Background: The Hospitalist Service of Wellstar-MCG Health run the Family Medicine In-Service (FMIS) rotations. It is a month-long rotation with a team consisting of a hospitalist attending, one or two senior residents, and several interns. A large portion of learning to care for inpatients occurs during these rotations. There currently is no process in place [...]

Background: Consistent with national reports, post-pandemic burnout rates for the >100 hospitalist faculty at our institution were noted to be disproportionally high relative to the department1. Hospitalists engage in a wide range of non-clinical work including QI projects and committees embedded in the structure of efficient and high-quality inpatient care2. Building off literature in which [...]

Background: Problem Definition: Inadequate Advance Care Planning conversations and documentation remain a persistent gap in healthcare delivery. Admitting patients to the inpatient service without explicitly exploring the ‘goals of care’ and ‘code status’ results in stressful moments for the patients, their families, and providers if the condition deteriorates and may result in providing care that [...]

Background: Asking patients “what matters” to them is one of the 4 evidence-based elements of care developed by the Age-Friendly Health Systems initiative to improve the care of older adults, and the question “what matters most” has been extended to other settings. We conducted a study to assess the frequency and categories of responses to [...]

Background: Hospital medicine patients with complex behavioral and psychiatric needs benefit from specific resources and training. Inability to provide intensive, longitudinal, and specialized support for patients with psychiatric needs contributes to dissatisfaction in clinical work for hospitalists, and may increase the risk for workplace violence from patients. Little is known about the prevalence of psychiatric [...]

Background: The primary driver of hospital acquisitions is desire to increase market share. While financial impacts of hospital mergers are well demonstrated and include cost savings and economies of scale, quality impacts are less clear. A systematic review conducted through January 2020 reported inconsistent findings and few statistically significant results of hospital mergers on healthcare [...]

Background: Septic shock is a significant burden: average length of stay (LOS) for sepsis patients in US hospitals is 75% greater than most other conditions. Mean LOS dramatically increases with sepsis severity: 4.5 days for sepsis, 6.5 for severe sepsis, and 16.5 for septic shock. Administration of antibiotics in < 1 hour after presentation at [...]

Background: Constipation is commonly encountered in patients admitted to the hospital, with a variety of possible treatments to choose from. Docusate is often prescribed to treat constipation, though evidence suggests it is ineffective. Utilizing an ineffective medication adds to patients’ pill burden, health care costs, and may delay the use of effective medications with downstream [...]

Background: Email represents an administrative burden which contributes to overall burnout. While general strategies to mitigate burnout related to email have been published (Armstrong 2017), formal clinical workplace guidelines and specifically their impact have not been described in the literature. The University of Michigan (UM) Division of Hospital Medicine (HM) developed and distributed email management [...]

Background: Alcohol use disorder (AUD) is a pervasive disease affecting 28.6 million (11.3%) American adults in 2021.1 Medications for AUD (MAUD), including naltrexone, acamprosate, and disulfiram, are effective, yet less than 5% of these patients received treatment.1,2    Inpatient encounters of patients with AUD present a crucial opportunity to initiate MAUD, prompting this quality improvement [...]