assess for LAE. However, prior studies reported only modest test characteristics with sensitivity, specificity, and 60-75% accuracy using outdated gold standard reference ranges. This study was designed to determine the [...]