HM2009 Abstract Number: 1001

Baclofen‐lnduced Psychosis in a Pediatric Patient

Case Presentation: This is the first case report in the literature of a pediatric patient with psychosis attributed to therapeutic doses of intrathecal (IT) baclofen. We present a case report of a pediatric patient treated [...]

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HM2009 Abstract Number: 1000

A Fatal Case of Necrotizing Fasciitis from Invasive Streptococcus pneumoniae: Support for Pneumococcal Vaccination

Case Presentation: A 60‐year‐old white woman with a history of sarcoidosis (remote and in remission), asthma, chronic obstructive pulmonary disease (COPD), and emphysema presented to the emergency department with a 1‐week history of worsening dyspnea, [...]

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HM2009 Abstract Number: 215

Mononeuritis Multiplex — A Rare Presentation of Diabetes Mellitus

Case Presentation: A 24‐year‐old previously healthy man presented with sudden left‐hand weakness that lasted 6 days before complete resolution. This was followed a week later by simultaneous development of right‐hand and left‐foot weakness and numbness. [...]

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HM2009 Abstract Number: 214

Acute Porphyria in a 14‐Year‐Old Presenting with Hypertension and Hyponatremia

Case Presentation: A 14‐year‐old boy with mental retardation, seizure disorder, and spastic quadriplegia was admitted with a 5 day history of lethargy, constipation, and reddish urine. He also had increased seizure frequency, which was usually [...]

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HM2009 Abstract Number: 213

Early Recognition of Stroke in Sickle Cell Disease: Don't Blame the Pain Meds!

Case Presentation: A 19‐year‐old woman with a history of sickle cell disease (HgbSC) presented to the hospital with an acute pain crisis. Initial vital signs were stable with normal oxygen saturation. Examination was unremarkable. The [...]

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HM2009 Abstract Number: 212

Tuberculosis: A Gutless Opportunist

Case Presentation: A 55‐year‐old man with a history of peptic ulcer disease, status post‐Bill roth I gastrectomy in 1997, presented with a 15‐day history of fevers, chills, night sweats, weight loss, productive cough, and progressive [...]

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HM2009 Abstract Number: 211

A Pain in the Neck

Case Presentation: A 20‐year‐old woman from Honduras presented with a 4 × 3‐cm mass on her left neck that had been gradually enlarging over the past 3 years. The mass was well defined, mobile, and nonerythematous. She [...]

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HM2009 Abstract Number: 210

Hemolytic Anemia in Dapsone Overdose: A Late Complication

Case Presentation: LC is a 17‐year‐old HIV‐positive male on dapsone for PCP prophylaxis. He was admitted to the ICU after ingesting 6 g of dapsone in a suicide attempt. Initial ABG showed PO2 saturation of [...]

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HM2009 Abstract Number: 209

Beware of the Seemingly Stable Sickle Cell Patient

Case Presentation: A 27‐year‐old woman with sickle cell disease presented with acute bilateral leg, abdominal, and chest pain accompanied by nausea, nonbloody vomit, and a productive cough. The woman stated that the pain was consistent [...]

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HM2009 Abstract Number: 208

Rhizobium radiobacter Bacteremia in an Immunocompetent Host

Case Presentation: Rhizobium spp are aerobic gram‐negative bacilli widely distributed in soil and commonly known as tumorigenic plant pathogens. R. radiobacter is an uncommon cause of human infection. Immunocompromised patients with indwelling vascular devices are [...]

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HM2009 Abstract Number: 207

An Unusual Cause of Anemia and a Rash

Case Presentation: Mr. B is a 45‐year‐old man with a history of depression, anxiety, and severe gastroesophageal reflux disease who presented to the emergency department for evaluation of a rash on his right ankle. He [...]

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HM2009 Abstract Number: 206

Permissive Hypernatremia: Comanagement of Intracranial Pressure

Case Presentation: A 17‐year‐old female was admitted to the surgical ICU after a motor vehicle accident. Her Glasgow coma score was 4. She had multiple traumatic injuries and required intubation. CT of the brain showed [...]

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HM2009 Abstract Number: 205

A Case of Extreme Subcutaneous and Peripheral Insulin Resistance

Case Presentation: A 34‐year‐old man was admitted for evaluation of elevated blood glucose despite extreme subcutaneous (SQ) insulin requirements. He had a 12‐year history of type 2 diabetes mellitus without episodes of ketoacidosis, managed initially [...]

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HM2009 Abstract Number: 204

Never the Twain Shall Meet: Confusing Primary CNS Lymphoma with Neurosarcoidosis

Case Presentation: A 44‐year‐old African American man without a significant medical history presented to an outside hospital with 10 days of nausea, vomiting, weakness, and confusion. He was hydrated, stabilized, and subsequently discharged. Over the [...]

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HM2009 Abstract Number: 203

Carcinoid Heart Disease: An Uncommon Cause of Right Heart Failure

Case Presentation: A 67‐year‐old man presented to the emergency room with progressive bilateral lower extremity edema for 3 weeks. He denied any dyspnea, oliguria, or chest pain. His medical history was significant for an intestinal [...]

