HM2008 Abstract Number: 189

Recurrent Ascites: Tapping into an Uncommon Cause

Case Presentation: A 52‐year‐old woman with a medical history of hypothyroidism and shingles presented to the ED with a monthlong history of abdominal distention, nausea, and decreased appetite. Three years ago, she had had an [...]

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HM2008 Abstract Number: 190

Teenager with Seizure‐like Events

Case Presentation: The patient was a 14‐year‐old girl with new‐onset seizurelike episodes over 3 months. Her parents identified various triggers for the events: raising her arm, standing from a sitting position, and turning her head [...]

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HM2008 Abstract Number: 188

Esophageal Perforation from the Heimlich Maneuver: Still the Preferred Technique?

Case Presentation: An 87‐year‐old man with a medical history of dementia, stroke, hypertension, seizure disorder, and ITP began to choke on an orange, when his daughter successfully performed the Heimlich maneuver. Following this, the patient [...]

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HM2008 Abstract Number: 187

Noncompaction of the Left Ventricle: a Rare Cause of Dilated Cardiomyopathy

Case Presentation: A 45‐year‐old woman presented with dyspnea on exertion, and tachycardia. On presentation, vitals were normal except for a resting heart rate of 100. Exam revealed tachycardia, trace pedal edema, and jugular venous pressure [...]

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HM2008 Abstract Number: 186

Get the Lead Out

Case Presentation: A 45‐year‐old man suffered a left knee gunshot wound 3 months prior to presentation. His physical examination and radiograph revealed an unfragmented bullet in the left knee synovium. Pertinent laboratory data revealed a [...]

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HM2008 Abstract Number: 185

Pulmonary Emboli in a Patient with Hereditary Hemorrhagic Telangiectasia

Case Presentation: A 44‐year‐old woman with a history of hereditary hemorrhagic telangiectasia presented to the ED with complaints of epistaxis, coffee‐ground emesis, dyspnea, and burning chest pain. In the ED, she was mildly hypotensive but [...]

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HM2008 Abstract Number: 184

Alcohol Withdrawal in a Suicidal Patient

Case Presentation: A 63‐year‐old man with a history of alcoholism and withdrawal seizures presented to the ED after a suicide attempt. The patient had persistent suicidal ideation and was placed on a psychiatric hold. In [...]

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HM2008 Abstract Number: 183

Emphysematous Pyelonephritis

Case Presentation: A 62‐year‐old woman with diabetes presented with 4 days of crampy, epigastric pain exacerbated by urination and radiating to the right and left upper quadrants. She endorsed nausea and emesis but denied fever [...]

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HM2008 Abstract Number: 182

A Case of Salty Voluminous Urine

Case Presentation: A 51‐year‐old woman with a history of glioblastoma multiforme resection and meningitis presented with mental status changes. Ventriculostomy was performed for hydrocephalus, and CSF revealed recurrent staph meningitis. Antibiotics were started. The RNs [...]

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HM2008 Abstract Number: 181

Tylenol 'Round the Clock

Case Presentation: A 3‐week‐old was admitted to the pediatrics service for evaluation of fever and administration of parenteral antibiotics. Acetaminophen 15 mg/kg/dose every 4 hours was ordered. The infant received 6 daily doses of acetaminophen [...]

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HM2008 Abstract Number: 180

Effort Thrombosis in a Teenage Female

Case Presentation: A 17‐year‐old white female presented to the ER with a 5‐day history of right upper extremity swelling. The patient reported that she carried a heavy book bag on her right shoulder all day, [...]

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HM2008 Abstract Number: 179

Prosthetic Valve Endocarditis Due to Neiserria gonorrhoeae — Report of a Case and a Review

Case Presentation: A 46‐year‐old man presented with a 2‐month history of fatigue, worsening dyspnea, and lower extremity swelling. He had a prosthetic aortic valve implanted 10 years ago and was noncompliant with anticoagulation. His medical [...]

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HM2008 Abstract Number: 178

The Pseu, Pseu, Pseudo‐Heart Attack

Case Presentation: A 62‐year‐old man presented with 1 day of chest pain and shortness of breath. Four months earlier, he had been diagnosed with MRSA endocarditis and had aortic valve replacement surgery. The preoperative evaluation [...]

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HM2008 Abstract Number: 177

Can't PEE and PE: An Uncommon Combination of 2 Common Diseases in an Air Marshal

Case Presentation: A 38‐year‐old man with no significant medical history presented to the emergency room with inability to void, yellow urethral discharge, and fever up to 101.4°F. He reported being sexually active with 1 female [...]

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HM2008 Abstract Number: 1000

A Case of Profound Anemia in a Jehovah's Witness: Using “Bloodless Medicine” in Hospital Medicine

Case Presentation: R.C. is a 42‐year‐old G3P2 Jehovah's Witness who presented to the E.D. in her 17th week of pregnancy with vaginal bleeding. A bedside ultrasound showed fetal demise and the patient was admitted for [...]

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HM2008 Abstract Number: 176

PCR in the Diagnosis of TB Meningitis

Case Presentation: A 36‐year‐old man who had emigrated from Ecuador 4 years prior presented to the ED with 2 months of drenching night sweats and fever. Additional complaints included a productive cough with greenish sputum, [...]

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HM2008 Abstract Number: 175

Crazy in Costa Rica: Chloroquine‐lnduced Encephalopathy

Case Presentation: A 17‐year‐old female patient developed altered mental status while on a high school‐sponsored summer exchange program in Costa Rica. She was living with a local family in a rural town. Travel immunizations were [...]

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HM2008 Abstract Number: 174

A Rare But Important Disease Resembling Adult Respiratory Distress Syndrome (ARDS)

Case Presentation: A 50‐year‐old previously healthy man from a rural area in the Midwest initially felt feverish and had generalized body aches for 2 days. On the third day he developed mild dry cough with [...]

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HM2008 Abstract Number: 173

A Unique Case of Thrombophilia: Elevated Factor VIII Level

Case Presentation: A 48‐year‐old obese African American woman presented to the ED with left lower extremity pain. She had recently begun oral contraceptives and had had a prolonged automobile drive a few days before presentation. [...]

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HM2008 Abstract Number: 172

Severe Ciprofloxacin‐lnduced Neutropenia

Case Presentation: A 50‐year‐old African American woman with a medical history of alcoholic hepatitis with acute renal failure complained of mild shortness of breath, lower extremity edema, and weakness on a routine follow‐up visit in [...]

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HM2008 Abstract Number: 171

Pulmonary Tumor Microemboli: A Rare Cause of Dyspnea

Case Presentation: The patient is a 54‐year‐old woman with a history of ovarian adenocarcinoma, status postdebulking TAH with lymph node dissection, who presented to the ER with acute on chronic dyspnea. She also had progressive [...]

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HM2008 Abstract Number: 170

Recurrent Rhabdomyolysis: The Innocuous Culprit

Case Presentation: A 61‐year‐old male patient was admitted with diffuse myalgias and dark red urine for 3 days .He was started on Levaquin for an upper respiratory tract infection (URI) 5 days prior to admission. [...]

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HM2008 Abstract Number: 169

Bilateral Adrenal Hemorrhage after Bilateral Total Knee Arthroplasty

Case Presentation: A 52‐year‐old man with bilateral total knee arthroplasty (TKA) done 9 days prior to admission presented with complaints of bilateral upper quadrant abdominal pain, nausea, and vomiting of 2 days' duration. He was [...]

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HM2008 Abstract Number: 168

Vancomycin‐lnduced Linear IgA Bullous Dermatosis

Case Presentation: A 77‐year‐old man with a history of colon cancer was admitted with early sepsis. He was given vancomycin and ceftriaxone. On hospital day 4, the vancomycin was discontinued because of a high drug [...]

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HM2008 Abstract Number: 167

A Penetrating Odor from a Comatose Patient: A Case of Severe Organophosphate Poisoning

Case Presentation: An 82‐year‐old woman with a history of depression presented to the ER unconscious with a report of seizurelike activity and urinary incontinence. On exam she had copious oral secretions, pinpoint pupils, tachycardia, diffuse [...]

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HM2008 Abstract Number: 166

Not Always Is Preeclampsia: Viral Encephalitis in Pregnancy

Case Presentation: A 23‐year‐old woman with a 24‐week pregnancy presented to the ED with complaints of a progressively worsening headache of 2 weeks' duration. The headache was frontal, pounding in nature, rated 10/10 in severity, [...]

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HM2008 Abstract Number: 165

Utility of Continuous Renal Replacement Therapy in Extended‐Release Calcium Channel Blocker Overdose

Case Presentation: A 38‐year‐old woman with a history of depression and hypertension was transferred to our facility after an intentional overdose of extended‐release diltiazem, with coingestion of clinically insignificant amounts of clonazepam and acetaminophen. It [...]

