HM2007 Abstract Number: 1002

An Unusual Case of Stomatitis with a Usual Pathogen

Case Presentation: A 21‐year‐old local college student with no medical history presented with progressive odynophagia, dysphagia, and facial swelling. Her symptoms started 1 week prior to admission with a progressive cough, purulent yellow expectorate, and [...]

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HM2007 Abstract Number: 1001

Abdominal Pain and Jaundice: A Family Affair

Case Presentation: A 30‐year‐old Guatemala‐born man presented with severe, nonradiating epigastric and right upper quadrant abdominal pain, intermittent for the past 2 years, requiring several prior hospitalizations. Pain was accompanied by moderate nausea, vomiting, and [...]

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HM2007 Abstract Number: 1000

Human Monocytic Ehrlichiosis Presenting as Altered Mental Status

Case Presentation: A previously healthy 54‐year‐old man presented with a history of fever, sore throat, myalgias, worsening lethargy, diarrhea, and epistaxis. The patient had traveled to Mount Calazano, Italy, and England the month before admission [...]

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HM2007 Abstract Number: 154

A Not‐So‐Unusual “VIP”‐oma: Iatrogenesis from Overly Aggressive Treatment of a Physician's Spouse

Case Presentation: A 44‐year‐old woman presented 6 days aftera cesarean section with worsening left leg swelling. The patient, whose spouse was a physician at the admitting hospital, had been on bed rest for the last [...]

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HM2007 Abstract Number: 153

A Rare Cause of Cardiac Tamponade

Case Presentation: A 70‐year‐old white female patient was admitted fora subarachnoid hemorrhage and underwent aneurysm clipping of the anterior communicating artery. Postoperatively she complained of angina‐like pain and subsequently became hypotensive with systolic blood pressures [...]

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HM2007 Abstract Number: 152

Brain Abscess Following Self‐inflicted Trauma with Weaving Needle

Case Presentation: A 40‐year‐old blind woman presented with progressively altered mental status 1 week after an emergency department visit for a “viral URI.” PMH was significant for giant optic glioma, anxiety, neurodermatitis, and mild mental [...]

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HM2007 Abstract Number: 151

Acute Abdominal Aortic Thrombosis as a Complication of the Heimlich Maneuver

Case Presentation: An 81‐year‐old frail man (weight 99 lb) with a medical history significant for chronic obstructive pulmonary disease, lower‐extremity deep venous thrombosis (on warfarin), hypertension, and recent left hip replacement was undergoing rehabilitation and [...]

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HM2007 Abstract Number: 150

Nonresolving Pulmonary Infiltrates in a Smoker

Case Presentation: A 28‐year‐old woman with a medical history of asthma, migraine, depression, and smoking presented to the emergency department (ED) with shortness of breath and cough fora month. She had previously been treated by [...]

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HM2007 Abstract Number: 149

Brugada Syndrome: An Uncommon Cause of Syncope and Sudden Cardiac Death

Case Presentation: A 37‐year‐old man with a family history of “heart disease” presented to the emergency room (ER) with a witnessed syncopal event lasting 1 minute. He had no chest pain, dyspnea, dizziness, or palpitations [...]

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HM2007 Abstract Number: 148

Intimal Sarcoma of Aorta Mimicking Thrombus

Case Presentation: An 83‐year‐old‐active white man with a medical history of hypertension and osteoarthritis and 1‐month history of low back pain presented to the emergency department with a right intertrochantericfemurfracture. He underwent emergent open reduction [...]

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HM2007 Abstract Number: 147

Pulmonary Artery Sarcoma Masquerading as Pulmonary Embolism

Case Presentation: A 39‐year‐old woman with a medical history of polycystic ovarian syndrome presented with pleuritic chest pain, fever, progressive dyspnea on exertion for 1 month, and right upper quadrant abdominal pain. Her physical exam [...]

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HM2007 Abstract Number: 146

Chronic Diarrhea and Abdominal Pain — Pin the Pinworm

Case Presentation: An 84‐year‐old female patient from an assisted‐living facility (ALF) was admitted with complaints of abdominal pain and diarrhea (7‐8 episodes/day, watery, non‐foul‐smelling) for 2 months. She denied nausea, vomiting, fever, chills, anal pruritus, [...]

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HM2007 Abstract Number: 145

Staph aureus Bacteremia Presenting as Red Eyes

Case Presentation: A 74‐year‐old white man with end‐stage renal disease, diabetes mellitus, coronary artery disease, congestive heart failure, and S/P pacemaker placement was admitted to the hospital with a chief complaint of painful red eyes [...]

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HM2007 Abstract Number: 144

Neonatal Hyperbilirubinemia: An Unexpected Cause

Case Presentation: A 5‐day‐old male infant born after 38 weeks' gestation presented to the emergency department with hyperbilirubinemia (total bilirubin level 29.8 mg/dL) and anemia (hemoglobin 10.6 g/dL). His other blood indices were normal (white [...]

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HM2007 Abstract Number: 143

Rapidly Expanding Belly: A Classic Presentation of a Rare Cause of Acute Renal Failure

Case Presentation: A 59‐year‐old man presented to the emergency department with new‐onset right testicular pain in the setting of back pain and abdominal distention. After evaluation by his primary care physician 2 weeks prior, he [...]

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HM2007 Abstract Number: 142

Fatal Spontaneous Rectus Sheath Hematoma Presenting as a Leukemoid Reaction

Case Presentation: A 62‐year‐old woman with a medical history of chronic obstructive pulmonary disease (COPD), renal insufficiency, and chronic atrial fibrillation was admitted to the hospital for treatment of community‐acquired pneumonia and exacerbation of her [...]

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HM2007 Abstract Number: 141

A Total Crisis? Steroid Self‐Prescription and an Unusual Cause of Acute Renal Failure

Case Presentation: A 56‐year‐old physician with vitiligo and hypothyroidism presented to the emergency department with malaise, intermittent fevers and flulike symptoms of 1 month's duration. She had taken ibuprofen for 10 days and self‐prescribed dexamethasone [...]

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HM2007 Abstract Number: 140

Reversal of Opioid‐Induced Gastric Dysfunction in a Critically Ill Burn Patient with Methylnaltrexone

Case Presentation: A 21‐year old man had been admitted to the ICU for a 30% burn injury incurred in a house fire and explosion. He underwent excision and skin grafting and was receiving 60‐100 mg [...]

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HM2007 Abstract Number: 139

RLQ Pain Long after an Appendectomy

Case Presentation: An 11‐year‐old girl presented to the pediatric emergency department complaining of 3 days of right lower quadrant (RLQ) abdominal pain. Her pain was sharp, intermittent, exacerbated by touch or movement, alleviated by lying [...]

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HM2007 Abstract Number: 138

Shrimper's Gastroenteritis

Case Presentation: A 64‐year‐old retired shrimper with hypertension, hyperlipidemia, gout, and nonalcoholic steatohepatitis (NASH) with stage 3 fibrosis, presented to the emergency department with fever and vomiting. He had spent the day on his boat [...]

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HM2007 Abstract Number: 137

Hepatoblastoma Presenting as Severe Osteopenia and Pathologic Fracture in a Medically Complex Child

Case Presentation: A 1‐year‐old girl with multiple medical problems including trisomy 18, tetralogy of Fallot, and gastroesophageal reflux presented with a 3‐week history of fever and irritability. In addition, she had had several weeks of [...]

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HM2007 Abstract Number: 136

Tumefactive Multiple Sclerosis Presenting as Ring‐Enhancing Lesions on Computerized Tomography of the Brain in a 27‐Year‐Old Man

Case Presentation: A 27‐year‐old man presented to the emergency department with 1 week of right‐hand weakness and ataxia. Three weeks earlier, he had developed flulike symptoms consisting of headache, fatigue, and nausea. He took Theraflu, [...]

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HM2007 Abstract Number: 135

Cefepime: An Underrecognized Cause of Change in Mental Status

Case Presentation: A 72‐year‐old woman with moderately reduced renal function (creatinine, 2.1 mg/dL; GFR, 36 mL/min) was admitted to our institution because of worsening chronic back pain. Her physical examination was unremarkable except for decreased [...]

