Background: The availability of beds within healthcare systems has been stressed during each wave of the COVID-19 pandemic. Healthcare systems with tertiary hospitals have had increasing patient volumes and face limitations of specialized urgent (e.g., ECMO) and routine (e.g., Percutaneous Coronary Intervention) functions during critical inpatient surge volumes. Reserving the limited capacity at a tertiary […]

Background: Community-acquired pneumonia (CAP) is the most common infectious diagnosis necessitating adult hospitalization in the United States (US). Timely diagnosis of CAP is important to improve patient outcomes. However, overdiagnosis of CAP, or treatment of CAP despite inadequate signs or symptoms of CAP, may also pose a significant threat to patient safety. Potential harm of […]

Background: Fewer hospitalized patients are discharged per day on weekends as compared to weekdays.1 Hospital medicine groups have implemented quality improvement (QI) initiatives to increase weekend discharges, however, the factors contributing to lower rates of weekend discharges are not well-described.2 To better understand contributors to missed opportunities for weekend discharge, we analyzed patients discharged on […]

Background: Observation Units (OUs) are a common healthcare delivery model for health systems across the United States. OUs vary from a type 1 to type 4 based on several factors[1]. Another category of OUs – second-level OUs – does not fit this traditional classification due to a different patient population composition and staffing model. The […]

Background: The use of metered-dose inhalers (MDIs) with spacers for delivering bronchodilator therapy is established as equivalent to the use of nebulizers (nebs) for symptom response.[1-3] Additional well-documented benefits to using MDIs in place of nebs include fewer systemic side effects, better long-term patient adherence to therapy, and, in the era of COVID-19, decreased use […]

Background: In 2017, Emory University Hospital Midtown (EUHM) instituted fast track dialysis (FTD) which identified low risk patients in the emergency department (ED) in need of hemodialysis (HD) and provided it efficiently. The FTD development team consisted of hospital medicine, emergency medicine, nephrology, dialysis unit nursing, and ED nursing. This program showed a reduction in […]

Case Presentation: A 90-year-old-male with history of hypertension, coronary artery disease and chronic lymphocytic lymphoma presented with shortness of breath that had been getting worse over the previous few weeks, particularly at night and with lying down. He also reported increased cough and worsening leg swelling. In the ED, he was hypoxic (84% on room […]

Background: There is recognition by educational regulatory bodies that physicians need to have some level of leadership skills. In 2007 the Residency Review Committee for Family Medicine approved a new requirement for training in leadership during family medicine residency. Seven years later in 2014, the Journal of Graduate Medical Education published the relationship between physician […]

Background: Diabetic Ketoacidosis (DK)A at our center has historically been managed in the intensive care unit (ICU) utilizing low-dose insulin infusion. According to the American Diabetes Association (ADA) and a 2016 Cochrane review, cases of mild to moderate DKA can be safely managed on general medical floors utilizing subcutaneous short-acting insulin. Prior studies have demonstrated […]

Background: Career exploration and professional identity formation (PIF) are critical in undergraduate medical education (UME). With its focus on management of acutely ill, hospitalized patients, Hospital Medicine (HM) is an opportune environment for pre-clinical students to gain valuable, diverse clinical experiences. While widely utilized in UME, shadowing on HM direct-care services (HM-DCS) (i.e., those without […]