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HM2008 Abstract Number: 164

Severe Asymptomatic Retropharyngeal Hematoma: A Delayed Complication of Failed Internal Jugular Vein Cannulation

Case Presentation: A 73‐year‐old man with diabetes and end‐stage renal disease was admitted with bilateral lower extremity cellulitis. He was also hypoglycemic, with a blood glucose of 29 mg/dL. Because of the difficulty obtaining peripheral [...]

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HM2008 Abstract Number: 163

To Gad or Not to Gad

Case Presentation: A 54‐year‐old white man with a medical history of stage III chronic kidney disease (CKD), diabetes, hypertension, and stroke was admitted with a generalized rash for 2 weeks. About a month prior to [...]

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HM2008 Abstract Number: 162

Acute Lower Extremity Weakness and Pain: Finding Leriche in the Heart

Case Presentation: A 58‐year‐old woman presented with acute onset of bilateral lower extremity weakness and inability to walk. She described aching pain, “pins and needles,” and numbness over both thighs and buttocks that was worse [...]

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HM2008 Abstract Number: 161

Dynamic Left Ventricular Outflow Tract Obstruction in a Patient with Massive Pulmonary Embolism

Case Presentation: A 63‐year‐old white man complained of shortness of breath with sharp chest pain radiating to his left arm. His medical history included hypertension and several distant orthopedic surgeries. He denied immobility, recent long [...]

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HM2008 Abstract Number: 160

Spontaneous Esophageal Rupture in HIV

Case Presentation: A 54‐year‐old HIV‐positive male patient with history of cocaine abuse presented to the emergency room with a 1‐day duration of chest and epigastric pain. He had poor medication compliance, with a low CD4 [...]

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HM2008 Abstract Number: 159

A Beguiling Concurrence of Central Venous Thrombosis and Variant Angina in a Newly Diagnosed Case of SLE

Case Presentation: A 31‐year‐old woman with Raynaud's syndrome presented to the ED with a 2‐day history of a severe headache and blurry vision lasting 2 days. Review of systems was notable for photosensitivity, malar rash, [...]

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HM2008 Abstract Number: 158

Raynaud's Phenomenon with Profound Variations in Capillary Blood Glucose Levels: A Case of Pseudohypoglycemia

Case Presentation: A 49‐year‐old man with a history of schizophrenia, diabetes mellitus, and scleroderma presented with recurrent episodes of atypical chest pain and vomiting. Repeated physical examinations revealed intermittent peripheral cyanosis with decreased digital capillary [...]

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HM2008 Abstract Number: 157

Tularemia Presenting as a Painless Ulcer with Fever

Case Presentation: A 14‐year‐old man presented with a 3‐week history of nightly fevers and a painless upper back ulcer. The lesion had grown in size despite oral antibiotics after initial culture revealed MSSA. Review of [...]

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HM2008 Abstract Number: 156

Lactic Alkalosis: an Unusual and Confusing Presentation of Pulmonary Embolism

Case Presentation: A 63‐year‐old woman with a history of obesity and breast cancer metastatic to the spine presented with 3 days of fatigue, decreasing exercise tolerance, and dyspnea. She had gemcitabine and carboplatin 4 days [...]

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HM2008 Abstract Number: 155

Something to Think About: Nocardia Brain Abscess in a Renal Transplant Patient

Case Presentation: A 59‐year‐old Mexican man on immunosuppressive agents for a cadaveric renal transplant in October 2006 presented to an outside medical center for headache, weakness, and repeated falls. Over the prior month, the patient [...]

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HM2008 Abstract Number: 154

TTP or Not TTP?

Case Presentation: A 25‐year‐old woman with a history of systemic lupus erythematosus (SLE), hypertension (HTN), and class IIIA lupus nephritis was admitted to the ICU for a generalized tonic‐clonic seizure. Her blood pressure was 250/150, [...]

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HM2008 Abstract Number: 153

Painless Acute Aortic Dissection Presenting as Left Lower Extremity Weakness and Numbness

Case Presentation: A 76‐year‐old woman presented with left lower extremity numbness and weakness for 1 hour. She denied chest or back pain. Vital signs were unremarkable. Neurological examination revealed 0/5 motor strength and decreased pinprick [...]

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HM2008 Abstract Number: 152

Intra‐arterial tPA Use in an Acute Embolic CVA in an Elderly Hospitalized Patient with Recent Gastrointestinal Bleeding

Case Presentation: An 89‐year‐old woman with a history of paroxysmal atrial fibrillation and gastrointestinal (GI) bleeding less than 2 weeks prior was admitted to the hospital with worsening dyspnea over the past 3 days. She [...]

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HM2008 Abstract Number: 151

Acute Stroke Mimicking as Postpartum Depression

Case Presentation: A 31‐year‐old woman with history of depression was 7 days postpartum with no peripartum complications and presented with depressed mood and aphasia. Her family reported depressed mood, decreased verbal communication, and fatigue. She [...]

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HM2008 Abstract Number: 150

Persistent Obstructive Jaundice in a 56‐Year‐Old Man

Case Presentation: A 56‐year‐old white man with history of gallstone cholecystitis status post‐ERCP 11 years ago with sphincterotomy presented with bilateral upper quadrant pain after meals for 2 days. He had dark urine but no [...]

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HM2008 Abstract Number: 149

Meningitis Associated with IVIG: A Real Pain in the Neck

Case Presentation: The patient is a 33‐year‐old white woman with dermatomyositis who was well until she awoke one night with a severe frontal and bibasilar headache associated with neck stiffness, bilateral eye and neck pain [...]

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HM2008 Abstract Number: 148

Spurious Thrombocytosis: a Rare Presentation of Cryoglobulinemia

Case Presentation: The patient is a 51‐year‐old man with history of IVDA and depression who presented with complaints of bilateral leg pain and swelling. He attributed his symptoms to cold weather during a snowstorm. A [...]

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HM2008 Abstract Number: 147

Not All Brain Lesions Are Created Equal

Case Presentation: An otherwise healthy 37‐year‐old woman presented to a local hospital with left arm paresthesias and word‐finding difficulties. A head CT found a 3‐cm corona radiata lesion with mass effect and steroids were prescribed [...]

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HM2008 Abstract Number: 146

Sudden Cardiac Compromise in a Young Patient with Bipolar Disease

Case Presentation: A 24‐year‐old male patient with bipolar disorder presented with his family to the emergency room with complaints of dyspnea and palpitations. He was diaphoretic and a poor historian. An electrocardiogram revealed diffuse ST‐T [...]

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HM2008 Abstract Number: 145

CNS‐Negative Disseminated Meningococcemia: Arthritis‐Dermatitis Syndrome

Case Presentation: A healthy 65‐year‐old man with history of high‐risk sexual activity presented to the ED with 5 days of oligoarthritis. The patient was in Florida 1 week prior to admission, when he developed URI [...]

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HM2008 Abstract Number: 144

Curative Therapy for a 25 Year‐Old Woman with an Adnexal Mass and Omental Caking

Case Presentation: A 25‐year‐old woman presented to the ED with a 3‐month history of worsening abdominal distention. She had previously been diagnosed with “belly fluid” and was treated with Lasix. She denied any weight loss, [...]

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HM2008 Abstract Number: 143

Tuberculous Meningitis in an Immunocompetent Man Presenting as Change in Mental Status

Case Presentation: A 68‐year‐old Filipino man with a medical history of COPD, tobacco abuse, and transient ischemic attacks, presented to an outside hospital with complaints of change in mental status, an approximate 30‐pound weight loss [...]

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HM2008 Abstract Number: 142

Pleurocutaneous Fistula Complicating Chest Tube Placement for Prevotella Empyema: A Case Report

Case Presentation: An 88‐year‐old man presented to the emergency room with respiratory distress, severe leukocytosis, and a large loculated effusion with an air‐fluid level in the left hemithorax. He was intubated and started on broad‐spectrum [...]

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HM2008 Abstract Number: 141

A Not‐So‐Typical Cause of Painless Jaundice

Case Presentation: A 63‐year‐old white woman presented with a 3‐week history of painless jaundice, pruritus, and weight loss. She was a former smoker with a family history of colon cancer. The exam was unremarkable, except [...]

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HM2008 Abstract Number: 140

Solifenacin‐lnduced Small Bowel Pseudo‐obstruction

Case Presentation: An 89‐year‐old with stage 0 CLL and a history of stage III colorectal cancer treated with hemicolectomy and capecitabine in 2003 was admitted to the hospital in 2006. She felt dehydrated, nauseated, and [...]

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HM2008 Abstract Number: 139

Pulmonary Talc Granulomatosis Mimicking Malignant Disease 30 Years After Last Exposure

Case Presentation: A 53‐year‐old man with a history of emphysema and hepatitis C presented with a 4‐month history of dyspnea and weight loss. He had a 35‐pack‐year smoking history and reported intravenous heroine abuse 30 [...]

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HM2008 Abstract Number: 138

Idiopathic CD4+ T‐Cell Lymphocytopenia

Case Presentation: A previously healthy 65‐year‐old man presented to Dartmouth‐Hitchcock Medical Center with 3 months of decreased energy, dyspnea, and fever. The patient was afebrile and normotensive but required 100% O2 by face mask. His [...]

