Randy Smith is a career hospitalist and currently serves as Unit Medical Director for Unit 16 West at Northwestern Memorial Hospital. He has served as an implementation mentor in four Federally or privately funded multihospital quality improvement programs. His quality improvement experience includes direct involvement in development projects at thirteen hospitals throughout his career, with project focus ranging from prevention of unplanned readmissions, optimization of hospital throughput, design of handover systems and diagnosis notification systems for discharged patients, inpatient medication reconciliation, unit-level teamwork and service design, quality dashboard design, standardization of acute asthma care, and opiate use in inpatient pain management. He is a Consultant in Acute Medicine (United Kingdom) and previously served as Clinical Director of Medicine at the Royal Infirmary of Edinburgh/NHS Lothian in Scotland. His work as a health services researcher focuses on hospital resource utilization, and how hospital resources and service design shape medical decision making. He has consulted for counsel in medical litigation in seven US states, and has led over 50 root cause analyses of adverse events for institutions. He is a fellow of the Royal College of Physicians of Edinburgh, a senior fellow of the Society of Hospital Medicine, and is presently clinically active in the care of medical inpatients, both independently and via the supervision of residents and students.