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HM2009 Abstract Number: 202

Gut Amyloidosis: A Rare Cause of Iron Deficiency

Case Presentation: A case of malabsorption syndrome secondary to primary amyloidosis is presented here. A male in his forties presented with intermittent rectal bleeding, watery diarrhea, steatorrhea, dizziness and weight loss of 30 pounds over [...]

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HM2009 Abstract Number: 201

Cutaneous Histoplasmosis Lesions Associated with Immune Reconstruction Inflammatory Syndrome

Case Presentation: A 31‐year‐old man with AIDS and disseminated MAC presented with 2 weeks of pruritic rash. Rash was associated with fever, cough, and weight loss. The patient lived in southeastern Louisiana but had recently [...]

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HM2009 Abstract Number: 200

When Is a Hiccup Not Just a Hiccup?

Case Presentation: A 67‐year‐old man presented to the emergency department with a complaint of a presyncopal episode associated with persistent hiccupping and vomiting for 3 weeks. He also reported decreased oral intake, although he denied [...]

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HM2009 Abstract Number: 199

Reversible Paraneoplastic Syringomyelia Related to Diffuse Large B‐Cell Lymphoma

Case Presentation: A 39‐year‐old man with no medical history presented to the emergency department with a 2‐month history of urinary incontinence, constipation, and erectile dysfunction. He also reported paraesthesias, bilateral lower extremity weakness, and jerking [...]

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HM2009 Abstract Number: 198

Hospitalist Dilemma Facing the Forgotten Disease

Case Presentation: A 30‐year‐old African American woman with an unremarkable medical history presented to the emergency room with 14 days of progressive sore throat, high fever, malaise, voice changes, and dysphagia to solids. Positive findings [...]

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HM2009 Abstract Number: 197

Between a Rock and a Hard Place: Tumoral Calcinosis in a Dialysis Patient

Case Presentation: A 54‐year old African American man with history of dialysis‐dependent renal failure secondary to diabetes, presented with a large, painful swelling in his right buttock. Three years ago, his primary physician noted it [...]

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HM2009 Abstract Number: 196

Remembering Exceptions to the Rules

Case Presentation: A 41‐year‐old woman with a medical history significant for gastroesophageal reflux was admitted for atypical chest pain and dyspnea on exertion for 2 months. She also reported recent low‐grade fevers, drenching night sweats, [...]

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HM2009 Abstract Number: 195

Peritoneal Tuberculosis: If at First You Don't Succeed, Work Up and Work Up Again

Case Presentation: A 73‐year‐old man with a history of hypertension was admitted for the evaluation of progressive, generalized weakness and fatigue of several months' duration. Aside from significant weight loss and lack of appetite, the [...]

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HM2009 Abstract Number: 194

A 17‐Year‐Old with Exertional Vision Loss

Case Presentation: A 17‐year‐old Korean female presented to the emergency department with a 6‐month history of intermittent dizziness and bilateral vision loss with activity. She described loss of vision as whiteness for 30 seconds on [...]

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HM2009 Abstract Number: 193

A 6‐Year‐Old Girl with Malaria and Altered Mental Status

Case Presentation: A 6‐year‐old girl presented to an outside ED with 2 days of fever (Tmax 104°F) and vomiting. She had recently returned from a 2‐year stay in Sierra Leone 2 weeks prior to admission. [...]

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HM2009 Abstract Number: 192

A Catty Cough

Case Presentation: A 66‐year‐old woman presented with 3 days of shortness of breath. He also reported a productive cough, fever, and chills. Prior to 3 days the patient reported no dyspnea and reported excellent exercise [...]

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HM2009 Abstract Number: 191

Tale of Pulled Pork and Helminths — Streptococcus bovis Meningitis Associated with Strongyloides Hyperinfection in a Southeast Asian Immigrant

Case Presentation: A 58‐year‐old Laotian man with a medical history of diabetes mellitus, hypertension, and asthma presented with confusion, fever, and a rash. Review of systems was remarkable for abdominal discomfort in the preceding days [...]

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HM2009 Abstract Number: 190

SMA Syndrome: The SBO Mimic

Case Presentation: An 18‐year‐old man with a history of GERD transferred to our institution from an outside hospital for evaluation of refractory nausea, projectile bilious emesis, and abdominal pain. He had been in his usual [...]

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HM2009 Abstract Number: 189

An Orange a Day Keeps the Doctor Away

Case Presentation: A 3‐year‐old boy with PDD, keratosis pilaris, and gingivitis presented to a New York City ED with limping after a fall. Initial evaluation was negative for fracture, and he was discharged with follow‐up [...]

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HM2009 Abstract Number: 188

Metamorphism: Crescentic Transformation with Anti‐GBM (Glomerular Basement Membrane) Antibodies Arising from Idiopathic Membranous Glomerulopathy

Case Presentation: Rapidly progressive glomerulonephritis (RPGN) is a well‐known cause of acute renal failure. However, its abrupt presentation with anti‐GBM antibodies in the setting of membranous nephropathy is quite uncommon, A 73‐year‐old man presented with [...]