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HM2008 Abstract Number: 137

Abdominal Pain That Is Not in the Abdomen — An Unusual Presentation of Non‐Hodgkin B‐Cell Lymphoma

Case Presentation: The epidural space is a well‐known, albeit uncommon, location for lymphomatous involvement. We present a Hispanic man with an initial complaint of upper abdominal pain that progressed to a posterior spinal canal compression [...]

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HM2008 Abstract Number: 136

Miliary Tuberculosis Presenting as Postpartum Fever and Back Pain

Case Presentation: A 24‐year‐old Hispanic woman was admitted 2 weeks postpartum by the obstetricians with fever and back pain and treated empirically for postpartum endometritis. A medical consultation was requested to evaluate for other sources [...]

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HM2008 Abstract Number: 135

“Please Come Back to the Hospital: Your Test Results Show You May Have…“

Case Presentation: A 61‐year‐old nonsmoker presented with right‐sided weakness and an unstable gait for 2 days. Exam showed an obvious right‐sided weakness and dysarthria. He was admitted for inpatient care. PE revealed an edentulous, frail [...]

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HM2008 Abstract Number: 134

Unmasking of Brugada Syndrome by Lithium

Case Presentation: A 38‐year‐old man was brought by EMS after resuscitation following cardiac arrest. The patient was walking on the street when he collapsed and lost consciousness. EMS found the patient to be cold, clammy, [...]

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HM2008 Abstract Number: 133

Catastrophe Unleashed: Cardiac Tamponade Due to Metastatic Melanoma

Case Presentation: A 29‐year‐old man with a medical history of melanoma was being treated in the hospital for radiation‐induced esophagitis. He was first diagnosed with melanoma in the axillary region 5 years ago and since [...]

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HM2008 Abstract Number: 132

Page Kidney Phenomenon: A Case Report and Literature Review

Case Presentation: This is a 29‐year‐old African American man who suffered from a work‐related crush injury leading to multiple complications including maxillary and sacral fractures as well as kidney and liver lacerations. He underwent multiple [...]

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HM2008 Abstract Number: 131

Recurrent Bacterial Meningitis (RBM): An Interesting Presentation Due to a Motor Vehicle Accident (MVA) 10 Years Ago

Case Presentation: A 51‐year‐old diabetic and hypertensive woman was life‐flighted with complaints of fever, headache, mental status changes, and acute respiratory failure. She was found to be in diabetic ketoacidosis. Vancomycin, ceftriaxone, and an insulin [...]

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HM2008 Abstract Number: 130

Nocardiosis Presenting as a Solitary Pulmonary Nodule and Pleural Effusion in a Patient with Relapsing Polychondritis

Case Presentation: An 86‐year‐old man with a history of hypertension and relapsing polychondritis (RPC) on remission with immunosuppressant therapy (MTX and PDN) presented with pleuritic chest pain and shortness of breath 6 months prior to [...]

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HM2008 Abstract Number: 129

Epidural Lipomatosis and Cushing's Disease: A Case Report

Case Presentation: A 23‐year‐old woman with a history of recently diagnosed diabetes mellitus (DM) type 2 and hypertension (HTN) and recent significant weight gain presented to the ED with a 2‐month history of extreme low [...]

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HM2008 Abstract Number: 128

Rebound Hyperkalemia in a Patient with Thyrotoxic Periodic Paralysis

Case Presentation: We present a 40‐year‐old woman who called EMS for generalized weakness and vomiting of 2 days' duration. On arrival, the emergency paramedic found her sitting in bed complaining of chest tightness. An EKG [...]

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HM2008 Abstract Number: 127

Acute Myocardial Infarction after Intravenous Administration of Dexamethasone for Acute Asthma

Case Presentation: A 35‐year‐old woman presented to the emergency department complaining of worsening shortness of breath of 2 days' duration. Her medical history was remarkable for mild intermittent bronchial asthma. Physical examination revealed an anxious [...]

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HM2008 Abstract Number: 126

Hospitalist Training Program for Postgraduate Physician Assistants

Background: A recent Society of Hospital Medicine survey reported that approximately 15% of hospitalist groups utilize physician assistants (PAs), and many more are looking to hire PAs to augment their physician services. However, finding physician [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Hospitalist Training Program for Postgraduate Physician Assistants

HM2008 Abstract Number: 125

Formation of a Geographically Based Hospitalist Clinical Innovations Unit (CIU) to Improve Patient Outcomes, Efficiency, and Team‐Based Care

Background: Hospitalists are increasingly expected to improve patient outcomes while maintaining a high level of efficiency. In addition, attaining high levels of patient and employee satisfaction is critical to a hospital's mission. Creating a research [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Formation of a Geographically Based Hospitalist Clinical Innovations Unit (CIU) to Improve Patient Outcomes, Efficiency, and Team‐Based Care

HM2008 Abstract Number: 124

Bundling of Performance Measures on Admission and Discharge as a Hospitalist‐Specific Reporting Strategy for the 2007 Physician Quality Reporting Initiative. Who, What, Where, and When

Background: On July 1, 2007, the CMS launched the Physicians Quality Reporting Initiative (PQRI) as a voluntary pay‐for‐reporting program to reward individual physicians for providing quality care based on 74 performance measures. The program calls [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Bundling of Performance Measures on Admission and Discharge as a Hospitalist‐Specific Reporting Strategy for the 2007 Physician Quality Reporting Initiative. Who, What, Where, and When

HM2008 Abstract Number: 123

Hospitalist Comanagement of Neurosurgery Patients

Background: When the 80‐hour restriction took effect nationwide, surgical trainees' time outside the operating room became inadequate to optimally manage complex patients in the perioperative period. A busy neuroscience facility specializing in treatment of arteriovenous [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Hospitalist Comanagement of Neurosurgery Patients

HM2008 Abstract Number: 122

Bridging the Healthcare Gap: An Effective Collaboration of Hospital Medicine and Community Case Management

Background: All too often the transition of patient care from the inpatient to the outpatient setting is a dilemma. Our hospital administration recognized this issue and developed a community case management program (CCMP). The staff [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Bridging the Healthcare Gap: An Effective Collaboration of Hospital Medicine and Community Case Management

HM2008 Abstract Number: 121

A Novel System Designed to Optimize Communication between Hospitalists and Primary Care Physicians

Background: Communication is central to the coordination of quality patient care. Yet studies have documented poor communication among physicians and have associated poor communication with serious adverse outcomes. A recent meta‐analysis revealed that direct communication [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on A Novel System Designed to Optimize Communication between Hospitalists and Primary Care Physicians

HM2008 Abstract Number: 120

Physician‐to‐Physician Handoff: The Veterans Affairs Cairo Project

Background: The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) introduced a National Patient Safety Goal that states hospitals should “implement a standardized approach to ‘handoff’ communications, including an opportunity to ask and respond to [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Physician‐to‐Physician Handoff: The Veterans Affairs Cairo Project

HM2008 Abstract Number: 119

Standardization and Simulation Training for Central Venous Catheter Placement to Improve Patient Safety

Background: Improved methods for training medical residents on common procedures offer the possibility of minimizing complications. Currently residents are often trained to perform procedures such as central venous catheter (CVC) placement on real patients in [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Standardization and Simulation Training for Central Venous Catheter Placement to Improve Patient Safety

HM2008 Abstract Number: 118

Morning Intake for Grownups: A Report on Peer and Practice‐Based, Small Group Continuing Clinical Education

Background: Continuing medical education is important not merely for the maintenance of certification but also for the ongoing growth and development of clinicians. This may be particularly relevant in the field of hospital medicine, where [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Morning Intake for Grownups: A Report on Peer and Practice‐Based, Small Group Continuing Clinical Education

HM2008 Abstract Number: 117

Strengthening Clinical Research in an Academic Hospitalist Program Via a Master Teacher Position

Background: Emphasis is shifting from the simple justification of hospital medicine to identifying/implementing steps enabling it to move more solidly into academia. Establishing a robust fundable research base — allowing for diversity in funding and [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Strengthening Clinical Research in an Academic Hospitalist Program Via a Master Teacher Position

HM2008 Abstract Number: 116

EMR for Standardization of the Hospital Discharge Appointment Process

Background: Discharge from the hospital is a critical transition point in patient care. This transition is a vulnerable time for patients, with many experiencing medical error and adverse events after discharge. Improving patient safety during [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on EMR for Standardization of the Hospital Discharge Appointment Process

HM2008 Abstract Number: 115

Resident Reflections on a New Community Hospital Rotation

Background: Every day, internal medicine (IM) house staff members work on the wards with hospitalist teachers and attendings. Increasing numbers are choosing careers in hospitalist medicine postresidency despite limited exposure to the full range of [...]