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HM2007 Abstract Number: 134

When a Patient Has No Voice

Case Presentation: A 75‐year‐old man with a distant history of laryngeal squamous cell cancer underwent a laryngoscopy to evaluate a new left piriform mass. Complications during the procedure lead to an emergent tracheostomy, and he [...]

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HM2007 Abstract Number: 133

Lamotrigine‐Induced Aseptic Meningitis

Case Presentation: A 36‐year‐old white woman with a history of hypothyroidism and type 2 bipolar disorder presented with a 4‐day history of fever, rigors, nausea, vomiting, neck stiffness, photophobia, and severe diffuse headaches. She had [...]

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HM2007 Abstract Number: 132

Posterior Leukoencephalopathy Syndrome: Blindness in 2 Peripartum Patients

Presentation of Case 1: A healthy 20‐year‐old primagravid woman was admitted to the hospital for delivery. Her prenatal course was unremarkable with no evidence of hypertension. On admission her blood pressure was elevated up to [...]

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HM2007 Abstract Number: 131

Pheochromocytoma Presenting as Cardiogenic Shock: An Atypical Presentation

Case Presentation: A 51 ‐year‐old white woman with a history of recent‐onset hypertension and diabetes mellitus presented to a community hospital complaining of chest pain, shortness of breath, and several episodes of emesis over the [...]

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HM2007 Abstract Number: 130

Query Fever

Case Presentation: A 37‐year‐old man with no significant PMH was admitted for evaluation of a 3‐week history of high fevers, fatigue, decreased appetite, and flulike symptoms. As an outpatient, he had been seen by his [...]

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HM2007 Abstract Number: 129

Postprandial Nitroglycerin: A Novel Approach for Chronic Mesenteric Ischemia

Case Presentation: A 69‐year‐old man was transferred from a community hospital with the complaint of postprandial abdominal pain for 1 year. The pain was described as dull, gradually increasing in severity over 1‐2 hours, often [...]

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HM2007 Abstract Number: 128

Acetaminophen Induced High Anion Gap Metabolic Acidosis

Case Presentation: A 66‐year‐old woman presented to the emergency room with complaints of weakness and shortness of breath. She had been taking acetaminophen (ACT) tablets for the 2 weeks prior to admission for increasing low [...]

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HM2007 Abstract Number: 127

Systemic Capillary Leak Syndrome Mimicking Polycythemia Vera

Case Presentation: A 54‐year‐old man was referred for evaluation of polycythemia vera that was diagnosed after a series of dramatic hospitalizations for near‐syncope. The patient first presented with sudden lightheadedness and presyncope, which led to [...]

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HM2007 Abstract Number: 126

Mosquito Madness: Improvement of West Nile Virus Encephalitis after Interferon Alpha‐2b

Case Presentation: A 49‐year‐old man presented with a 1‐day history of headache, drenching sweats, photophobia, and vomiting that prompted a CSF evaluation for meningitis. A lumbar puncture revealed protein of 105 mg/dL, a total of [...]

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HM2007 Abstract Number: 125

A Thorough History: Worth a Million‐Dollar Workup and a Trip to the Operating Room

Case Presentation: A 21‐year‐old woman with no significant medical history presented to the emergency room with a 2‐day history of acute‐onset, intractable nausea associated with nonbloody, nonbilious vomiting. Four years earlier she had experienced similar [...]

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HM2007 Abstract Number: 124

Weight Loss and Gastrointestinal Bleeding from Gastric Amyloidosis Secondary to Occult Plasma Cell Myeloma

Case Presentation: A62‐year‐old white man with a medical history of hypothyroidism and atrial fibrillation was admitted for evaluation of early satiety, nausea, lethargy, and a 20‐pound weight loss over the preceding 3 weeks. On physical [...]

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HM2007 Abstract Number: 123

Acute Pancreatitis after Propofol Administration

Case Presentation: A 36‐year‐old woman with no medical history presented to the emergency department complaining of 1 day of chills, vomiting, and progressively worsening epigastric pain. The previous day the patient had had dilatation and [...]

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HM2007 Abstract Number: 122

Rapidly Progressive Dementia in an Elderly Hospitalized Patient

Case Presentation: A 67‐year‐old man with hypertension and hyperlipidemia presented with a 3‐day history of intermittent confusion. His wife had also noticed changes in personality, irritability, ataxia of 3 weeks' duration, and impairment of short‐term [...]

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HM2007 Abstract Number: 121

A Case of Paradoxical Vocal Cord Movement

Case Presentation: A 24‐year‐old woman with no significant medical history was admitted for stridor. One month before, the patient had an uncomplicated laparoscopic cholecystectomy. She had an EGD 3 days before admission. The EGD was [...]

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HM2007 Abstract Number: 120

Radiocontrast‐Induced Acute Thrombocytopenia

Case Presentation: An 89‐year‐old white man presented to the emergency department with diffuse abdominal pain of several days' duration. He was afebrile, an abdominal exam was benign, and a stool sample was negative for occult [...]

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HM2007 Abstract Number: 119

“Still” A Mystery!

Case Presentation: A 29‐year‐old white woman with a history of fever spikes for 1 month presented with complaints of fever, poor appetite, arthralgia, and an erythematous rash on her lower extremities. She had been seen [...]

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HM2007 Abstract Number: 118

An Unusual Case of Pyomyositis of the Neck

Case Presentation: A 59‐year‐old woman with a medical history of Crohn's disease and hypertension presented to the emergency room with pain in the left side of her neck that had been progressively worsening for 4 [...]

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HM2007 Abstract Number: 117

Intracardiac B‐Cell Lymphoma Presenting as New‐Onset Atrial Fibrillation and Diastolic Heart Failure

Case Presentation: A 68‐year‐old woman was admitted to a tertiary referral center after presenting to her local emergency department (ED) with a complaint of shortness of breath. She initially presented to the ED with a [...]

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HM2007 Abstract Number: 116

Withdrawal of Enteral Nutrition and Intravenous Hydration in Pediatric Palliative Care

Case Presentation: A 5‐month‐old girl presented to the emergency room with lethargy and respiratory depression. She had multiple injuries consistent with inflicted trauma, including massive intracranial injury, lacerated liver, ruptured bladder, fractured femur, and facial [...]

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HM2007 Abstract Number: 115

Chicken of the “C”: One Man's Tale of Syncope

Case Presentation: A 51 ‐year‐old man was brought to the hospital after being found unconscious in the hallway of his transitional housing establishment. At the time of presentation, he was alert and interactive but made [...]

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HM2007 Abstract Number: 114

Peripherally Inserted Central Catheter Fracture and Embolization: An Unusual Cause of Chest Pain

Case Presentation: A 43‐year‐old man on chronic intravenous antibiotic therapy presented with new‐onset chest pain that had developed while flushing his peripherally inserted central catheter (PICC) line. The pain was pleuritic in quality and was [...]

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HM2007 Abstract Number: 113

Diabetic Myonecrosis: An Uncommon Complication of a Common Disease

Case Presentation: A 29‐year‐old man with long‐standing, poorly controlled diabetes mellitus presented with change of mental status. Past medical history included: chronic kidney disease, diabetic retinopathy and neuropathy, left UE occluded AV fistula, congestive heart [...]

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HM2007 Abstract Number: 112

Oxygen‐Induced Pulmonary Toxicity 20 Years after Bleomycin Exposure

Case Presentation: A 41‐year‐old man with a history of Hodgkin's lymphoma treated successfully 20 years prior presented to the emergency room with bilateral ankle fractures after a fall. He underwent operative repair of his injuries [...]

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HM2007 Abstract Number: 111

Occam's Razor in Action: Simultaneous Pulmonary Embolism and Acute Myocardial Infarction Secondary to a Previously Undiagnosed Patent Foramen Ovale

Case Presentation: A 79‐year‐old man with no antecedent coronary artery disease underwent resection of recurrent high‐grade lipo‐sarcoma of the right upper extremity with placement of hollow catheters for perioperative brachytherapy. On postoperative day 2, he [...]