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HM2009 Abstract Number: 186

A Punch in the Gut

Case Presentation: A 93‐year‐old man presented following acute onset of substemal and epigastric pain that progressed to crushing pressure over the course of 4 hours. He described a sensation of fullness in his throat, dysphagia, [...]

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HM2009 Abstract Number: 185

Fatal Herpes Simplex Hepatitis in an Immunocompetent Patient: A Case Report and Review of the Literature

Case Presentation: A 78‐year‐old man with hypertension, diabetes mellitus, and hyperlipidemia presented to the ER for a 3‐day history of generalized malaise and fever. He denied headache, cough, abdominal pain, nausea, or vomiting. Medications included [...]

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HM2009 Abstract Number: 184

Diabetic Neuropathic Cachexia — A Nerve‐Racking Diagnosis!

Case Presentation: A 65‐year‐old woman was transferred to us with 3 weeks of bandlike, nonexertional lower chest tightness associated with severe dizziness on standing and palpitations. She had difficulty ambulating because of leg weakness and [...]

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HM2009 Abstract Number: 183

Henoch‐Schönlein Purpura: An Atypical Presentation with Esophageal Perforation

Case Presentation: A 17‐year‐old boy was in his usual state of health until 3 weeks prior to admission, when he developed intermittent abdominal pain, vomiting, arthralgia, and skin rash. He started with localized, sharp, continuous [...]

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HM2009 Abstract Number: 182

The Concrete Heart

Case Presentation: A 52‐year‐old man with a history of heavy alcohol use was admitted for cellulitis and chronic edema attributed to cirrhotic liver disease. Exam findings included significant peripheral edema, ascites, and jugular venous distention. [...]

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HM2009 Abstract Number: 181

Coronary Stent Infection: An Esoteric Complication of a Common Procedure

Case Presentation: A 58‐year‐old white man underwent primary percutaneous transluminal intervention (PCI) with 2 stents for acute coronary syndrome (ACS). On the second day he developed fever. Antecubital thrombophlebitis was noted, and the peripheral catheter [...]

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HM2009 Abstract Number: 180

Missing Meigs

Case Presentation: A 33‐year‐old obese woman presented in respiratory distress 4 weeks after an ovarian cystectomy. She reported a 30‐pound weight gain in the month prior to admission. She had recently been treated with antibiotics [...]

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HM2009 Abstract Number: 179

Calciphylaxis in a Patient with Hypo parathyroidism and Normal Kidney Function

Case Presentation: A 76‐year‐old white woman with type 2 diabetes (DM), hypothyroidism, coronary artery disease, and atrial fibrillation on oral anticoagulation was transferred to our institution with a 3‐month history of painful ulcerative lesions of [...]

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HM2009 Abstract Number: 178

Convalescent Serologic Testing: Second Time's the Charm

Case Presentation: A 36‐year old previously healthy hairstylist presented with a 3‐day history of fever, dry cough, and “throbbing” headache with mild photophobia. She reported generalized weakness and lethargy, but no confusion. She had no [...]

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HM2009 Abstract Number: 177

Infant Botulism Presenting as Constipation

Case Presentation: A 7‐month‐old healthy female infant presented to the emergency room with a 10‐day history of no stools. Her mother noted that she had a decreased activity level, decreased appetite, and abdominal distention and [...]

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HM2009 Abstract Number: 176

The New Mimicker of Pancreatic Cancer: Sarcoidosis

Case Presentation: A 58‐year‐old African American man presented to our hospital with 1‐month history of anorexia with a 20‐pound weight loss and progressive painless jaundice. He denied significant alcohol use and admitted to 25 pack‐year [...]

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HM2009 Abstract Number: 175

Addressing DRESS Syndrome

Case Presentation: A 24‐year‐old man with a history of IgA nephropathy, hypertension, and gout presented to the hospital with complaints of fevers for 3 weeks and rash for 3 days. He reported daily fevers to [...]

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HM2009 Abstract Number: 174

When to Depend on the Kinins of Strangers: An Unusual Case of Chronic Abdominal Pain

Case Presentation: A 28‐year‐old woman presented with an acute exacerbation of chronic, intermittent abdominal pain. The patient described intense cramping and colicky periumbilical pain lasting 1‐2 days and occurring 2‐3 times per year for 9 [...]

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HM2009 Abstract Number: 173

Waxing and Waning Purpuric Rash

Case Presentation: A 65‐year‐old Middle Eastern man with a history of coronary artery disease, chronic renal failure stage III, diabetes mellitus, and gout was admitted with hematuria and a purpuric rash on his upper and [...]

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HM2009 Abstract Number: 172

Drug Interaction Simulating Elusive Systemic Illness

Case Presentation: A 75‐year‐old white man with a medical history significant for fibromyalgia and self‐medication with chronic acetaminophen use for 2 years presented with bilateral knee pain and a flulike illness. On presentation his vital [...]