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HM2008 Abstract Number: 114

A Hospitalist‐Run Exercise Treadmill Testing Laboratory in an Emergency Department

Background: Emergency department (ED) physicians in our hospital commonly use exercise treadmill testing (ETT) to manage low‐risk patients who present with chest pain. Selected patients undergo ETT either on the day of presentation or within [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on A Hospitalist‐Run Exercise Treadmill Testing Laboratory in an Emergency Department

HM2008 Abstract Number: 113

Experience with an Off‐Site Hospitalist Service to Receive Transfers of General Medical Patients from an Emergency Department in a University Hospital

Background: As part of a larger initiative to increase capacity for subspecialty patients, this university hospital (UH), a 573‐bed quaternary‐care facility in a large urban center, decreased the size of its general medicine service (GMS) [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Experience with an Off‐Site Hospitalist Service to Receive Transfers of General Medical Patients from an Emergency Department in a University Hospital

HM2008 Abstract Number: 112

Formal Procedural Instruction for Residents — An Opportunity for Academic Hospitalists

Background: Residents often feel inadequately instructed to perform invasive procedures and believe this poses a risk to patients. Formal teaching using task trainers (ie, models) has the potential to improve competence and confidence, and advance [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Formal Procedural Instruction for Residents — An Opportunity for Academic Hospitalists

HM2008 Abstract Number: 111

A Case Review Tool for Quality Analysis

Background: Individual case review is an important mechanism for peer assessment and quality improvement. Today, most case reviews of hospitalized patients are performed in an unstructured manner outside the context of a broader quality improvement [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on A Case Review Tool for Quality Analysis

HM2008 Abstract Number: 110

Implementation of Physician Quality Reporting Initiative Program in a Large Community Hospitalist Group

Background: The Centers for Medicare and Medicaid services (CMS) established an incentive program referred to as Physician Quality Reporting Initiative (PQRI) in 2007 for voluntary reporting of at least 3 of the 74 designated measures [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Implementation of Physician Quality Reporting Initiative Program in a Large Community Hospitalist Group

HM2008 Abstract Number: 109

Hospitalist‐Unit Staff Partnership to Implement and Evaluate Improvements in the Discharge Process: Utilizing Lean Thinking as a Common Methodology

Background: Hospitalists often care for patients on multiple hospital units simultaneously, limiting opportunities for consistent interactions and collaboration on quality improvement initiatives with a familiar group of unit staff members. Our hospitalist group partnered with [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Hospitalist‐Unit Staff Partnership to Implement and Evaluate Improvements in the Discharge Process: Utilizing Lean Thinking as a Common Methodology

HM2008 Abstract Number: 108

Using Lean/Toyota Production System (TPS) to Improve Inpatient Care

Background: Caring for acutely ill patients in a 40‐bed ward while constantly admitting, discharging, and transferring care is a challenge. The clinical staff spends significant time completing nonclinical tasks (eg, searching for supplies). This time [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Using Lean/Toyota Production System (TPS) to Improve Inpatient Care

HM2008 Abstract Number: 107

The Inpatient Apprenticeship

Background: We have implemented an inpatient “apprenticeship” for all PGY1 IM residents. We hypothesize this rotation will expedite the development of core competencies as related to care of hospitalized patients by having a one‐on‐one experience [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on The Inpatient Apprenticeship

HM2008 Abstract Number: 106

Benefits of Initiating a Hospitalist PICC Program — Experience from an Academic Community Medical Center

Background: Hospitalists play a key role in procedural training at many academic institutions and are frequently called on to assist with vascular access. PICCs have been shown to be safe and cost effective. Their use [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Benefits of Initiating a Hospitalist PICC Program — Experience from an Academic Community Medical Center

HM2008 Abstract Number: 105

Building a Hospital Medicine Curriculum to Enhance Internal Medicine Residency Education Using the Hospital Medicine Core Competencies

Background: Our program's house staff and medical student curricula were heavily weighted toward ambulatory medicine. Our division and training program wanted to develop a learning tool focused on inpatient skills, using the Society of Hospital [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Building a Hospital Medicine Curriculum to Enhance Internal Medicine Residency Education Using the Hospital Medicine Core Competencies

HM2008 Abstract Number: 104

A Multidisciplinary Approach to Improving “Hospital Flow”

Background: In an attempt to improve the efficiency of patient care, the Institute for Healthcare Improvement (IHI) has studied “hospital flow.” This work suggests that a multidisciplinary approach using formulas that examine flow in a [...]

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HM2008 Abstract Number: 103

A Pilot Study Using the Confusion Assessment Method (CAM) Instrument to Assess for Delirium among Hospitalized Patients

Background: Delirium is an underdiagnosed and often untreated health care burden associated with poor outcomes including increased length of stay, increased inpatient mortality, and higher rates of institutionalization. One technique for identifying patients with delirium [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on A Pilot Study Using the Confusion Assessment Method (CAM) Instrument to Assess for Delirium among Hospitalized Patients

HM2008 Abstract Number: 102

Sickle Cell Quality Improvement Team: Improving the Quality, Consistency, and Coordination of Care for Patients with Sickle Cell Anemia

Background: Sickle cell anemia is a chronic disease punctuated by acute pain crises. Up to 60% of patients with sickle cell anemia will have an episode of severe pain in a given year, making their [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Sickle Cell Quality Improvement Team: Improving the Quality, Consistency, and Coordination of Care for Patients with Sickle Cell Anemia

HM2008 Abstract Number: 101

Can Tissue Models Be Used to Teach Central Line Placement? Phase II of the Procedure Patient Safety Initiative (PPSI)

Background: Legitimate concerns continue to mount with regard to having novice physicians learn and practice procedures on patients. It is incumbent on the education community to develop effective modalities for teaching proper procedure technique that [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Can Tissue Models Be Used to Teach Central Line Placement? Phase II of the Procedure Patient Safety Initiative (PPSI)

HM2008 Abstract Number: 100

Innovative Strategies Which Improve the Clinical Handoff (I‐SWITCH) Phase 1: Development of a Cognitive Handoff Simulation

Background: With the evolution of ACGME duty‐hour requirements, there are an increasing number of patient handoffs. Much of the handoff literature has focused on tools to assist residents in the handoff process; however, few studies [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Innovative Strategies Which Improve the Clinical Handoff (I‐SWITCH) Phase 1: Development of a Cognitive Handoff Simulation

HM2008 Abstract Number: 99

Using Hospital Administrative Data to Determine if DVT/PE Was Present on Hospital Admission or Was Hospital Acquired: Why Your Institution Needs to Know

Background: Hospital‐acquired deep venous thrombosis (DVT) and pulmonary embolism (PE) are common yet preventable diagnoses. Beginning in October 2008, the Centers for Medicare and Medicaid Services (CMS) will not reimburse hospitals for several hospital‐acquired conditions, [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Using Hospital Administrative Data to Determine if DVT/PE Was Present on Hospital Admission or Was Hospital Acquired: Why Your Institution Needs to Know

HM2008 Abstract Number: 98

Hospitalists as Emerging Leaders in Patient Safety (HELPS): Lessons Learned and Future Directions

Background: The emergence of hospitalists has resulted in large numbers of patients being cared for by small cadres of physicians. Most hospitalists and hospital medicine programs participate in and in many cases coordinate quality improvement [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Hospitalists as Emerging Leaders in Patient Safety (HELPS): Lessons Learned and Future Directions

HM2008 Abstract Number: 97

A Novel Internet‐Based Consult Curriculum for Hospitalists

Background: The 2005‐2006 Society of Hospitalist Medicine survey documented the growth of the specialty to approximately 15,000 hospitalists in 2006. As the hospitalist inpatient role has grown, other specialties have turned to hospitalists for consultative [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on A Novel Internet‐Based Consult Curriculum for Hospitalists

HM2008 Abstract Number: 96

Medical Journal Podcasts as Tools for Continuous Medical Education

Background: A podcast is an audio or video file that is distributed over the Internet using syndication feeds for playback on demand. Most major medical journals and organizations provide free podcast feeds that can be [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Medical Journal Podcasts as Tools for Continuous Medical Education

HM2008 Abstract Number: 95

Indication‐Based Ordering: A New Paradigm for Glycemic Control in Hospitalized Patients

Background: Improving inpatient glycemic control is challenging. Institutional insulin management protocols and structured order sets are commonly advocated but are not well studied as methods to improve glycemic control. Integration of protocol guidance into the [...]

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HM2008 Abstract Number: 94

Contributing Factors to Short‐Term Readmissions to an Academic Center Hospital Medicine Program

Background: The literature on hospital medicine emphasizes length of stay, resource utilization, and readmission rates. However, investigation into reasons for readmissions to hospital medicine services remains minimal. Purpose: To describe the ongoing experience of a [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Contributing Factors to Short‐Term Readmissions to an Academic Center Hospital Medicine Program

HM2008 Abstract Number: 93

Help! No One Is Using Our Hospitalists!

Background: During their fledgling state, many hospitalist programs have struggled from a lack of acceptance among primary care physicians. Multiple stereotypical reasons exist for this problem including financial incentives and personal physician/patient preferences. We present [...]