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HM2007 Abstract Number: 110

Pneumococcal Endocarditis Presenting as Endophthalmitis

Case Presentation: A 64‐year‐old man with a medical history of hypertension and smoking presented to the emergency department (ED) with an acutely swollen and painful left eye, along with a 2‐week history of fevers, chills, [...]

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HM2007 Abstract Number: 109

Mycobacterium Aurum/Neoaurum Bacteremia: A Case Report and Review of the Literature

Case Presentation: A 49‐year‐old woman was admitted to the hospital with fevers, chills, and hematuria and found to have urosepsis with Enterococcus faecalis. Her medical history included ischeal tuberosity ulcer from pressure necrosis and resulting [...]

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HM2007 Abstract Number: 108

A Pain in the Neck: A Case of Lemierre's Syndrome

Case Presentation: A previously healthy 18‐year old man initially presented to his outpatient physician with fevers and a cough. After 1 week of telithromycin, he developed a sore throat, nausea, and recurrent high fevers. His [...]

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HM2007 Abstract Number: 107

Thinking Globally: Adrenal Tuberculosis in an Indian Man on Vacation in the United States

Case Presentation: A 41‐year‐old Indian man vacationing in the United States presented with a 2‐day history of vomiting and lightheadedness. He had been vomiting at least 6 times a day and felt extremely thirsty. Review [...]

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HM2007 Abstract Number: 106

E&M and U&Me: An Effective Hospital Medicine Compliance Program for Small‐Group Physician Practices

Background: The Office of Inspector General (OIG) of the Department of Health and Human Services established compliance program guidelines for individual and small‐group physician practices and for hospitals. Although having a formal compliance plan was [...]

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HM2007 Abstract Number: 105

Back to the Future: Redesigning the Emergency Department Admission Process to Improve Throughput

Background: At FirstHealth Moore Regional Hospital (FMRH), emergency department (ED) visits since 2003 have continued to increase at an average rate of more than 2.5%. In FY 2006 alone, visits totaled 57,678, a 3% increase [...]

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HM2007 Abstract Number: 104

Simplifying Bed Selection Results in More Optimal Patient Care That Is Cost Effective

Background: Sleep support surfaces play an important role in preventing pressure injury in hospitalized patients. There are hundreds of specialty beds and mattresses available through scores of companies. Because of differences in terminology, facility contracts, [...]

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HM2007 Abstract Number: 103

Reduction in Code Blue Calls Using a Rapid‐Response Team Aided by an Early‐Warning Scoring System

Background: The early signs and symptoms of patients at risk for clinical deterioration are frequently difficult to assess. The complex nature of patient care coupled with the need for accurate critical evaluation skills contributes highly [...]

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HM2007 Abstract Number: 102

Implementation of Multidisciplinary Collaborative Rounding in the General Practice Unit: Implications for Patient Safety and Resident Education

Background: Multiple barriers exist to improving patient safety during regular rounds on an internal medicine inpatient unit: lack of standardization, limited time because of high patient turnover, and reduced communication with all members of the [...]

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HM2007 Abstract Number: 101

Queuing Theory for Designing Geographically Localized Hospitalist Units and Impact on Hospital Throughput

Background: Most patient arrivals at hospitals are unsynchronized with their discharges. If beds are assigned on a first come, first served basis, the result is patients being dispersed among several nursing units. This geographical disconnect [...]

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HM2007 Abstract Number: 100

Quality Improvement to Optimize Neonatal Nutrition in Low‐Birth‐Weight Infants

Background: There is increasing evidence that providing early and aggressive nutrition to premature infants improves clinical outcomes related to length of stay, weight gain and growth, and improved neurodevelopment. In addition, the early introduction of [...]

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HM2007 Abstract Number: 99

A Successful Strategy to Improve Inpatient Pneumococcal Vaccination

Background: Administration of the pneumococcal vaccine to inpatients more than 65 years old with community‐acquired pneumonia (CAP) is a measure of hospital quality according to the Joint Commission on Accreditation of Healthcare Organizations and CMS. [...]

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HM2007 Abstract Number: 98

Multidisciplinary Teamwork Training on a Medical Service

Background: Communication failures pose a significant and ongoing threat to patient safety. The current modes of training in educational silos foster poor teamwork and lack a shared model for high‐quality patient care. A growing emphasis [...]

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HM2007 Abstract Number: 97

Brain Attack Response Team (BART) Assures Evaluation and Treatment of Stroke and Stroke Mimics in Hospitalized Patient

Background: Between 5% and 15% of strokes occur in hospitalized patients and are associated with 54% mortality, increased cost of care, and a longer length of stay. Stroke or transient ischemic attack (TIA) patients arriving [...]

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HM2007 Abstract Number: 96

The Physician Manager: A Quality and Efficiency Improvement Strategy Utilizing Hospitalist Leadership

Background: Maximal efficiency is increasingly prioritized in the ever‐changing health care environment, and hospitalists are being called on to function beyond their traditional role of patient care provider. Multidisciplinary rounds are increasingly used to improve [...]

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HM2007 Abstract Number: 95

Recorded Patient Care Reports as the Foundation of JCAHO‐Compliant Handoffs That Improve Patient Safety

Background: To improve patient safety through communication among health care professionals, in 2006 the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) began to require a standardized approach to physician‐to‐physician handoff communications. Criteria included an [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Recorded Patient Care Reports as the Foundation of JCAHO‐Compliant Handoffs That Improve Patient Safety

HM2007 Abstract Number: 94

Newborn Circumcision Adds Significant Income to an Academic Pediatric Hospitalist Program

Background: To comply with the 80‐hour workweek restrictions in 2004, the OB‐GYN department at a teaching hospital turned over the routine circumcision program to the pediatric hospitalist group. Taking over the program required a dedicated [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Newborn Circumcision Adds Significant Income to an Academic Pediatric Hospitalist Program

HM2007 Abstract Number: 93

A Multi‐Institutional Perioperative Medicine Retreat for Internal Medicine Trainees

Background: Perioperative medicine has gained increasing importance in both academic and community hospitals and has been identified as an area in which physicians feel inadequately prepared during training. Exposure to perioperative medicine continues to be [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on A Multi‐Institutional Perioperative Medicine Retreat for Internal Medicine Trainees

HM2007 Abstract Number: 92

Development of a Critical Care Nursing Coordinator Model to Lead a Rapid‐Response Team in an Academic Medical Center

Background: Rapid‐response teams (RRTs) are a patient safety intervention designed to identify, diagnose, and treat hospitalized patients who are clinically deteriorating outside an intensive care unit (ICU). The ability to implement and sustain a successful [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Development of a Critical Care Nursing Coordinator Model to Lead a Rapid‐Response Team in an Academic Medical Center

HM2007 Abstract Number: 91

Effects of an Intern Curriculum on the Quality of Hospital Discharge Summaries

Background: The discharge summary is critical to safe transitions from the inpatient to the outpatient setting. However, there are few educational models on how best to teach those on the house staff, who write most [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Effects of an Intern Curriculum on the Quality of Hospital Discharge Summaries

HM2007 Abstract Number: 90

A Strategy to Improve Provider Use of Deep‐Venous Thrombosis Prophylaxis

Background: Health care organizations have had significant difficulty getting providers to prescribe deep venous thrombosis (DVT) prophylaxis for their patients. Organizations including the Joint Commission on Accreditation of Healthcare Organizations and the Agency for Health [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on A Strategy to Improve Provider Use of Deep‐Venous Thrombosis Prophylaxis

HM2007 Abstract Number: 89

Habits for Lifelong Learning of Core Competencies in Hospital Medicine for Physician Assistants

Background: In 2006 both the American Academy of Physician Assistants and the Society of Hospital Medicine published core competencies (CCs) in the practice of medicine. There is no published literature on the application of CCs [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Habits for Lifelong Learning of Core Competencies in Hospital Medicine for Physician Assistants

HM2007 Abstract Number: 88

Pediatric Observation vs. Admission Designation: Optimizing Performance Through Rapid‐Cycle Improvement