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HM2009 Abstract Number: 171

West Nile Virus Myocarditis Causing a Fatal Arrhythmia

Case Presentation: A 65‐year‐old man presented to the emergency department in late summer complaining of fever, cough, and decreased oral intake for the past 7 days. His symptoms were associated with blurry vision and nausea. [...]

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HM2009 Abstract Number: 170

Lemierre's Syndrome: Reemergence of a Forgotten Disease?

Case Presentation: A 27‐year‐old man with no prior medical history presented to the emergency department (ED) for a 2‐day history of sore throat, nonproductive cough, and fever. Physical exam revealed pharyngeal erythema and cervical lymphadenopathy. [...]

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HM2009 Abstract Number: 169

Whipple's Disease — An Unusual Cause of Severe Pancytopenia

Case Presentation: A 53‐year‐old man presented with new‐onset pedal edema and memory loss of 1 month's duration. He also complained of a 1‐year history of generalized weakness, joint pains, neck stiffness, watery diarrhea, and significant [...]

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HM2009 Abstract Number: 168

Catastrophic Antiphospholipid Antibody Syndrome and Heparin‐lnduced Thrombocytopenia‐Related Diseases or Chance Association?

Case Presentation: A 37‐year‐old man with a significant family history of systemic lupus erythematosus presented with cellulitis and bilateral chronic leg ulcers. While hospitalized, he became hemodynamically unstable and was diagnosed with deep venous thromboses [...]

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HM2009 Abstract Number: 167

Extensive Dynamic Airway Collapse: A COPD/Asthma Imitator

Case Presentation: This is a 55‐year‐old woman who presented to our facility with worsening dyspnea and a productive cough. She was hospitalized more than 4 times recently for the same symptoms and was managed as [...]

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HM2009 Abstract Number: 166

Thrombotic Thrombocytopenic Purpura and Positive Coombs Test — Not Mutually Exclusive!

Case Presentation: A 48‐year‐old man was hospitalized with fatigue, dyspnea, mild confusion, and faint lower extremity petechiae that followed an upper respiratory infection. At admission, his blood pressure was normal, and his temperature was 100.8°F. [...]

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HM2009 Abstract Number: 165

A Rare Cause of Hyperthyroidism Metastatic Testicular Choriocarcinoma

Case Presentation: Choriocarcinoma accounts for 1% of testicular carcinomas. Choriocarcinoma primarily spreads hematogeneously into viscera and lungs and involves retroperitoneal lymph nodes and liver. Human chorionic gonadotropin (HCG)‐induced hyperthyroidism in germ‐cell cancers is rare, and [...]

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HM2009 Abstract Number: 164

Exercise‐Induced Rhabdomyolysis Associated with Isotretinoin Therapy: A Case Report

Case Presentation: This is an 18‐year‐old white man with no prior medical history who had been taking the acne treatment isotretinoin for several months before deciding to start power lifting to build muscle mass. He [...]

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HM2009 Abstract Number: 163

Sweet's Syndrome: Unusual Presentation of Unusual Disease

Case Presentation: A healthy 47‐year‐old man presented with pain and swelling of multiple joints. Four months prior to admission he had a sinus infection, for which he was treated with trimethoprim‐sulfamethoxazole (Bactrim). After 7 days [...]

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HM2009 Abstract Number: 162

Neonatal Kawasaki Disease

Case Presentation: A 27‐day‐old Asian female infant was admitted for a fever of 102°F and a subsequent neonatal sepsis workup. A CBC with differential, blood, urine, and CSF cultures was performed. She was started on [...]

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HM2009 Abstract Number: 161

Cervical Epidural Injection Resulting in Quadriplegia—It's Not What You Think

Case Presentation: A 32‐year‐old Korean man presented to the emergency room with 4 hours of progressive weakness of his upper and lower extremities following an elective cervical epidural steroid injection done 12 hours earlier. He [...]

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HM2009 Abstract Number: 160

Severe Headache, Scotomata, and Brain Imaging Abnormalities: A Case of Reversible Cerebral Vasoconstriction Syndrome (RCVS) Associated with Sertraline Use

Case Presentation: A 62‐year woman was admitted for evaluation of recent‐onset, moderate‐intensity headaches. The headaches began 2 weeks prior, shortly after starting sertraline (a selective serotonin reuptake inhibitor) to treat depression. Waxing‐waning headaches persisted, accompanied [...]

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HM2009 Abstract Number: 159

An Unusual Cause of Iron‐Deficiency Anemia

Case Presentation: A 39‐year‐old white woman presented to the emergency department with complaints of weakness and fatigue. On physical examination, the patient had orthostatic changes, and lung examination revealed bibasilar crackles. Laboratory data were significant [...]

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HM2009 Abstract Number: 158

Cervical Spine Manipulation: Neck Relief and Brain Grief

Case Presentation: A 37‐year‐old woman with an unremarkable medical history was admitted with sudden onset of dizziness, aphasia, and right arm numbness and weakness. The patient's symptoms lasted approximately 45 minutes and then slowly resolved, [...]

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HM2009 Abstract Number: 157

Young Man with Respiratory Failure

Case Presentation: A 28‐year‐old white man was transferred to our facility from an outside hospital for 1 week of fatigue and cough. He smoked half a pack a day and had a history of asthma [...]

