Background: Over 1 million patients are hospitalized in the United States yearly for pneumonia, of which 40% develop parapneumonic effusion. Left untreated, these effusions can progress to complex effusions requiring more invasive treatment, including tube thoracostomy and surgical decortication, increasing hospital length of stay and overall morbidity. In patients with complex parapneumonic effusion, intrapleural lytic [...]

Background: Despite 80 years of documentation of the “evil sequellae”(1) of immobility for inpatients, lack of ambulation remains prevalent and deleterious. Hospitalized patients have been shown to spend an average of 83% of their stay in bed(2), leading to complications including loss of independence in activities of daily living, higher rates of discharge to facility, [...]

Background: A patient typically encounters countless new faces during their hospital stay, particularly at a teaching hospital. Often, patients may not know who they’ve interacted with, due to the overwhelming amount of new information. They might ask the wrong person about discharge, or recount an important conversation but not be able to identify who they [...]

Background: Secure text messaging platforms are increasingly replacing traditional paging systems for in-hospital communication1,2. At our institution, the number of secure texts per month nearly doubled from 4.4 million in September 2020 to 8.1 million in September 2023. This growing burden of automated notifications from secure texts without a framework to triage message urgency contributes [...]

Background: Outside-hospital (OSH) transfers are crucial to providing patients with a higher level or more specialized care. Despite the intent to improve care, OSH transfers are associated with negative outcomes due to miscommunication, lack of information, and other factors affecting patient care. Currently, there is no widely standardized process for OSH transfers. Studies show that [...]

Background: There are mounting evidence that the clinical outcomes of conservative blood utilization strategy are equal or superior to liberal blood utilization in patients with anemia in the absence of severe acute hemorrhage, hemodynamic instability, or acute ischemia. However, practice variations among clinicians continue to create a challenge to effective blood utilization stewardship. Hospital Medicine [...]

Background: Carotid artery Doppler ultrasound is a valuable diagnostic tool for patients with neurological symptoms suggestive of cerebrovascular disease, such as transient ischemic attack (TIA), stroke, or focal neurological deficits. However, its diagnostic utility is limited in patients presenting with non-specific symptoms such as syncope, dizziness, or headache. Unnecessary Doppler orders in these cases can [...]

Case Presentation: A 55-year-old male from Brooklyn, NY with insulin-dependent diabetes and dental abscess (s/p I&D 9 days prior) presented to an outside hospital with 3 days of fevers, headaches, persistent mouth pain, and altered mental status. He was transferred to our hospital on day 3 for Oral and Maxillofacial Surgery (OMFS) consultation. The patient’s [...]