Background: In the age of declining reimbursement and insurance‐driven health care, it has become increasingly important for hospital systems to proactively address their compliance and revenue patterns. In 2003 our institution began to designate all [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Pediatric Observation vs. Admission Designation: Optimizing Performance Through Rapid‐Cycle Improvement

HM2007 Abstract Number: 87

Partnership of Palliative Medicine Team and Hospitalists: Continuity of Care

Background: In a tertiary‐care setting, the culture of curative medicine can prevent physicians and parents from initiating a palliative medicine consult. Children who most need the service are those with chronic complex disease who have [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Partnership of Palliative Medicine Team and Hospitalists: Continuity of Care

HM2007 Abstract Number: 86

Indication‐Based Ordering Produces Improved Outcomes in Reducing Rate of Preventable Venous Thromboembolic Events

Background: Venous thromboembolic (VTE) disease is a significant burden for hospitalized inpatients. At our institution, we designed an intervention that would force physician users both to rate degree of VTE risk and to intervene with [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Indication‐Based Ordering Produces Improved Outcomes in Reducing Rate of Preventable Venous Thromboembolic Events

HM2007 Abstract Number: 85

Rapid‐Response Teams and Internal Medicine Training: Original Descriptive Summary of Rapid‐Response Team Implementation in a Community‐Based Residency Program

Background: Rapid‐response teams (RRTs) are associated with decreases in unexpected inpatient death, code blue, and unexpected ICU transfer rates. There are many RRT designs, but little has been written about RRTs coordinated by internal medicine [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Rapid‐Response Teams and Internal Medicine Training: Original Descriptive Summary of Rapid‐Response Team Implementation in a Community‐Based Residency Program

HM2007 Abstract Number: 84

Implementation of an Acute Care Preceptorship for Second‐Year Medical Students

Background: Medical students traditionally learn the clinical skills of taking a patient history and performing a physical examination in Introduction to Clinical Medicine (ICM) courses. Increasingly, these courses use real or simulated patients to give [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Implementation of an Acute Care Preceptorship for Second‐Year Medical Students

HM2007 Abstract Number: 83

Strategies for Effective Noise Reduction in a Neonatal Intensive Care Unit

Background: Low sound levels are important for the normal neurological development of preterm infants. The American Academy of Pediatrics recommends an average noise level of 45 dB for premature infants. However, as a consequence of [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Strategies for Effective Noise Reduction in a Neonatal Intensive Care Unit

HM2007 Abstract Number: 82

Creation of a New Admitting Structure to Minimize Patient Handoffs at a University‐Affiliated Teaching Hospital

Background: In July 2003 the ACGME 80/30 work hour regulations went into effect. To maintain compliance with these regulations, new systems of care that might include cross cover and patient handoffs were created. Cross cover [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Creation of a New Admitting Structure to Minimize Patient Handoffs at a University‐Affiliated Teaching Hospital

HM2007 Abstract Number: 81

Internet‐Based Sign‐Out System

Background: The exchange of clinical information and patient care responsibility between physicians is crucial in the care of hospitalized patients. Many studies have looked at sign‐out/handoffs involving residents and interns and elicited mixed opinions. Very [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Internet‐Based Sign‐Out System

HM2007 Abstract Number: 80

Pharmacist Facilitated Discharge: A Prospective Study of Medication Discrepancies

Background: Medical patients frequently experience medication changes during hospitalization. This increases the risk of medication‐related errors at discharge that may cause adverse events, resulting in increased mortality, readmission, and costs. As a result, the Joint [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Pharmacist Facilitated Discharge: A Prospective Study of Medication Discrepancies

HM2007 Abstract Number: 79

Jump‐Starting Hospitalist Clinical Research: The Specialist‐Hospitalist Allied Research Program (SHARP)

Background: Clinical research has developed slowly in most hospitalist programs. Although partly related to the field's youth, it likely also reflects a lack of specific expertise about the clinical issues most worthy of study. Because [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Jump‐Starting Hospitalist Clinical Research: The Specialist‐Hospitalist Allied Research Program (SHARP)

HM2007 Abstract Number: 78

“Minirounds” Improve Physician‐Patient Communication and Satisfaction

Background: Physician‐patient communication is of paramount importance in providing efficient, cost‐effective, and compassionate patient care. Many lawsuits stem from poor communication between health care providers and patients. Face‐to‐face contact is essential for providing good patient [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on “Minirounds” Improve Physician‐Patient Communication and Satisfaction

HM2007 Abstract Number: 77

Implementation of Code Green

Background: Following a regional natural disaster, our hospital experienced an influx of patients who presented unique challenges. Patients formerly managed by the local charity system instead were processed through our emergency department, nearly tripling our [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Implementation of Code Green

HM2007 Abstract Number: 76

Enhancing the Transition from Hospital to Home for the Older Adult

Background: When elderly patients are discharged home following an acute hospitalization, they are at high risk of having an unsuccessful transition with untoward health care outcomes. Our team has developed an interdisciplinary, comprehensive intervention to [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Enhancing the Transition from Hospital to Home for the Older Adult

HM2007 Abstract Number: 75

NURSVEY: A Web‐Based Nursing Satisfaction Tool

Background: A hospitalist program serves numerous stakeholders: patients, hospital administration, primary care physicians, and nursing staff, to name a few. It is imperative to gauge hospitalist performance as evaluated by these stakeholders. Although surveying patients [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on NURSVEY: A Web‐Based Nursing Satisfaction Tool

HM2007 Abstract Number: 74

Review of 7‐Day Readmissions to a Hospital Medicine Program in an Academic Medical Center

Background: Since the advent of hospitalist programs, multiple studies reported in the literature have compared readmission rates on hospitalist and nonhospitalist services. However, specific reasons for readmission are often not available. Purpose: To describe the [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Review of 7‐Day Readmissions to a Hospital Medicine Program in an Academic Medical Center

HM2007 Abstract Number: 73

Reduction in Utilization of Intravenous Proton Pump Inhibitors Following Implementation of a Computerized Physician Order Entry Order Set

Background: A number of studies reported in the literature suggest there is overuse of proton pump inhibitor (PPI) medications in hospitalized patients. Purpose: The goals of the study were to implement a computerized physician order [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Reduction in Utilization of Intravenous Proton Pump Inhibitors Following Implementation of a Computerized Physician Order Entry Order Set

HM2007 Abstract Number: 72

Intern‐Perceived Effectiveness of a Program Designed to Teach Resident Handoffs

Background: The resident duty‐hour limitations mandated by theACGME increases the number of handoffs of patient responsibility, raising concerns about discontinuity of care and patient safety (Charap, Ann Intern Med. 2004). Meanwhile, the handoff process is [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Intern‐Perceived Effectiveness of a Program Designed to Teach Resident Handoffs

HM2007 Abstract Number: 71

Club Hospital Med: Integrating SHM's Core Competencies into a Journal Club

Background: Incorporating continuing medical education for hospital medicine programs is an important component of practice development. This can be particularly challenging for practices that do not have access to grand rounds and the usual calendar [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Club Hospital Med: Integrating SHM's Core Competencies into a Journal Club

HM2007 Abstract Number: 70

Web‐Based Team Collaboration Environment for Clinical Care, Research, and Education at an Academic Hospitalist Group

Background: As hospitalist groups grow larger, it is important for every member of the team to be on the same page with new developments and in‐house rules and regulations. Exchanging e‐mails has the limitation of [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Web‐Based Team Collaboration Environment for Clinical Care, Research, and Education at an Academic Hospitalist Group

HM2007 Abstract Number: 69

Hospitalist Track for Internal Medicine Residents

Background: Internal medicine (IM) resident training in the United States is undergoing a “relook” through “residency reform” by various medical organizations. One idea is to give residents more flexibility in planning their training to meet [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Hospitalist Track for Internal Medicine Residents

HM2007 Abstract Number: 1000

Predictors of Fatigue for Interns in Cognitive Specialties

Background: ACGME duty‐hour limitations were intended, in part, to reduce resident fatigue and decrease its many negative consequences. Prior data suggest fatigue‐related reductions in patient safety and resident well‐being. We aimed to assess the factors [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Predictors of Fatigue for Interns in Cognitive Specialties