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HM2009 Abstract Number: 156

Cardiac Arrest after Percutaneous Transthoracic Needle Biopsy: A Consideration Other Than Pneumothorax

Case Presentation: A 59‐year‐old man with a medical history significant for congestive heart failure and diabetes mellitus presented with a new right upper lobe nodule (positive on PET scan), for which he underwent a CT‐guided [...]

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HM2009 Abstract Number: 155

Hickam's Dictum

Case Presentation: A 34‐year‐old woman presented with 2 days of headache, nausea, vomiting, and bilateral eye pain. The headache was describes as throbbing and radiated from the base of her skull down the back of [...]

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HM2009 Abstract Number: 154

The Eye of the Storm: A Severe Case of Immune Reconstitution Inflammatory Syndrome (IRIS)

Case Presentation: A 51‐year‐old man with a new diagnosis of HIV/AIDS complicated by cryptococcemia and toxopSasma brain abscess, with a CD4 count of 17 cells/μL, presented to our hospital 2 months after his initial diagnosis [...]

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HM2009 Abstract Number: 153

A Case of Algid Malaria

Case Presentation: A 49‐year‐old African American woman presented to the emergency room (ER) with a 3‐day history of high‐grade fevers, chills, and generalized muscie aches after returning from a 3‐week trip to Nigeria without malaria [...]

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HM2009 Abstract Number: 152

Influenza Encephalitis: An Uncommon Presentation of a Common Disease

Case Presentation: This is a case of an 8‐year‐old girl who presented with a 2‐day history of abdominal pain, vomiting, and fever. She subsequently developed cough, lethargy, and “sniffing” paroxysms consisting of arm and leg [...]

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HM2009 Abstract Number: 151

Sulfonamides and Tick Bites: A Dangerous Combination

Case Presentation: A 22‐year‐old previously healthy woman presented in May 2008 describing fever, fatigue, diarrhea, and dysuria for 1 week. She recalled a tick bite 3 weeks prior to her illness. She was prescribed trimethoprim‐sulfamethoxazole [...]

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HM2009 Abstract Number: 150

Chest Pain … Add Another Life‐Threatening Condition!

Case Presentation: Chest pain is the second most common reason for visiting an emergency department in the United States. Ruling out medical emergencies is crucial. We are presenting a case of chest pain due to [...]

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HM2009 Abstract Number: 149

It May Look Like Malignancy … But the Truth Lies in the Tissue!

Case Presentation: A 51‐year‐old woman with a medical history of congestive heart failure, hepatitis B, and hypothyroidism was transferred from an outside hospital for a workup of an abdominal mass. The patient had presented several [...]

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HM2009 Abstract Number: 148

A Fatal Case of Nitrofurantoin Pulmonary Toxicity

Case Presentation: A 92‐year‐old woman with a medical history of recurrent urinary tract infections (UTIs) presented with progressive dyspnea, a dry cough, and low‐grade fevers for 6 weeks. She was taking nitrofurantoin for prophylaxis of [...]

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HM2009 Abstract Number: 147

Disseminated Cryptococcal Infection Causing Epididymo‐Orchitis and Masquerading as Lymphoma

Case Presentation: A 26‐year‐old man with a history of hypertension and end‐stage renal disease (ESRD) on hemodialysis for the past 8 months was sent to the hospital from the hemodialysis center for complaints of a [...]

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HM2009 Abstract Number: 146

The Fizzing Diaper — A Disturbing Case of Munchausen Syndrome by Proxy

Case Presentation: The patient was a 14‐month‐old male presenting with feeding intolerance and failure to thrive with associated vomiting and diarrhea. His medical history was significant, including chronic emesis and poor weight gain with a [...]

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HM2009 Abstract Number: 145

Interfering with Glucose Homeostasis

Case Presentation: A 61‐year‐old man presented with progressively worsening nausea and nonbloody vomiting for 9 weeks. He reported thirst, polyuria, and polydipsia accompanied by weakness, lethargy, palpitations, and shortness of breath. He denied recent illness, [...]

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HM2009 Abstract Number: 144

A Fungus Among Us

Case Presentation: A 38‐year‐old diabetic presented to the emergency room with 2 days of worsening bitemporal headache, diplopia, left facial weakness, and partial left temporal numbness. This constellation of symptoms began while the patient was [...]

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HM2009 Abstract Number: 143

An Uncommon Cause of Fever in a Patient on Infliximab

Case Presentation: A 72‐year‐old woman with rheumatoid arthritis presented with confusion and fever. She had visited an urgent care 2 days prior to admission for fevers and low back pain. She was transferred to a [...]

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HM2009 Abstract Number: 142

Cerebral Nocardiosis Caused by N. brasiliensis, a Nocardial Species That Commonly Causes Skin Infection

Case Presentation: A 44‐year‐old woman with history of SLE on chronic prednisone presented to the ED with complaints of severe headaches and neck stiffness. A CT scan revealed acute communicating hydrocephalus and bilateral cerebellar lesions. [...]

