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 [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on A Not‐So‐Typical Cause of Painless Jaundice

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

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

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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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 [...]

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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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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

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

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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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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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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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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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 [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Solifenacin‐lnduced Small Bowel Pseudo‐obstruction

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

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