HM2007 Abstract Number: 68

Localizing Patients for Hospitalist Services on Dedicated Nursing Units

Background: Admission to the general internal medicine (GIM) service at our 1100‐bed tertiary‐care hospital occurs randomly, with bed assignments determined on a first come, first served basis. Consequently, patients are dispersed to geographically disparate nursing [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Localizing Patients for Hospitalist Services on Dedicated Nursing Units

HM2007 Abstract Number: 67

Modified TIMI Risk Score Accurately Identifies Low‐Risk Patients Presenting to an Emergency Department with Chest Pain: Implication for Safe Discharge for Outpatient Noninvasive Cardiac Testing

Background: The TIMI risk score has been validated in the emergency department (ED) setting as a tool for risk stratification of patients presenting with chest pain. The TIMI risk score is a 7‐point scale that [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Modified TIMI Risk Score Accurately Identifies Low‐Risk Patients Presenting to an Emergency Department with Chest Pain: Implication for Safe Discharge for Outpatient Noninvasive Cardiac Testing

HM2007 Abstract Number: 66

Safety and Tolerability of Subcutaneous Administration of Morphine + Human Recombinant Hyaluronidase (rHuPH20): Pooled Data from 3 Pharmacokinetic Studies

Background: Subcutaneous (SC) administration of human recombinant hyaluronidase (rHuPH20) temporarily increases the permeability of connective tissues by degrading hyaluronan and facilitating dispersion of coinjected molecules. SC administration of morphine + rHuPH20 in healthy volunteers and [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Safety and Tolerability of Subcutaneous Administration of Morphine + Human Recombinant Hyaluronidase (rHuPH20): Pooled Data from 3 Pharmacokinetic Studies

HM2007 Abstract Number: 65

Subcutaneous Administration of Morphine + Human Recombinant Hyaluronidase (rHuPH20) Enhances Morphine Absorption in Palliative Care Patients and Healthy Volunteers

Background: Subcutaneous (SC) administration of human recombinant hyaluronidase (rHuPH20) temporarily increases connective tissue permeability by degrading hyaluronan. Because this technique enhances dispersion of coadministered molecules, we evaluated whether rHuPH20 coadministered with SC morphine enhances morphine [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Subcutaneous Administration of Morphine + Human Recombinant Hyaluronidase (rHuPH20) Enhances Morphine Absorption in Palliative Care Patients and Healthy Volunteers

HM2007 Abstract Number: 64

Methylnaltrexone Is Effective in the Treatment of Opioid‐Induced Constipation in Patients with Advanced Illness and Postoperative Ileus without Affecting Analgesia

Background: Methylnaltrexone, a quaternary derivative of naltrexone, is being developed for the treatment of opioid‐induced constipation in patients with advanced illness and postoperative ileus. GI transit, slowed by morphine, is reversed by intravenous, subcutaneous, or [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Methylnaltrexone Is Effective in the Treatment of Opioid‐Induced Constipation in Patients with Advanced Illness and Postoperative Ileus without Affecting Analgesia

HM2007 Abstract Number: 63

Reducing Unnecessary Invasive Device Days in a Community ICU with a Physician Daily Note and Daily Multidisciplinary Rounds

Background: Health care‐acquired infections (HAIs) represent a far too common risk and cost of hospitalization. Urinary catheter‐associated urinary tract infection is the most common cause of HAIs, with prolonged catheter use conferring a relative risk [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Reducing Unnecessary Invasive Device Days in a Community ICU with a Physician Daily Note and Daily Multidisciplinary Rounds

HM2007 Abstract Number: 62

Cognitive Changes in Physician Documentation Habits and Revenue Cycle by Organized Training

Background: Physician documentation is the principal determinant of reimbursement for services provided. In 2001 the Office of Inspector General cited $20 billion of Medicare overpayment, 29% of which resulted from improper coding.1 Conversely, the Health [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Cognitive Changes in Physician Documentation Habits and Revenue Cycle by Organized Training

HM2007 Abstract Number: 61

Impact of Fundoplication Versus Gastrojejunal Feeding Tubes on Mortality and Aspiration Pneumonia Prevention in Young Children with Neurological Impairment Who Have Gastroesophageal Reflux Disease

Background: Aspiration pneumonia (AP) is the most common cause of death in children with neurological impairment who have gastroesophageal reflux disease (GERD). Fundoplications and gastrojejunal feeding tubes (GJT) are frequently employed to prevent AP in [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Impact of Fundoplication Versus Gastrojejunal Feeding Tubes on Mortality and Aspiration Pneumonia Prevention in Young Children with Neurological Impairment Who Have Gastroesophageal Reflux Disease

HM2007 Abstract Number: 60

Allowing for Better Resident Education and Improving Patient Care: Hospitalist‐Physician Assistant Teams Fill in the Gaps

Background: Duty‐hour limitations led to many changes in the residency experience at academic medical centers. Studies have suggested the quality of life of residents has improved but have questioned the impact on resident education and [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Allowing for Better Resident Education and Improving Patient Care: Hospitalist‐Physician Assistant Teams Fill in the Gaps

HM2007 Abstract Number: 59

Identification of Risk Factors for Immunization Delay in Hospitalized Infants < 1500 g (VLBW) in the Neonatal Intensive Care Unit: A Multicenter Retrospective Analysis

Background: Prematurity is a risk factor for primary immunization series delay. Catch‐up vaccination can take up to 3 years. Specific, neonatal‐based risk factors associated with immunization delay in the neonatal intensive care unit (NICU) have [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Identification of Risk Factors for Immunization Delay in Hospitalized Infants < 1500 g (VLBW) in the Neonatal Intensive Care Unit: A Multicenter Retrospective Analysis

HM2007 Abstract Number: 58

Preparedness of Hospitalized Patients to Quit Smoking

Background: Although counseling of inpatient smokers is a hospital quality measure, few hospitals assess preparedness of smokers to quit, an important predictor of future quit behaviors. This study aimed to assess the preparedness of hospitalized [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Preparedness of Hospitalized Patients to Quit Smoking

HM2007 Abstract Number: 57

Effects of a Subcutaneous Insulin Protocol, Computerized Order Set, and Education on Inpatient Management of Hyperglycemia in the Non‐ICU Setting

Background: Inpatient hyperglycemia is common and associated with adverse patient outcomes. Current guidelines recommend treatment to achieve glucose levels below 180 mg/dL in the inpatient non‐ICU setting. The best ways to achieve this glucose target [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Effects of a Subcutaneous Insulin Protocol, Computerized Order Set, and Education on Inpatient Management of Hyperglycemia in the Non‐ICU Setting

HM2007 Abstract Number: 56

Use of Central Venous Catheter‐Associated Bloodstream Infection Prevention Practices by U.S. Hospitals: A National Mixed‐Methods Study

Background: Catheter‐associated bloodstream infection (CA‐BSI) causes significant morbidity and mortality. Yet there are no national data describing the extent to which American hospitals are using proven strategies to prevent CA‐BSI, nor are there data assessing [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Use of Central Venous Catheter‐Associated Bloodstream Infection Prevention Practices by U.S. Hospitals: A National Mixed‐Methods Study

HM2007 Abstract Number: 55

Nosocomial Infections in Patients after Undergoing Bariatric Surgery at Our Institution

Background: Postoperative bariatric surgery (BS) infection rates (IRs) of 1%‐16.5% have been reported, with a mortality rate of up to 21.7%. This study investigated the 30‐day postoperative IR and mortality rate at our institution. It [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Nosocomial Infections in Patients after Undergoing Bariatric Surgery at Our Institution

HM2007 Abstract Number: 54

Documentation by Hospitalists and Nonhospitalists of Geriatric Syndromes in Elderly Acute Care Inpatients Discharged to Postacute Services

Background: Detection of geriatric syndromes is a critical step in caring for older patients and determining eligibility for post‐acute care services. Geriatric syndromes, notably delirium and malnutrition, are often undiagnosed and untreated in hospitalized elderly [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Documentation by Hospitalists and Nonhospitalists of Geriatric Syndromes in Elderly Acute Care Inpatients Discharged to Postacute Services