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HM2009 Abstract Number: 141

The Fugitive

Case Presentation: A 54‐year‐old woman presented to the ED with 6 months of right lower extremity swelling and intermittent pain. The swelling began after 3 international flights and had progressively worsened since. The pain was [...]

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HM2009 Abstract Number: 140

Acute Ischemic Stroke and Pseudosubarachnoid Hemorrhage in a HIV‐Negative Patient Presenting with Cryptococcal Meningitis

Case Presentation: A 75‐year‐old man with a history of chronic myeloid leukemia presented to the emergency room with bifrontal headache, syncope, and double vision of the right eye. Physical examination was unremarkable. He was afebrile, [...]

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HM2009 Abstract Number: 139

A Rare Cause of Anemia in Inflammatory Bowel Diseases — A Case Report and Review of the Literature

Case Presentation: A 32‐year‐old man with no significant medical history presented with complaint of dark‐colored urine, jaundiced skin, and fatigue for the last 4 weeks. He also reported having diarrhea mixed intermittently with blood for [...]

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HM2009 Abstract Number: 138

Ischemic Colitis and Adrenal Insufficiency: Unusual Manifestations of the Antiphospholipid Antibody Syndrome

Case Presentation: A 56‐year‐old man presented with 2 days of severe diffuse abdominal pain and diarrhea. CT scan of the abdomen and pelvis revealed diffuse colitis in the transverse, descending, and sigmoid colon. Admission labs [...]

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HM2009 Abstract Number: 137

Creutzfeldt‐Jacob Disease: A Diagnostic Dilemma

Case Presentation: A 50‐year‐old Chinese woman with a medical history of hepatitis B was brought to the emergency department by her family for a 6‐week history of hypersomnolence, irritability, and confusion. Other presenting symptoms included [...]

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HM2009 Abstract Number: 136

Case Report: Tetanus in a Hispanic Man: What Was the Role of Cobwebs?

Case Presentation: The patient is a 45‐year‐old Mexican‐American from South Texas. He is a construction worker who fell from a ladder lacerating his left ankle on a jagged brick. He was initially treated at home [...]

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HM2009 Abstract Number: 135

Rapid Response Team Narcotic Initiative — Educating Medical and Nursing Staff to Reduce the Need for Narcan on an Orthopedic Unit

Background: Our institution's rapid response team (RRT) data regarding interventions during RRT visits indicated a trend for increased Narcan administration for patients on our orthopedic surgery unit. Purpose: To identify the root cause of increased [...]

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HM2009 Abstract Number: 134

The Hospitalist Scholars Training Program: Leveraging Nonacademic Clinical Service into Fellowship Training for Academic Hospitalists

Background: The advancement of academic hospital medicine requires that academic hospitalists receive training that allows them to become leaders in research, education, quality improvement, and other scholarly aspects of academic medicine. However there are few [...]

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HM2009 Abstract Number: 133

The Comanagement Teaching Physician: A Promising New Role for the Hospitalist on the Academic Surgical Service

Background: Although surgical comanagement is a rapidly expanding role for hospitalists, the growing challenge is to create a clinical experience that is rewarding to hospitalists long term particularly in academic medical centers. Purpose: To implement [...]

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HM2009 Abstract Number: 132

Effects of a Discharge Time‐Out on the Quality of Hospital Discharge Summaries

Background: High‐quality discharge summaries are a key component of a safe transition in care from the inpatient to the outpatient setting. However, the best ways to incorporate resident training in discharge summary creation into clinical [...]

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HM2009 Abstract Number: 131

Automated Real‐Time Relay of Actionable Performance Data to Nursing Units: A Transferable Quality Improvement Strategy

Background: Hospitals still have no readily transferable strategy to deliver optimal care consistently. Moreover, the regular data flow necessary to track and drive better performance is typically not available. Pilot work from our hospital medicine [...]

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HM2009 Abstract Number: 130

Reducing latrogenic Pneumothorax: Making Central Venous Catheter Placement Safer

Background: The Agency for Healthcare Research and Quality (AHRQ) has adopted iatrogenic pneumothorax (IAP) as a zpatient safety indicator. From 2006 to 2007 our institution was ranked within the lowest United Healthcare Consortium performance quartile [...]

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HM2009 Abstract Number: 129

Impact of Behavioral Modification on Laboratory Test Utilization at an Academic Medical Center

Background: The culture of academic medicine lends itself to compulsory laboratory testing and the overutilization of tests. Physicians in training constitute the primary cohort of testers, and a certain tolerance is afforded their ordering behaviors [...]

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HM2009 Abstract Number: 128

Pressure Ulcer Prevention and Treatment Strategies at Northwestern Memorial Hospital

Background: Pressure ulcers cause pain, disfigurement, and infection and often require months to heal. Many patients commonly cared for by hospitalists (elderly, malnourished, and immobile) are at risk. Traditionally, pressure ulcers have been viewed as [...]