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HM2008 Abstract Number: 92

Fostering Improvement in DVT Prophylaxis Rates in High‐Risk Patients by Applying the Caprini Risk Score to an Administrative Database

Background: VTE prophylaxis is a core component of inpatient care and an established quality and safety measure. Measuring rates of appropriate VTE prophylaxis in medical patients is difficult and has previously required the use of [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Fostering Improvement in DVT Prophylaxis Rates in High‐Risk Patients by Applying the Caprini Risk Score to an Administrative Database

HM2008 Abstract Number: 91

A New Discharge Appointment Process Resulting in Improved Transition of Care and Increased Show Rate for Follow‐up Appointments

Background: Transitioning care from hospitalization to ambulatory care can be a stressful and confusing experience for patients. The Society of Hospital Medicine has been charged to develop quality measures around the processes of appropriate and [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on A New Discharge Appointment Process Resulting in Improved Transition of Care and Increased Show Rate for Follow‐up Appointments

HM2008 Abstract Number: 90

The ABIM Hospital‐Based Practice Improvement Module (PIM): Who Are the Completers and What Have We Learned?

Background: The ABIM recently developed a series of Web‐based practice‐focused self‐evaluation instruments called Practice Improvement Modules (PIM) as a requirement of its maintenance of certification program. PIMs facilitate the implementation of quality improvement (QI) processes [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on The ABIM Hospital‐Based Practice Improvement Module (PIM): Who Are the Completers and What Have We Learned?

HM2008 Abstract Number: 89

Mortality Review

Background: It is known that 60% of American patients die in the hospital. As our population ages and technology advances, in‐patient management becomes more complex in the hospital. It is unknown how much of inpatient [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Mortality Review

HM2008 Abstract Number: 88

The Inpatient Influenza Immunization Initiative — Using Computerized Provider Order Entry to Improve Screening and Immunization Rates

Background: Annual influenza vaccination is the most effective method for preventing influenza virus infection and its potentially severe complications, which account for 200,000 hospitalizations and 36,000 deaths in the United States each year. Patients age [...]

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HM2008 Abstract Number: 87

Bringing Root Cause Analysis up to Speed: The Impact of Increasing the Volume and Rapidity of RCAs

Background: In 1999, the Institute of Medicine's To Err is Human reported that nearly 100,000 people die from medical errors each year in the United States. One proposed solution was detailed root cause analyses of [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Bringing Root Cause Analysis up to Speed: The Impact of Increasing the Volume and Rapidity of RCAs

HM2008 Abstract Number: 86

A Targeted Intervention and Detection System to Detect Adverse Drug Events in Hospitalized Patients

Background: To implement an automated system that will identify impending and latent adverse drug events (ADEs) in hospitalized patients and to (1) assess the effectiveness of the system at identifying true‐positive ADEs and (2) assess [...]

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HM2008 Abstract Number: 85

Status of Hospitalist Group Leaders' Knowledge of Hospital Participation in Payer to Hospital Pay for Performance Programs

Background: Hospital participation in pay‐for‐performance (P4P) programs with payers provides an opportunity for aligning incentives between hospitals and hospitalists. These programs may prompt hospitals to reward hospitalists for compliance with performance measures specified in payer‐to‐hospital [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Status of Hospitalist Group Leaders' Knowledge of Hospital Participation in Payer to Hospital Pay for Performance Programs

HM2008 Abstract Number: 84

Prevalence and Basis of Performance Incentives for Hospitalists

Background: Hospitalists are increasingly being asked to comply with performance measures related to quality of care, efficiency, and patient satisfaction. Overall, little is known about existing incentives to reward hospitalist performance outside of professional billings. [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Prevalence and Basis of Performance Incentives for Hospitalists

HM2008 Abstract Number: 83

Cardiorenal Rescue with Slow Continuous Venovenous Ultrafiltration in Patients with Heart Failure

Background: Cardiorenal syndrome (CRS) occurs in 25% of patients hospitalized for heart failure and is associated with increased length of stay, readmission, and death; currently, there are no treatments with proven efficacy. We report our [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Cardiorenal Rescue with Slow Continuous Venovenous Ultrafiltration in Patients with Heart Failure

HM2008 Abstract Number: 82

Inpatient Obesity Perception and Intervention Project

Background: Many hospital admissions can be attributed to the comorbid conditions obese patients struggle with. Research shows that hospitalization can serve as a trigger to successfully implement lifestyle modifications. We conducted this study to assess [...]

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HM2008 Abstract Number: 81

Current and Future Trends in the Growth of Hospitalists in California

Background: The number of hospitalists is growing rapidly, even though managed care, one of the field's major initial stimuli, is abating in California. Little research has examined the current factors responsible for the continued growth [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Current and Future Trends in the Growth of Hospitalists in California

HM2008 Abstract Number: 80

Relationship between Hospitalist Prevalence and Quality Performance among California Hospitals

Background: Hospitalists improve efficiency, but their effect on quality of care is not well characterized. We analyzed data from a sample of California hospitals to assess the relationship between prevalence of hospitalists and the frequency [...]

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HM2008 Abstract Number: 79

A Survey of Hospitalists Transfusion Practices

Background: Utilization of blood products has been studied among anesthesiologists, surgeons, and intensivists, but little is known about blood utilization among hospitalists. The purpose of this study was to examine the transfusion thresholds and factors [...]

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HM2008 Abstract Number: 78

Hospitalists Intent to Participate in the Physician Quality Reporting Initiative, a National Physician‐Level Pay for Reporting Program

Background: Involving physicians in value‐based purchasing or pay for performance programs is gaining momentum as a solution to aligning quality and costs for health care reform. In July 2007, the Centers for Medicare and Medicaid [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Hospitalists Intent to Participate in the Physician Quality Reporting Initiative, a National Physician‐Level Pay for Reporting Program

HM2008 Abstract Number: 77

Do Hospitalists Perform More Inpatient Procedures Than Nonhospitalists

Background: The number of hospitalist physicians in the United States has grown rapidly over the past decade. Given their constant, on‐site presence, hospitalists are well suited to perform many inpatient procedures. Yet little is known [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Do Hospitalists Perform More Inpatient Procedures Than Nonhospitalists

HM2008 Abstract Number: 76

Frequency of Appropriate Laboratory Utilization in an Academic Medical Center: Opportunities for Cost Savings?

Background: As health care expenditures in the United States take an ever‐expanding piece of the U.S. economy, the contribution of “little‐ticket” items such as common lab tests is being explored. Magnesium (Mg) and phosphorus (Phos) [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Frequency of Appropriate Laboratory Utilization in an Academic Medical Center: Opportunities for Cost Savings?

HM2008 Abstract Number: 75

Low Incidence of Overly Rapid Serum Sodium Increase During Treatment of Euvolemic and Hypervolemic Hyponatremia with Conivaptan

Background: Conivaptan hydrochloride injection (Vaprisol) is an arginine vasopressin ViA/V2‐receptor antagonist approved for the treatment of euvolemic or hypervolemic hyponatremia in hospitalized patients. Overly rapid increases in serum sodium concentration ([Na+]), regardless of treatment, may [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Low Incidence of Overly Rapid Serum Sodium Increase During Treatment of Euvolemic and Hypervolemic Hyponatremia with Conivaptan

HM2008 Abstract Number: 74

Situational Awareness Improves Prevalence of VTE Prophylaxis on Multiple Nursing Units

Background: Research in hospital care delivery has yet to elucidate a transferable strategy to deliver optimal care on a consistent basis. Most hospitals struggle even to generate the regular data flow necessary to track performance. [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Situational Awareness Improves Prevalence of VTE Prophylaxis on Multiple Nursing Units

HM2008 Abstract Number: 73

Use of an Insulin Infusion Conversion Equation (MCE) to Improve Inpatient Glycemic Control

Background: Data from the medical literature suggest a benefit of glycemic control during acute illness. Glycemic control can be accomplished easily by use of IV insulin infusions. However, IV insulin is often discontinued during a [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Use of an Insulin Infusion Conversion Equation (MCE) to Improve Inpatient Glycemic Control

HM2008 Abstract Number: 72

Attending Physician and Medical Student Perception of Medical Jargon in Bedside Presentations

Background: In recent decades, patient “rounds” have largely shifted from the bedside to the conference room. The literature suggests that one reason may be the fear of provoking patient anxiety with the use of medical [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Attending Physician and Medical Student Perception of Medical Jargon in Bedside Presentations

HM2008 Abstract Number: 71

Improving Patient Identification of Their Inpatient Physicians: Use of FACE™ Cards

Background: Although stating both the names and roles of physicians is considered an important part of physicians' introductions, patients frequently complain that doctors do not introduce themselves and that they are not sure who they [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Improving Patient Identification of Their Inpatient Physicians: Use of FACE™ Cards

HM2008 Abstract Number: 70

Physician Awareness of and Communication about Hospital Readmissions

Background: Patients recently discharged from inpatient medicine services often require hospital readmission and often are readmitted to a different physician or team, potentially without the knowledge of the prior caregivers. Thus, physicians may lose the [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Physician Awareness of and Communication about Hospital Readmissions