HM2007 Abstract Number: 53

The Hospitalist: Improving Patient Care and Closing the Quality Gap in Patients with Hip Fracture

Background: Patients with hip fracture are generally elderly, have coronary artery disease (CAD) or risk factors for CAD, and require urgent surgery. Perioperative use of beta‐ers is associated with decrease cardiac mortality and morbidity. However, [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on The Hospitalist: Improving Patient Care and Closing the Quality Gap in Patients with Hip Fracture

HM2007 Abstract Number: 52

Conivaptan for the Treatment of Severe Hyponatremia: Open‐Label Study Results

Background: Hyponatremia is a common electrolyte disorder in hospitalized patients often resulting from elevated arginine vasopressin (AVP) levels. Conivaptan (CNV) is a novel AVP‐receptor antagonist that produces aquaresis, the solute‐free, electrolyte‐sparing excretion of water, by [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Conivaptan for the Treatment of Severe Hyponatremia: Open‐Label Study Results

HM2007 Abstract Number: 51

Methylnaltrexone Administered Postoperatively to Patients Following Segmental Colectomy Improves Postoperative Ileus Outcome and Hospital Discharge Eligibility without Affecting Opioid Analgesia

Background: Postoperative ileus (POI) occurs in patients undergoing bowel resection and can lead to prolonged hospitalization. Methylnaltrexone, a quaternary derivative of naltrexone, avoids the peripheral effects of opioids while sparing their central analgesic effects. It [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Methylnaltrexone Administered Postoperatively to Patients Following Segmental Colectomy Improves Postoperative Ileus Outcome and Hospital Discharge Eligibility without Affecting Opioid Analgesia

HM2007 Abstract Number: 50

Effect of Posting Life Stories on Patient Emotional Weil‐Being

Background: Hospitalized patients often experience feelings of anxiety and dehumanization. It is not well understood if creating a strong positive relationship between health care providers and patients can positively affect these feelings. We investigated using [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Effect of Posting Life Stories on Patient Emotional Weil‐Being

HM2007 Abstract Number: 49

Trends in Pulmonary Complications after Major Abdominal Surgery

Background: Pulmonary complications following abdominal surgery are a major cause of morbidity, mortality, and prolonged hospitalization. Despite this, there is scarce information about national trends in postoperative pulmonary complications. Methods: The National Hospital Discharge Survey [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Trends in Pulmonary Complications after Major Abdominal Surgery

HM2007 Abstract Number: 48

Effect of a Hospitalist—Clinical Nurse Specialist Team on a Nonteaching Hospitalist Service

Background: The addition of a clinical nurse specialist (CNS) to an inpatient medical team has been shown to reduce length of stay (LOS) and improve patient satisfaction. Many hospitalists practice in nonteaching settings and without [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Effect of a Hospitalist—Clinical Nurse Specialist Team on a Nonteaching Hospitalist Service

HM2007 Abstract Number: 47

Uncovered Academic Hospitalist Services: Are They Justifiable?

Background: Although there are some data on the effect of hospitalist‐run teaching services at academic institutions, there is very little data about the effect of nonteaching hospitalist services compared with traditional house staff‐associated teaching services [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Uncovered Academic Hospitalist Services: Are They Justifiable?

HM2007 Abstract Number: 46

Associated Factors and Impact of Resident Teaching Time in the Era of Limitation of Duty Hours

Background: Some residents report spending less time teaching since the implementation of duty‐hour restrictions. This study aimed to assess factors associated with spending less time teaching and to determine the impact of time spent teaching [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Associated Factors and Impact of Resident Teaching Time in the Era of Limitation of Duty Hours

HM2007 Abstract Number: 45

Effect of a Standardized Subcutaneous Insulin Order Set and an Insulin Management Algorithm on Inpatient Glycemic Control and Hypoglycemia

Background: Poor glycemic control in hospitalized patients is strongly associated with increased length of stay, mortality, infections, and other undesirable outcomes. Poor glycemic control and suboptimal insulin regimens are the rule in inpatient ward settings, [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Effect of a Standardized Subcutaneous Insulin Order Set and an Insulin Management Algorithm on Inpatient Glycemic Control and Hypoglycemia

HM2007 Abstract Number: 44

Internal Medicine Residents' and Hospitalists' Attitudes toward Artificial Nutrition

Background: The initiation or withdrawal of artificial nutrition, via nasogastric and gastrostomy tubes, is a common and difficult issue in medical practice. Resident physicians and hospitalists frequently involve families in making these decisions, as the [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Internal Medicine Residents' and Hospitalists' Attitudes toward Artificial Nutrition

HM2007 Abstract Number: 43

Differences in Epidemiology of Invasive Candidiasis Between Academic and Community Hospitals Participating in the Candida Surveillance Study (cass)

Background: Candida species are the fourth most common cause of nosocomial bloodstream infection in the United States. Of the various Candida species, Candida albicans caused the majority of infections during the 1980s. However, during the [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Differences in Epidemiology of Invasive Candidiasis Between Academic and Community Hospitals Participating in the Candida Surveillance Study (cass)

HM2007 Abstract Number: 42

Improvement of Academic Inpatient Attending Physicians' Performance Scores: How Long Until Underperforming Rookies Bat the Department Average?

Background: Most inpatient physicians learn how to be attending physicians through experience, not formal training. Yet little has been written about how the performance of attending physicians changes over time. Methods: We evaluated attending physicians [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Improvement of Academic Inpatient Attending Physicians' Performance Scores: How Long Until Underperforming Rookies Bat the Department Average?

HM2007 Abstract Number: 41

High Recidivism Rates after Discharge from a Hospitalist‐Run Short‐Stay Unit Preparing to Reduce the “Frequent Flyer” Effect

Background: Short‐stay units (SSUs) provide traditional inpatient services in locations commonly adjacent to emergency departments (EDs). Hospitalists are well positioned to staff these units because of their expertise in caring for inpatients. However, little is [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on High Recidivism Rates after Discharge from a Hospitalist‐Run Short‐Stay Unit Preparing to Reduce the “Frequent Flyer” Effect

HM2007 Abstract Number: 40

Outcomes of Patients Treated by Hospitalists, General Internists, and Family Physicians

Background: The hospitalist model has been rapidly adopted across the United States; however, supporting evidence is derived from a small number of studies examining the practice of few physicians. Methods: We conducted a retrospective cohort [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Outcomes of Patients Treated by Hospitalists, General Internists, and Family Physicians

HM2007 Abstract Number: 39

Association between Nurse Staffing Levels and Inpatient Falls

Background: Falls remain a source of preventable morbidity and mortality of hospitalized patients with acute medical illnesses. Because of the high cost associated with falls in dollars, length of stay, and patient outcomes, much research [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Association between Nurse Staffing Levels and Inpatient Falls

HM2007 Abstract Number: 38

Student Satisfaction with Physical Examination Instruction on Attending‐Only Hospitalist Services Versus Traditional Ward Teams

Background: Attending‐only hospitalist services have been developed at academic centers in response in part to resident duty‐hour restrictions. The efficacy of these clinical services as teaching venues for medical students has not been assessed. Purpose: [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Student Satisfaction with Physical Examination Instruction on Attending‐Only Hospitalist Services Versus Traditional Ward Teams

HM2007 Abstract Number: 37

Patient Perspectives on Medication Use after Hospital Discharge

Background: Patients often have trouble managing their medications after hospital discharge, and adults with limited literacy skills may face added difficulties. These problems and their potential solutions are not well characterized. Methods: Patients admitted to [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Patient Perspectives on Medication Use after Hospital Discharge

HM2007 Abstract Number: 36

Impact of Sex, Race, Nursing Home Residence, and Coexisting Diseases on Presentation and Outcome of Myocardial Infarction in the Elderly

Background: The forthcoming wave of geriatric patients is expected to result in rising incidence of myocardial infarction (MI), made uniquely challenging by atypical symptoms, multiple comorbidities, and cognitive impairment. Hence, misdiagnosis, undertreatment, and poor outcome [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Impact of Sex, Race, Nursing Home Residence, and Coexisting Diseases on Presentation and Outcome of Myocardial Infarction in the Elderly

HM2007 Abstract Number: 35

Charlson Score as a Predictor of Increased Risk of Postoperative Infection and Mortality of Geriatric Patients Undergoing Hip Surgery

Background: Most patients who undergo hip surgery are elderly with significant comorbidities. Postoperative infection and mortality are potentially preventable complications. As with cardiac risk stratification, infection and mortality risk stratification may be possible. This study [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Charlson Score as a Predictor of Increased Risk of Postoperative Infection and Mortality of Geriatric Patients Undergoing Hip Surgery

HM2007 Abstract Number: 34

Emergency Room Triage of Upper Gastrointestinal Bleed Patients: Is Early Endoscopy Feasible

Background: Upper gastrointestinal hemorrhage (UGIH) is a common reason for emergency department (ED) evaluation and hospital admission. Despite validated risk‐assessment methods, it is not known how risk stratification is used to influence early endoscopy (EGD) [...]