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HM2009 Abstract Number: 127

Implementation of Strategies to Improve Documentation of CMS Present on Admission Conditions

Background: Starting in October 2008, the Center for Medicare and Medicaid Services (CMS) mandated no longer paying for treatment costs of certain conditions deemed preventable unless documentation and coding reflecting that those conditions were present [...]

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HM2009 Abstract Number: 126

A Strategy to Enhance the Discharge Process and Improve Throughput

Background: The discharge process is consistently rated among the lowest components of patient satisfaction markers in surveys. Discharge delays and late discharges can also negatively affect throughput by preventing bed availability for new admissions. Barriers [...]

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HM2009 Abstract Number: 125

Patient Safety M&M Conferences: Open Interdisciplinary Review of Patient Safety Events

Background: Creating a culture of safety to support clinicians and improve the quality of patient care is a goal for nearly all health care organizations. However, it can be difficult to envision specific efforts that [...]

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HM2009 Abstract Number: 124

Peer Group Mentoring of Pediatric Hospitalists

Background: Pediatric hospital medicine is a rapidly growing field. The growth occurring at academic institutions reflects a rise in the number of pediatricians who are choosing careers in academic pediatric hospital medicine. As this number [...]

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HM2009 Abstract Number: 123

Use of Modified Early Warning Scores by a Rapid Response Team for the Purpose of Code Reduction in the Non‐ICU Patient Population

Background: Current research supports the fact that early recognition of vital sign deterioration provides the opportunity for early intervention and subsequent reduction of cardiac and respiratory arrest risk for non‐ICU patients. MEWS, or Modified Early [...]

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HM2009 Abstract Number: 122

Development of a Computerized Decision Support System for Critical Laboratory Values and Abnormal Trends on Discharge

Background: The discharge process is increasingly being studied as an area of quality improvement. Patients can inadvertently be discharged home with critical laboratory values or abnormal trends because of cognitive or non‐cognitive errors. Previous studies [...]

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HM2009 Abstract Number: 121

Medical Error and Self‐Reflection: Analysis of Internal Medicine Residents' Adverse Event Self‐Reflective Exercises

Background: The Institute of Medicine (IOM) report released in 1999 estimated between 44,000 and 98,000 inpatient hospital deaths resulted from medical errors within the United States annually. Although we have made advances during the past [...]

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HM2009 Abstract Number: 120

Use of Continuous Glucose Monitoring (CGM) to Improve Glucose Control in the Inpatient Setting

Background: Hospitalized patients with diabetes or hyperglycemia are typically monitored through finger‐stick glucose checks 4 times a day. Intermittent monitoring of blood glucose can miss many glucose excursions, particularly in the postprandial and nocturnal periods. [...]

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HM2009 Abstract Number: 119

SIMPLE: Simulated Internal Medicine Patient Learning Experience

Background: In the internal medicine clerkship, students are required by the Liaison Committee on Medical Education (LCME) to see patients with each of the conditions that the clerkship director identifies as core to the clerkship [...]

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HM2009 Abstract Number: 118

Breaking the Cycle: Reducing Readmissions for Patients with Congestive Heart Failure

Background: Congestive heart failure (CHF) is the leading hospital admission diagnosis for patients over 65. It carries with it a significant toll on the quality of life and mortality of the patients diagnosed with it. [...]

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HM2009 Abstract Number: 117

Ambulatory Connections Clinic—Bridging the Divide Between Inpatient and Outpatient Medicine in a Predominantly Indigent Population

Background: One of the greatest frustrations for health care providers is obtaining timely follow‐up appointments. Hospitalists often feel compelled to extend a patient's length of stay because of their concern for patients being lost to [...]

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HM2009 Abstract Number: 116

A Hospital Medicine Track and Patient Safety, Quality Improvement, and Leadership Experience for Residents

Background: Hospitalists in the United States continue to increase. The scope of their practice has also evolved over time. Of this growing cadre of hospitalists, >80% are internal medicine–trained. Residency in internal medicine (IM) provides [...]

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HM2009 Abstract Number: 115

Speed or Accuracy? Seeking Both in an Electronic Standardized Discharge Summary Tool

Background: Discharge summaries at the study institution are currently completed by house staff using a computerized system in place of a handwritten summary or dictation. The system was conceived in 1997 as a handoff tool [...]

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HM2009 Abstract Number: 114

Enhancing a Commercial Electronic Health Record with a Novel Patient Handoff Application

Background: Patient handoffs increase the likelihood of miscommunication — and ultimately medical errors — among hospitalized patients. The Joint Commission has recommended a standardized approach to patient handoff as part of its National Patient Safety [...]

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HM2009 Abstract Number: 113

An Internet‐Based Consult Curriculum for Hospitalists

Background: JHCME.com is a free consultative medicine curriculum created for the 20,000 hospitalists in the profession. Now in its second year, the Web site is a response to the growing role that hospitalists play in [...]

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HM2009 Abstract Number: 112

Teaching New Dogs New Tricks: An Interactive Patient Safety Curriculum for House Staff

Background: Although it is important for physicians to be involved with initiatives to enhance patient safety, little training is devoted to this area. In addition, the topic is challenging to teach, as house staff may [...]

