Background: Discharge summaries assist in the transition from inpatient to outpatient care by communicating key diagnoses, medication changes, and follow-up instructions. Despite use of standard formats for discharge summaries through electronic medical records (EMR), primary care physicians (PCPs) report dissatisfaction with locating important information in discharge summaries. Purpose: The aim of our project was to […]

Background: Discharge summaries assist in the transition from inpatient to outpatient care by communicating key diagnoses, medication changes, and follow-up instructions. Despite use of standard formats for discharge summaries through electronic medical records (EMR), primary care physicians (PCPs) report dissatisfaction with locating important information in discharge summaries. Purpose: The aim of our project was to […]

Case Presentation: A 52‐year‐old man with a history of obesity with Roux‐en‐Y gastric bypass (RYGB) in 2002, chronic back pain, diabetes, hypertension, and benign prostatic hypertrophy presented with 1 day of alteration in mental status and tremors. In the preceding 4 months, he had 2 similar admissions for altered mental status secondary to acute kidney […]

Background: The transitioning from pediatric to adult care has been correlated with worsened outcomes including increased mortality [1]. Improving patient experience (PEX) has been correlated to improved adherence and lower inpatient mortality rates [2] as well as lower 30-day readmission rates for patients with heart failure, acute MI and pneumonia [3]. Young adults transiting from […]

Background: Hospitalization despite lack of medical acuity (so-called “non-medical” or “social” admission) is relatively common, especially in a safety-net setting. Hospitalists directly involved in triaging admission requests from the Emergency Department (ED) bring unique insight of the process. Here, we use a qualitative approach to explore hospitalist perspectives on disposition decisions for patients thought not […]

Case Presentation: A 63‐year‐old morbidly obese woman with no known medical history presented emergently with worsening shortness of breath. She had a CT scan of the abdomen, which showed free intraperitoneal air. Because of her short neck and morbid obesity, intubation was difficult. Following intubation, an emergent exploratory laparotomy was done. After a complicated and […]

Background: Despite system-level focus on avoidance of potentially preventable hospitalizations, the decision to admit a patient with low medical acuity has been understudied. Our study sought to identify factors associated with admission versus discharge from the Emergency Department (ED) for patients considered unlikely to be medically appropriate for admission. Methods: We conducted a retrospective cross-sectional […]

Case Presentation: A 57‐year‐old woman with a history of herpes encephalitis and residual right temporal lobe encephalomalacia (diagnosed 9 years prior to our encounter) presented to the emergency department on 2 separate occasions 1 month apart, with altered mental status and subjective fevers. The patient was taking valacyclovir prophylactically due to similar presentations in the […]

Case Presentation: A 73‐year‐old African American man presented with productive cough and shortness of breath for 2½ weeks. He was ex‐smoker with about a 30‐pack‐per‐year history and family history of lung cancer. On presentation, vital signs were stable. Chest examination was unremarkable and other systemic exam was within normal limit. Initial chest x‐ray showed a […]

Background: Hospitalists have increasingly engaged in admission decision-making for acute care medical patients. The role, duties, and impact of a Hospital Medicine Triage Attending (“triagist”) are emerging yet ill-defined. To our knowledge, no study thus far has catalogued the activities of these physicians in a comprehensive way. Our objectives were to 1) characterize the demands […]