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HM2007 Abstract Number: 33

Beyond Troponin: Does the Addition of Creatinine Kinase and Creatinine Kinase Isoenzyme Mb Add to the Diagnosis and Management of Patients with Chest Pain

Background: The current consensus guidelines of the American College of Cardiology state that troponins (TnT or TnI) are the preferred biomarkers of myocardial necrosis to evaluate patients with chest pain syndrome to make the diagnosis [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Beyond Troponin: Does the Addition of Creatinine Kinase and Creatinine Kinase Isoenzyme Mb Add to the Diagnosis and Management of Patients with Chest Pain

HM2007 Abstract Number: 32

Incidence of Cardiac Complications Following Hip Surgery: A Population‐Based Study

Background: After coronary artery bypass grafting, hip surgery is the most commonly performed procedure in patients older than 65. In the current American College of Cardiology/American Heart Association (ACC/AHA) preoperative evaluation guideline, orthopedic surgical procedures [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Incidence of Cardiac Complications Following Hip Surgery: A Population‐Based Study

HM2007 Abstract Number: 31

Formal Preoperative Evaluation Is Associated with Higher Rates of Perioperative Beta‐ers in Noncardiac Surgery

Background: Several randomized and observational trials in the past decade and the more recent ACC/AHA guidelines support the use of preoperative beta‐ers (PBB) in selected patients undergoing noncardiac surgery (NCS). National patient quality and safety [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Formal Preoperative Evaluation Is Associated with Higher Rates of Perioperative Beta‐ers in Noncardiac Surgery

HM2007 Abstract Number: 30

Is Low Health Literacy a Significant Risk Factor for Hospital Readmission

Background: Even though some readmissions are unavoidable, there is an implicit concern that they represent a failure in the health care system or inappropriate wishful thinking. Readmissions are not only expensive but suggest we have [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Is Low Health Literacy a Significant Risk Factor for Hospital Readmission

HM2007 Abstract Number: 29

Incidence and Predictors of Postoperative Fevers in Patients Undergoing Hip and Knee Surgery

Background: Surgeons in the perioperative management of their patients are increasingly involving hospitalist physicians. This relationship includes preoperative assessments and postoperative referrals or comanagement for medical conditions including fevers, diabetes, hypertension, and coronary artery disease. [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Incidence and Predictors of Postoperative Fevers in Patients Undergoing Hip and Knee Surgery

HM2007 Abstract Number: 28

Hospitalization of Children with Type 2 Diabetes

Background: The rise in prevalence of type 2 diabetes mellitus (T2DM) in children is well recognized; however, its effect on diabetes‐related hospitalization rates is not well characterized. The objective of this study was to examine [...]

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HM2007 Abstract Number: 27

Effect of Type 2 Diabetes on Elective Joint Arthroplasty Outcomes

Background: Hospitalized diabetic patients do worse than nondiabetic patients, and the level of inpatient hyperglycemia predicts some of this excess morbidity. However, little is known about the outcomes of diabetic patients undergoing elective joint arthroplasty [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Effect of Type 2 Diabetes on Elective Joint Arthroplasty Outcomes

HM2007 Abstract Number: 26

Predictive Value of Hemoglobin A1c in Type 2 Diabetic Patients Undergoing Elective Joint Arthroplasty

Background: Hospitalized diabetic patients do worse than nondiabetic patients, and the level of inpatient hyperglycemia is associated with some of this excess morbidity. We endeavored to identify if preoperative hemoglobin A1c (HbA1c) could predict the [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Predictive Value of Hemoglobin A1c in Type 2 Diabetic Patients Undergoing Elective Joint Arthroplasty

HM2007 Abstract Number: 25

Pediatric Nurses' Perceptions of Pediatric Hospitalist and Nonhospitalist Faculty in the Care of Hospitalized Children

Background: Effective collaboration between physicians and nurses is necessary to ensure the optimal care of hospitalized patients. The increasing number of hospitalists across the United States provides the opportunity to affect this working relationship. However, [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Pediatric Nurses' Perceptions of Pediatric Hospitalist and Nonhospitalist Faculty in the Care of Hospitalized Children

HM2007 Abstract Number: 24

Electronic Sign‐Out for Patients in a Hospital: Cumbersome System or Effective Communication Tool?

Background: Communication problems between hospital house staff are one of the most common causes of preventable medical adverse events. The process of signing out is a critical part of the communication process that takes place [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Electronic Sign‐Out for Patients in a Hospital: Cumbersome System or Effective Communication Tool?

HM2007 Abstract Number: 23

Validation of a Tool Measuring Physician Attitudes and Knowledge of Nurse‐Practitioners

Background: Nurse‐practitioners (NPs) play an increasing role in the delivery of inpatient care, often within hospitalist programs. Work evaluating this collaborative relationship is limited. In other settings, qualitative studies have suggested there are role confusion [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Validation of a Tool Measuring Physician Attitudes and Knowledge of Nurse‐Practitioners

HM2007 Abstract Number: 22

How Do Hospitalized Patients Feel About Resident Work Hours, Fatigue, and Discontinuity of Care

Background: The resident work‐hour rules were implemented by the Accreditation Council for Graduate Medical Education to address the patient safety problems associated with physician fatigue, but they do not take into account the discontinuity of [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on How Do Hospitalized Patients Feel About Resident Work Hours, Fatigue, and Discontinuity of Care

HM2007 Abstract Number: 21

Inaccuracies in the Tabulated Input and Output in Intensive Care: A Potential Risk to Optimal Patient Care

Background: Fluid management of patients can be challenging in the best circumstances. The relationship of total fluid input to total output is commonly used to guide therapeutic decisions involving the use of diuretics and/or fluids. [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Inaccuracies in the Tabulated Input and Output in Intensive Care: A Potential Risk to Optimal Patient Care

HM2007 Abstract Number: 20

ICU Staffing in Michigan: The Role of Nonintensivist Providers and Hospitalists

Background: The National Quality Forum has advocated the use of board‐certified intensivists to deliver critical care in intensive care units (ICUs). However, the extent of intensivist staffing, the use of nonintensivist providers, and the role [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on ICU Staffing in Michigan: The Role of Nonintensivist Providers and Hospitalists

HM2007 Abstract Number: 19

Impact of Clinical Reminders on Documentation of Compliance with CMS Core Indicators

Background: Congestive heart failure (CHF) is one of the most prevalent clinical conditions seen by hospitalists. Therapy with angiotensin‐converting enzyme inhibitors (ACEIs) and angiotensin II receptor ers (ARBs) have been shown to reduce morbidity and [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Impact of Clinical Reminders on Documentation of Compliance with CMS Core Indicators

HM2007 Abstract Number: 18

Effect of 24/7 Hospitalist Coverage on Clinical Metrics

Background: There has been increasing discussion on whether hospitalists should provide 24/7 in‐hospital staffing. There have been no data to date that have shown a clinical advantage to this coverage arrangement. The goal of the [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Effect of 24/7 Hospitalist Coverage on Clinical Metrics

HM2007 Abstract Number: 17

Cardiac Arrest Team Debriefing: A Novel Method for Improving CPR Quality during In‐Hospital Cardiac Arrest