HM2008 Abstract Number: 69

Avoided Unnecessary Admissions (AUA): A Value‐Added Service from a Well‐Integrated Health Care Team

Background: ER physicians tend to be risk averse. Out of fear for what cannot be determined in a short time and concerns over litigation, many ER doctors believe they are erring on the side of [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Avoided Unnecessary Admissions (AUA): A Value‐Added Service from a Well‐Integrated Health Care Team

HM2008 Abstract Number: 68

Measuring Quality and Safety for Lumbar Punctures: Introducing the Atraumatic Index and the Traumatic Index

Background: The “champagne tap” is still considered the gold standard for lumbar puncture (LP) success. The Gertie‐Marx® (GM) atraumatic LP needle has been shown in multiple studies to be superior to the standard Quinke needle [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Measuring Quality and Safety for Lumbar Punctures: Introducing the Atraumatic Index and the Traumatic Index

HM2008 Abstract Number: 67

Safety First: Use of the Gertie‐Marx Needle for Lumbar Punctures

Background: Despite the strength of the 2005 AHRQ recommendations for the use of the Gertie‐Marx® spinal needle (GM) for lumbar punctures (LPs), the use of this device has not reached critical mass at our institution. [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Safety First: Use of the Gertie‐Marx Needle for Lumbar Punctures

HM2008 Abstract Number: 66

Family‐Centered Rounds: A Comparison of Pediatric Hospitalists in Nonacademic and Academic Hospitals

Background: Patient‐centered care is an aim of quality care identified by the Institute of Medicine. The American Academy of Pediatrics has issued recommendations for family‐centered care, including conducting rounds with the family present. To date, [...]

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HM2008 Abstract Number: 65

Glycemic Control Following Transition from an Insulin Drip: A Pilot Study

Background: Most patients in the ICU obtain excellent glycemic control with the use of an insulin drip protocol. How best to transition patients to a subcutaneous regimen and maintain adequate glycemic control is less well [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Glycemic Control Following Transition from an Insulin Drip: A Pilot Study

HM2008 Abstract Number: 64

Lessons Learned from a Mock Code Blue Program at a Large Academic Medical Center

Background: In our 1000‐bed tertiary medical center, codes are run by ACLS‐certified internal medicine residents who have variable clinical experience in managing a Code Blue response. Daily physician and nurse changes in the code team [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Lessons Learned from a Mock Code Blue Program at a Large Academic Medical Center

HM2008 Abstract Number: 63

A Sex‐Specific Meta‐analysis of Routine vs. Selective Invasive Strategy in Patients with Non‐ST‐Segment Elevation Acute Coronary Syndromes

Background: Non‐ST‐segment elevation acute coronary syndrome (NSTEACS) patients are managed either with a routine invasive strategy (RIS), in which all patients undergo coronary artery angiography, or with selective invasive strategy (SIS), in which only patients [...]

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HM2008 Abstract Number: 62

Incidence and Predictors of Stroke after Hip Surgery

Background: Hip surgery (either total hip arthroplasty or repair of the fracture) is the most common noncardiac surgical procedure performed in patients 65 years or older. Most postoperative complication reports have focused on cardiac events [...]

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HM2008 Abstract Number: 61

Beta‐Blocker Use and Tachycardia in Acute Pulmonary Embolism

Background: The initial clinical assessment of patients with suspected pulmonary embolism (PE) is an essential part of the current diagnostic algorithm. Standardized prediction rules can be used to determine a general pretest probability of PE [...]

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HM2008 Abstract Number: 60

Who Is My Doctor? The Use of Business Cards on an Internal Medicine Teaching Service to Improve Patient Identification of Their Hospital Physicians and Patient Satisfaction

Background: Patients cared for in the hospital today meet numerous new physicians including hospitalists, house staff, and consultants. The relationship of each provider to the care of the patient is often confusing. We proposed that [...]

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HM2008 Abstract Number: 59

Teamwork on Inpatient Medical Units: Assessing Attitudes and Barriers

Background: Studies demonstrate discrepant attitudes about teamwork among nurses and physicians in operating rooms and intensive care units. Little is known about teamwork attitudes on general medical services. Our objective was to assess ratings of [...]

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HM2008 Abstract Number: 58

Patterns of Nurse‐Physician Communication and Agreement on the Plan of Care

Background: Interdisciplinary communication is critically important for safe and effective patient care. Little is known about patterns of communication between nurses and physicians caring for hospitalized medical patients. Our objective was to characterize nurse‐physician communication [...]

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HM2008 Abstract Number: 57

Effect of Hospitalist Attending Physicians on Trainee Education: A Systematic Review

Background: Hospitalist programs are increasingly prevalent in teaching hospitals. Consequently, internal medicine and pediatrics trainees may receive much of their inpatient education from hospitalists. The objective of this study was to characterize the effects of [...]

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HM2008 Abstract Number: 56

Rifaximin Is Not Superior to Other Pharmacological Agents in the Treatment of Hepatic Encephalopathy

Background: Nonabsorbable disaccharides such as lactulose and poorly absorbed antibiotics such as neomycin and rifaximin are commonly used in the treatment of hepatic encephalopathy (HE). Although several studies have examined the efficacy of rifaximin in [...]

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HM2008 Abstract Number: 55

Effects of Computerized Alerts on the Use of Unapproved Medication Abbreviations by Medical Interns

Background: Medication abbreviation errors account for a substantial proportion of total medication errors. National regulatory organizations have prohibited the use of certain commonly misinterpreted medication abbreviations in an effort to improve patient safety, yet physician [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Effects of Computerized Alerts on the Use of Unapproved Medication Abbreviations by Medical Interns

HM2008 Abstract Number: 54

Optimal Duration of Antibiotic Treatment for Adult Patients with Community‐Acquired Pneumonia: A Systematic Review of Randomized Controlled Trials

Background: According to the 2007 guidelines from the Infectious Diseases Society of America and the American Thoracic Society, adult patients with community‐acquired pneumonia (CAP) should be treated for a minimum of 5 days, have no [...]

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HM2008 Abstract Number: 53

Effect of an Inpatient Anticoagulation Service on Improving the Safe Use of Warfarin Sodium

Background: Anticoagulation with warfarin in the hospital has many challenges, including a narrow therapeutic range, variable metabolism, and drug‐related interactions. These factors, combined with illness and the complexities of hospitalization, have the potential for significant [...]

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HM2008 Abstract Number: 52

Prevention of Hospital‐Acquired Venous Thromboembolism: Prospective Validation of a VTE Risk Assessment Model and Protocol

Background: Hospital‐acquired venous thromboembolism (HA VTE) is a common source of morbidity/mortality. Proven prophylactic methods are underutilized. Available risk assessment models are not prospectively validated. Methods: Participants in the study were adult inpatients on all [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Prevention of Hospital‐Acquired Venous Thromboembolism: Prospective Validation of a VTE Risk Assessment Model and Protocol

HM2008 Abstract Number: 51

Category P: Intended and Unintended Consequences of a Quality Improvement Algorithm Involving Electronic and Paper Reminders

Background: Hospitals are initiating new processes of care to improve compliance with CMS quality measures, often integrating electronic reminders into existing systems of care. Category P is an electronic and paper‐based algorithm to improve timing [...]

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HM2008 Abstract Number: 50

Role of Serial BNP Measurements in Congestive Heart Failure: A Descriptive Pilot Study

Background: Congestive heart failure remains the leading admission diagnosis in patients more than 65 years old. The treatment of these patients varies and dependent on each clinician's experience. Currently, there are not significant data reflecting [...]

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HM2008 Abstract Number: 49

Incidence of Myocardial Infarction Following Hip Fracture Repair: Higher than Predicted by National Guidelines

Background: The preoperative combined risk of myocardial infarction (MI) and mortality following orthopedic surgeries is <5% (2007 ACC/AHA Perioperative Guideline). Very little is known about incidence of MI specifically following urgent hip fracture repair. Methods: [...]

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HM2008 Abstract Number: 48

Diagnostic Accuracy of Hand‐Carried Ultrasound Echocardiography by Hospitalists after a Brief Training Program

Background: Hand‐carried ultrasound echocardiography (HCUE) rivals the image quality and advanced capabilities of standard echocardiography (SE) but offers more portability at less cost. Though not a substitute for comprehensive SE when needed, focused HCUE can [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Diagnostic Accuracy of Hand‐Carried Ultrasound Echocardiography by Hospitalists after a Brief Training Program

HM2008 Abstract Number: 47

Predictors of Disclosure of Hospital Adverse Events and Its Impact on Patients' Quality Ratings

Background: Some clinicians may fear that disclosing adverse events (AEs) to patients will result in malpractice claims and undermine patients' perceptions of health care quality. However, little is known about hospital and patient characteristics associated [...]

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HM2008 Abstract Number: 46

Impact of Hospitalists on the Quality of Care of Acute Medical Conditions

Background: Despite existing literature examining the effects of hospitalist care on inpatient hospital‐associated costs and experiences with care, little is known about the impact of hospitalists on performance as measured by the Hospital Quality Alliance [...]

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HM2008 Abstract Number: 45

Intravenous and Oral Steroids Are Associated with Similar Outcomes in Acute Exacerbations of Chronic Obstructive Pulmonary Disease

Background: Systemic corticosteroids are a cornerstone of treatment in acute exacerbations of chronic obstructive pulmonary disease (AECOPD), yet their optimal route of administration is uncertain. Methods: We conducted a retrospective cohort study of patients hospitalized [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Intravenous and Oral Steroids Are Associated with Similar Outcomes in Acute Exacerbations of Chronic Obstructive Pulmonary Disease

HM2008 Abstract Number: 44

Hospitalist Practice Patterns in Ischemic Stroke Care

Background: Hospitalists are frequently the primary providers of inpatient stroke care despite an underemphasis on neurology in traditional internal medicine training. Treatment attitudes and practices of hospitalists pertaining to stroke are unclear. Methods: A survey [...]

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HM2008 Abstract Number: 43

Impact of a Hospitalist‐Run Observation Unit on Length of Stay

Background: There has been little work on the impact of hospitalist involvement in short‐stay or observation units. In August 2005, the University Hospital consolidated the care of medical observation patients onto a hospitalist‐run, nonteaching “clinical [...]

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HM2008 Abstract Number: 42

Impact of a Predominant Geographic Model on Outcomes for Hospitalist Patients

Background: Concern for patient safety and efficient throughput has been the impetus for the development of many initiatives aimed at improving hospital processes. It is our hypothesis that the traditional assignment of patients may adversely [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Impact of a Predominant Geographic Model on Outcomes for Hospitalist Patients

HM2008 Abstract Number: 41

Dyspnea in Diabetics Is a Result of Restrictive Lung Pattern Rather Than Diastolic Dysfunction

Background: Although it is widely recognized that type II diabetes (DM) is associated with diastolic dysfunction (DD), and despite increasing evidence that diabetic lung disease is more prevalent than generally recognized, it is unknown which [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Dyspnea in Diabetics Is a Result of Restrictive Lung Pattern Rather Than Diastolic Dysfunction

HM2008 Abstract Number: 40

Use of an Embedded Template Improves Discharge Summary Timeliness

Background: Patients are at high risk for adverse events following hospital discharge. A discharge summary (DCS) helps to prevent such events but is rarely available to primary care physicians (PCPs) at follow‐up; at our institution, [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Use of an Embedded Template Improves Discharge Summary Timeliness

HM2008 Abstract Number: 39

Simple Ultrasound Measurement of the Internal Jugular Vein Accurately Estimates Central Venous Pressure Target in Critically III Patients

Background: Early goal‐directed therapy (EGDT) for severe sepsis or septic shock requires placement of a central venous catheter (CVC) to measure central venous pressure (CVP), with the aim of maintaining CVP ≥ 8‐12 mm Hg. This requirement [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Simple Ultrasound Measurement of the Internal Jugular Vein Accurately Estimates Central Venous Pressure Target in Critically III Patients

HM2008 Abstract Number: 38

Effect of Race on Length of Stay

Background: Ethnicity has been noted to have many effects on the delivery of health care. Race has been demonstrated as a factor in the appropriate treatment of many illnesses, a marker for access to care, [...]

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HM2008 Abstract Number: 37

Length of Stay Variation by Hospital Type

Background: Hospitals and hospitalists are increasingly being asked to measure their outcomes. An easy metric to assess is length of stay (LOS). However, there are no national standards for LOS in pediatrics. Furthermore, where some [...]

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HM2008 Abstract Number: 36

Efficacy of Genotype‐Guided Warfarin Prescribing: A Systematic Review

Background: In August 2007, the FDA issued a labeling change for warfarin emphasizing the “opportunity for healthcare providers to use genetic tests to improve their initial estimate“ of warfarin dosing. This is the first FDA [...]

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HM2008 Abstract Number: 35

Comparison of Outcomes between Hospitalists and General Internists in a Tertiary Academic Medical Center

Background: A recent study published in the New England Journal of Medicine showed that hospitalists only modestly reduced length of stay and observed costs. This is a finding different from that observed in prior studies. [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Comparison of Outcomes between Hospitalists and General Internists in a Tertiary Academic Medical Center

HM2008 Abstract Number: 34

Improving Physician Comfort, Increasing Prescription of Palliative Medications, and Decreasing Cost by Introducing a Palliative Care Order Set

Background: Although one fourth of Medicare dollars are spent during the last year of life, more than half of terminal hospitalized patients have inadequate symptom control. End‐of‐life care in hospitals is associated with uncomfortable physicians, [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Improving Physician Comfort, Increasing Prescription of Palliative Medications, and Decreasing Cost by Introducing a Palliative Care Order Set

HM2008 Abstract Number: 33

B‐Type Natriuretic Peptide in Cardiogenic Syncope

Background: Syncope may be a harbinger of sudden death. Untreated patients with cardiogenic syncope can have a 6‐month mortality rate exceeding 10%. An accurate and cost‐effective test that focuses on risk stratification is required for [...]

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HM2008 Abstract Number: 32

Impact of Postoperative Ileus on Hospital Length of Stay in Colectomy Surgery Patients

Background: The incidence of postoperative Ileus (POI) varies by type of surgery and could have a significant impact on economic and humanistic outcomes. Limited data are available on the impact of POI on hospital length [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Impact of Postoperative Ileus on Hospital Length of Stay in Colectomy Surgery Patients

HM2008 Abstract Number: 31

Impact of Palliative Medicine Intervention in Hospitalized Patients without Cancer

Background: Hospital‐based palliative medicine (PM) is becoming increasingly available. However, inpatient medical providers may underrecognize the value of PM interventions in their patients who do not have cancer, leading to delays in referral and decreased [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Impact of Palliative Medicine Intervention in Hospitalized Patients without Cancer

HM2008 Abstract Number: 30

Measuring Organizational Improvement in Safety: Application of the Global Trigger Tool

Background: At the end of 2006, the Institute of Healthcare Improvement (IHI) leadership announced the 5 Million Lives campaign to foster prevention of adverse events. The IHI global trigger tool (GTT) is the primary measurement [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Measuring Organizational Improvement in Safety: Application of the Global Trigger Tool

HM2008 Abstract Number: 29

Incidence of Myocardial Infarction Following Elective Total Hip Arthroplasty: A Population‐Based Study

Background: The 2007 ACC/AHA Perioperative Guideline groups elective hip arthroplasty with all other orthopedic procedures in a risk category of <5% of myocardial infarction (MI) or death within 1 year. Very little is known specifically [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Incidence of Myocardial Infarction Following Elective Total Hip Arthroplasty: A Population‐Based Study

HM2008 Abstract Number: 28

Service Change Communication among Hospitalists: A Qualitative Study

Background: Although service changes between hospitalists are vulnerable transition points for patients, there are no data about how poor communication leads to patient harm. This qualitative study describes deficiencies in handoff communications with a focus [...]

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HM2008 Abstract Number: 27

Characterizing Communication during Hospitalist Service Changes

Background: Although shift‐based hospitalist practices involve multiple changes of service, no data exist on how they are conducted. This study aimed to characterize hospitalist handoffs during service change. Methods: Between May and November 2007, 14 [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Characterizing Communication during Hospitalist Service Changes

HM2008 Abstract Number: 26

Perioperative β‐Blockade in Clinic Practice

Background: Studies examining the effect of perioperative β‐blockade on cardiac events have yielded conflicting results. This discrepancy is in part a result of differences in degrees of β‐blockade as assessed by heart rate (HR). Complications [...]

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HM2008 Abstract Number: 25

Impact of Obesity on MICU Outcomes

Background: As the epidemic of obesity spreads throughout the United States, an increasing number of obese patients are seen in the intensive care unit. Management of these patients can be challenging; however, it is unclear [...]

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HM2008 Abstract Number: 24

Deficits in Discharge Documentation in Patients Transferred to Rehabilitation Facilities on Anticoagulation: Results of a Systemwide Evaluation

Background: Effective communication among providers and patients during the hospital discharge process is critical to patient care. Anticoagulation has proven to be an effective therapy for several medical conditions, but communication deficits regarding anticoagulation may [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Deficits in Discharge Documentation in Patients Transferred to Rehabilitation Facilities on Anticoagulation: Results of a Systemwide Evaluation

HM2008 Abstract Number: 23

Communication and Information Deficits in Patients Discharged to Rehabilitation Facilities: An Evaluation of 5 Acute Care Hospitals

Background: Effective communication among physicians during the hospital discharge process is critical to patient care. The quality of discharge documentation of patients discharged to rehabilitation centers and other subacute facilities has been less well studied [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Communication and Information Deficits in Patients Discharged to Rehabilitation Facilities: An Evaluation of 5 Acute Care Hospitals

HM2008 Abstract Number: 22

Anticoagulation and Cardiac Tamponade: Is There a Relationship?