Background: Despite the widespread availability of defibrillators and advanced cardiovascular life support (ACLS)‐trained personnel, survival from in‐hospital cardiac arrest remains poor. We have previously shown that cardiopulmonary resuscitation (CPR) quality is highly variable and often [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Cardiac Arrest Team Debriefing: A Novel Method for Improving CPR Quality during In‐Hospital Cardiac Arrest

HM2007 Abstract Number: 16

A Pilot Study: Nurse‐Practitioners Improve Inpatient Time to Discharge

Background: Patients discharged from a university hospital operating at full capacity are often delayed. Inpatient cardiology is already highly efficient, and length of stay has been maximally shortened. The addition of a nurse‐practitioner to a [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on A Pilot Study: Nurse‐Practitioners Improve Inpatient Time to Discharge

HM2007 Abstract Number: 15

Cellulitis or DVT: Do Any Clinical Features Help to Differentiate

Background: Acute lower extremity (LE) cellulitis often presents with swelling and erythema. In many cases this leads hospitalists to work up the patient for concurrent deep venous thrombosis (DVT). No previous studies have looked specifically [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Cellulitis or DVT: Do Any Clinical Features Help to Differentiate

HM2007 Abstract Number: 14

Impact of Educational Intervention on Hospitalists' Knowledge and Attitudes Regarding Nurse‐Practitioner Scope of Practice and Collaboration

Background: Nurse‐practitioners (NPs) are increasingly utilized in the acute care setting. Prior qualitative studies suggest physician knowledge and attitude deficits create barriers to effective NP/physician collaboration. Little is known about hospitalists' knowledge and attitudes about [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Impact of Educational Intervention on Hospitalists' Knowledge and Attitudes Regarding Nurse‐Practitioner Scope of Practice and Collaboration

HM2007 Abstract Number: 13

Outcomes of Compensated Heart Failure Patients Undergoing Elective Major Noncardiac Surgery

Background: Perioperative outcomes of heart failure (HF) patients who have been clinically stabilized prior to noncardiac surgery have not been well studied. We sought to evaluate contemporary surgical outcomes in patients with compensated HF undergoing [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Outcomes of Compensated Heart Failure Patients Undergoing Elective Major Noncardiac Surgery

HM2007 Abstract Number: 12

Discontinuation of Antiplatelet Therapy Prior to Noncardiac Surgery in Patients with Drug‐Eluting Stents: A Retrospective Cohort Study

Background: Drug‐eluting coronary stents (DESs) pose a challenge in the perioperative setting. Sirolimus and paclitaxel may inhibit re‐endothelialization of the traumatized vessel, making it vulnerable to platelet‐mediated thrombosis. Given anecdotal evidence and case series suggesting [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Discontinuation of Antiplatelet Therapy Prior to Noncardiac Surgery in Patients with Drug‐Eluting Stents: A Retrospective Cohort Study

HM2007 Abstract Number: 11

Delayed Antibiotic Administration Associated with Restrictive Antibiotic Approval Process

Background: In‐hospital antibiotic approval policies are commonly implemented to curb the indiscriminant use of antibiotics and to prevent antibiotic resistance. These policies usually require written forms and/or direct phone/fax requests to an infectious disease specialist [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Delayed Antibiotic Administration Associated with Restrictive Antibiotic Approval Process

HM2007 Abstract Number: 10

Resource Utilization among Total Hip Arthroplasty Patients Cared for on Specialty Orthopedic Nursing Units

Background: The use of specialized orthopedic nursing units (SONUs) for patients undergoing elective total hip arthroplasty (THA) is a well‐established practice. Whether such units improve outcomes or are cost effective has not been evaluated. Our [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Resource Utilization among Total Hip Arthroplasty Patients Cared for on Specialty Orthopedic Nursing Units

HM2007 Abstract Number: 9

Mastery Learning of Thoracentesis Skills by Internal Medicine Residents Using Simulation Technology and Deliberate Practice

Background: Although internal medicine residents commonly perform bedside procedures, technical proficiency and knowledge regarding procedures such as thoracentesis may be lacking. The risk of complications from thoracentesis may also be increased when performed by physicians‐in‐training. [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Mastery Learning of Thoracentesis Skills by Internal Medicine Residents Using Simulation Technology and Deliberate Practice

HM2007 Abstract Number: 8

Diagnostic Value of Exercise Stress Test Versus Pharmacological Gated SPECT Myocardial Perfusion Imaging for Detection of 3‐Vessel Coronary Artery Disease

Background: In patients with 3‐vessel coronary artery disease (3VD), perfusion defects in multiple vascular territories may not always be evident because of globally reduced perfusion. The diagnostic value of an exercise stress test (EST) versus [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Diagnostic Value of Exercise Stress Test Versus Pharmacological Gated SPECT Myocardial Perfusion Imaging for Detection of 3‐Vessel Coronary Artery Disease

HM2007 Abstract Number: 7

PICC‐ing Up the Pace: A New Hospitalist Service for Peripherally Inserted Central Catheters

Background: Percutaneous intravenous central catheters (PICCs) are increasingly the devices of choice for providing long‐term central venous access among medicine inpatients. However, hospitalists are not typically trained in PICC insertion and often rely on other [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on PICC‐ing Up the Pace: A New Hospitalist Service for Peripherally Inserted Central Catheters

HM2007 Abstract Number: 6

Ability of Hospitalized Patients to Identify Their Inpatient Physicians

Background: Patients admitted to academic teaching hospitals are often cared for by multiple physicians of different training levels. This study aimed to ascertain the ability of patients to identify their inpatient physicians and patient and [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Ability of Hospitalized Patients to Identify Their Inpatient Physicians

HM2007 Abstract Number: 5

Medication Discrepancies during Patient Handoffs: Frequency, Characteristics, and Potential to Harm

Background: Despite increased focus on handoffs, the accuracy of information transferred using resident sign‐outs has not been well characterized. This study aimed to describe the frequency, types, and harm potential of medication discrepancies between patient [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Medication Discrepancies during Patient Handoffs: Frequency, Characteristics, and Potential to Harm

HM2007 Abstract Number: 4

Impact of Discharge Hyperglycemia on Rehospitalizations of Patients Admitted with Acute Decompensated Heart Failure (ADHF)

Background: Admission hyperglycemia has been associated with adverse clinical outcomes of patients admitted with acute myocardial infarction, stroke, or trauma. The effect of admission or discharge glucose level on clinical outcomes, particularly readmissions in ADHF, [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Impact of Discharge Hyperglycemia on Rehospitalizations of Patients Admitted with Acute Decompensated Heart Failure (ADHF)

HM2007 Abstract Number: 3

Do Large Electronic Medical Record Databases Permit Collection of Reliable and Valid Data for Quality Improvement Purposes?

Background: In a large tertiary‐care hospital, a quality improvement program was initiated to evaluate the current practices and trends in preoperative cardiac risk assessment and prescription of perioperative beta‐ers for patients undergoing elective, noncardiac surgery [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Do Large Electronic Medical Record Databases Permit Collection of Reliable and Valid Data for Quality Improvement Purposes?

HM2007 Abstract Number: 2

Assessing Adherence to the ACCP Recommendations for Thromboprophylaxis in Hospitalized Medical and Surgical Patients

Background: This study evaluated whether clinicians are providing appropriate thromboprophylaxis to at‐risk medical and surgical patients in accordance with ACCP guidelines. Methods: Premier's Perspective™ inpatient administrative database was used to assess VTE prophylaxis rates in [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Assessing Adherence to the ACCP Recommendations for Thromboprophylaxis in Hospitalized Medical and Surgical Patients

HM2007 Abstract Number: 1

Therapeutic Hypothermia in Cardiac Arrest: A Community Center Experience

Background: Mortality data estimates show that there are about 400,000‐460,000 sudden cardiac deaths (SCDs) in the United States annually. Managing cardiac arrest patients with coma postresuscitation has been largely supportive. Following restoration of spontaneous circulation [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Therapeutic Hypothermia in Cardiac Arrest: A Community Center Experience