Background: A pervasive belief exists in medicine that anticoagulation increases the risk of cardiac tamponade in patients with known pericardial effusions, especially when the effusion is malignancy related (MR). To our knowledge, there are no [...]

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HM2008 Abstract Number: 21

Using Virtual Patients to Improve Cardiac Examination Competency in Nurses

Background: Teamwork is essential for optimizing quality of care and safety of hospitalized patients. As part of the medical team, nurses play an important role in the care of patients and are well positioned to [...]

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HM2008 Abstract Number: 20

Impact of Fragmentation of Hospitalist Care on Length of Stay and Postdischarge Issues

Background: Different hospitalist staffing models provide different levels of inpatient continuity of care. There has been increasing discussion about the impact of discontinuity of care on length of stay (LOS) and other utilization and quality [...]

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HM2008 Abstract Number: 19

Integrated Results of 2 Phase III Studies Comparing Tigecycline with Levofloxacin in Patients with Community‐Acquired Pneumonia (CAP)

Background: TGC, a first‐in‐class glycylcycline approved for treating complicated skin, skin structure, and intra‐abdominal infections, has an expanded spectrum of activity against gram‐positive, gram‐negative, anaerobic, and atypical bacteria, including some resistant strains. The primary objective [...]

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HM2008 Abstract Number: 18

Reducing Heart Failure Readmissions

Background: Heart failure (HF) is the diagnosis responsible for the most hospital readmissions nationally. Our health system has set a performance goal of reducing all 30‐day readmissions for patients insured by Humana to fewer than [...]

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HM2008 Abstract Number: 17

Two‐Year Costs of Enoxaparin Prophylaxis, Unfractionated Heparin Prophylaxis, or No Prophylaxis in Medical Patients at Risk of Venous Thromboembolism

Background: Hospitalized medical patients with defined VTE risk factors are at high risk of venous thromboembolism (VTE) in the absence of VTE prophylaxis. As national quality initiatives are implemented in the United States to improve [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Two‐Year Costs of Enoxaparin Prophylaxis, Unfractionated Heparin Prophylaxis, or No Prophylaxis in Medical Patients at Risk of Venous Thromboembolism

HM2008 Abstract Number: 16

Enhancing the Transition from Hospital to Home for the Older Adult (Safe STEP — Safe and Successful Transition of Elderly Patients)

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. We developed an interdisciplinary, comprehensive intervention to try to [...]

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HM2008 Abstract Number: 15

Resident Exposure to and Perception of Pediatric Hospital Medicine

Background: Pediatric hospitalists (PHs) teach medical students and residents on inpatient services. Single‐institution studies suggest this improves medical student and resident education in pediatrics, but there have not been any national studies on resident exposure [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Resident Exposure to and Perception of Pediatric Hospital Medicine

HM2008 Abstract Number: 14

Use of a Medical Emergency Team Decreased Length of Stay in Severely Ill Medical Patients with Unscheduled ICU Admissions, But Not Costs and Mortality

Background: Medical emergency teams (METs) have been developed to meet the growing needs of unstable hospitalized patients. The benefits of medical emergency teams have been reported as inconsistent in the literature, but METs may decrease [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Use of a Medical Emergency Team Decreased Length of Stay in Severely Ill Medical Patients with Unscheduled ICU Admissions, But Not Costs and Mortality

HM2008 Abstract Number: 13

Development and Evaluation of a Low‐Literacy Discharge Medication Education Tool

Background: Medication nonadherence is a risk factor for poor clinical outcomes among cardiac patients. Using a randomized, controlled clinical trial, we developed and evaluated a low‐literacy picture‐ and icon‐based discharge medication education tool for teaching [...]

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HM2008 Abstract Number: 12

Effectiveness of a Program Designed to Teach Handoffs to Medical Students

Background: Duty‐hour limitations have increased the number of handoffs of patient responsibility in academic medical centers, raising concerns about discontinuity of care and patient safety (Charap, Annals of Internal Medicine, 2004). Fourth‐year medical students perform [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Effectiveness of a Program Designed to Teach Handoffs to Medical Students

HM2008 Abstract Number: 11

Visualizing Drivers of Inpatient Admissions Using Wavelet Analysis

Background: Although inpatient admissions to hospitals appear to be a random process, identifying and understanding any underlying patterns and drivers could have a significant impact on medical staffing and organizational planning. Methods: The number of [...]

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HM2008 Abstract Number: 10

A Qualitative Exploration of the Impact of Completing the ABIM Hospital‐Based Practice Improvement Module (PIM)

Background: To facilitate maintenance of certification (MOC) of hospital‐based physicians, the American Board of Internal Medicine (ABIM) developed the Hospital‐Based Practice Improvement Module (Hospital PIM). The Hospital PIM is one of a series of data‐driven, [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on A Qualitative Exploration of the Impact of Completing the ABIM Hospital‐Based Practice Improvement Module (PIM)

HM2008 Abstract Number: 9

Perioperative Anticoagulation Management: Practice Patterns and Outcomes at 9 Hospitals

Background: At the time of a major surgery, patients requiring chronic oral anticoagulation therapy must have had this treatment either stopped and restarted or "bridged," substituting heparin or low‐molecular‐weight heparin (LWMH) except during and shortly [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Perioperative Anticoagulation Management: Practice Patterns and Outcomes at 9 Hospitals

HM2008 Abstract Number: 8

High‐Fidelity Simulation Fails to Improve Clinical Performance in a Randomized Study of Actual In‐Hospital Cardiac Resuscitation

Background: Simulation is increasingly being incorporated into cardiopulmonary resuscitation (CPR) training. This educational method has been shown to improve trainee performance in simulated settings, but the effect on actual patient care remains unknown. Methods: Matriculating [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on High‐Fidelity Simulation Fails to Improve Clinical Performance in a Randomized Study of Actual In‐Hospital Cardiac Resuscitation

HM2008 Abstract Number: 7

Staff‐Only Pediatric Hospitalist Care of Medically Complex Subspecialty Patients in a Major Teaching Hospital

Background: General pediatric hospitalists are increasingly relied on to manage patients with subspecialty and/or complex medical conditions. Resident duty‐hour restrictions have limited resident coverage of these patients, prompting the proliferation of staff‐only pediatric hospitalist models. [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Staff‐Only Pediatric Hospitalist Care of Medically Complex Subspecialty Patients in a Major Teaching Hospital

HM2008 Abstract Number: 6

Use of a Mastery Learning Model to Improve Internal Medicine Resident Skills in Central Venous Catheter Insertion: Results of a Pilot Study

Background: Central venous catheter (CVC) insertions are frequently performed by internal medicine residents. Research shows that complications including pneumothorax and arterial puncture diminish when operators require fewer needle passes and use ultrasound. We demonstrated previously [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Use of a Mastery Learning Model to Improve Internal Medicine Resident Skills in Central Venous Catheter Insertion: Results of a Pilot Study

HM2008 Abstract Number: 5

Influence of Hospitalist Consultation on Antihypertensive Medication Prescribing for Surgical Inpatients

Background: Prior research suggests that elevated BP in hospitalized patients represents true hypertension (HTN) and that HTN and cardiovascular risk factors are prevalent among inpatients. Providers often fail to recognize and intensify treatment regimens for [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Influence of Hospitalist Consultation on Antihypertensive Medication Prescribing for Surgical Inpatients

HM2008 Abstract Number: 4

Rates of Guideline‐Recommended Venous Thromboembolism Prophylaxis in U.S. Hospital Patients

Background: The reduction of venous thromboembolism (VTE) via VTE prophylaxis practice improvement is a major health care goal for national quality initiatives, such as those of the Joint Commission. We assessed the rate of appropriate [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Rates of Guideline‐Recommended Venous Thromboembolism Prophylaxis in U.S. Hospital Patients

HM2008 Abstract Number: 3

Recombinant Human Hyaluronidase Enabled Hydration Therapy in Infants and Children

Background: Treatment of dehydration in the Emergency Department (ED) presents special challenges in infants and children. Their veins can be too small or fragile to allow easy intravenous (IV) access, especially if the vessels are [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Recombinant Human Hyaluronidase Enabled Hydration Therapy in Infants and Children

HM2008 Abstract Number: 2

Understanding Readmissions: How Much Do We Really Know?

Background: Readmission rates are an increasingly important indicator of quality hospital care. Understanding the characteristics of readmissions may help to reduce unnecessary readmissions. We evaluated characteristics of readmissions to our general medicine service and reviewed [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Understanding Readmissions: How Much Do We Really Know?

HM2008 Abstract Number: 1

Evaluation of an Electronic Early Warning System for the Detection of Critically III Hospital Patients

Background: Potentially avoidable deaths occur each year among hospital patients. A death is considered potentially avoidable when warning signs were present hours prior to death and when it was a result of a potentially reversible [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Evaluation of an Electronic Early Warning System for the Detection of Critically III Hospital Patients