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HM2009 Abstract Number: 111

Collaborative Comanagement Between Physicians and Nurse‐Practitioners

Background: The UHS Hospitalist Program of Pitt County Memorial Hospital in Greenville, North Carolina, began in 2001 with 4 physicians and 1 nurse‐practitioner. Since that time, our hospitalist program has grown to 23 physicians and [...]

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HM2009 Abstract Number: 110

MCOMM: Redefining Medical Communication in the 21st Century

Background: Communication between members of the medical team — MDs, RNs, PAs, and house staff — has traditionally relied on a 1‐way paging system. Although effective, this medium has significant limitations including a 1‐way flow [...]

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HM2009 Abstract Number: 109

A Hospitalist Model to Address the Quality of Care of Admitted Patients in the Emergency Department

Background: Emergency department (ED) overcrowding has become a common problem in U.S. hospitals, resulting in increasing numbers of patients admitted to the medicine service being “boarded” in the ED. These patients are typically remote from [...]

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HM2009 Abstract Number: 108

Promoting Hospital Medicine: The Undergraduate Preceptorship in Internal Medicine (UPIM)

Background: Interest in internal medicine (IM) has substantially decreased over the last decade. Although hospital medicine (HM) is currently the fastest‐growing specialty, many premedical and medical students are not aware of this field. With an [...]

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HM2009 Abstract Number: 107

An Electronic Health Record (EHR) Based Tool to Aid in the Prevention of Potentially Avoidable Deaths in Non‐ICU Hospital Patients

Background: Many hospitals have instituted rapid response teams (RRTs) to prevent potentially avoidable deaths in general medical surgical unit patients. However, studies to date have not found consistent improvement in clinical outcomes as a result [...]

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HM2009 Abstract Number: 1003

Cost Effectiveness of VTE Pharmacological Prophylaxis in Total Hip and Knee Replacement: A Systematic Review

Background: Various agents are recommended bv Drofessional societies for venous thromboembolism (VTE) prophvlaxis followina total hio replacement (THR) or total knee replacement (TKR), but the cost effectiveness of individual agents is poorly understood. Although multiple [...]

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HM2009 Abstract Number: 1002

Obtaining Successful IV Placement in Pediatric Patients: The Number of IV Attempts by Age Comparison

Background: Most pediatric patients admitted to inpatient wards require peripheral intravenous (PIV) access for the administration of fluids, medications, or other intravenous therapy. Even though peripheral intravenous insertion can be painful, time‐consuming, and often difficult, [...]

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HM2009 Abstract Number: 1001

A New Approach to VTE Screening: Analytical Assessment Versus Presumptive Prophylaxis

Background: Complications from venous thromboembolism (VTE) kill more Americans each year than AIDS and breast cancer combined. Despite evidence‐based knowledge regarding the benefits of venous thromboembolism (VTE) prophylaxis in hospitalized medical patients, as well as [...]

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HM2009 Abstract Number: 1000

Emergency Department Access Block: The Impact on Care of Boarding Admitted Children

Background: Emergency department (ED) access block is rapidly becoming a significant problem for children. ED access block is defined by total ED time > 8 hours because of an insufficient number of inpatient beds and [...]

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HM2009 Abstract Number: 106

A Nomogram for Prediction of Survival for Patients Undergoing Elective Major Noncardiac Surgery

Background: An accurate prediction model for perioperative outcomes of patients who have been clinically optimized prior to elective noncardiac surgery has not been well studied. We sought to develop a nomogram that would help physician [...]

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HM2009 Abstract Number: 105

Comparing the Effectiveness of Telephone and Palmtop Computer‐Based Experience Sampling Methods to Measure the Quality of Pain Control in Hospitalized General Medicine Patients

Background: Pain control is a key part of care for hospitalized patients. Despite calls from major health care organizations to improve provider awareness and training about pain control, pain management remains inadequate for many hospitalized [...]

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HM2009 Abstract Number: 104

Intensivists Versus Hospitalists in the ICU: A Prospective Cohort Study Comparing Mortality and Length of Stay Between Two Staffing Models

Background: Observational studies conducted prior to the hospitalist movement demonstrate improved patient outcomes in intensive care units (ICUs) staffed by intensivists compared with those staffed by nonintensivists. A large and growing nationwide intensivist shortage, however, [...]

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HM2009 Abstract Number: 103

Using Administrative Data for Quality Improvement: The Good, the Bad, and the Unknown

Background: Quality measurement is increasingly important for medical centers. Regulatory organizations and payers are demanding quality care and quality improvement initiatives. Measurement is a foundation for all improvement methodologies but can be costly. Administrative data [...]

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HM2009 Abstract Number: 102

Improving Glycemic Control in Non–Critically III Hospitalized Patients

Background: Blood glucose (BG) control is difficult to achieve in the hospital setting, and the best approach to BG control in non‐critically ill patients is unclear. A few quality improvement studies have demonstrated improvements in [...]

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HM2009 Abstract Number: 101

A Hospitalist‐Run Geriatrics Service Is Associated with Improved Processes of Care

Background: Hospitalization of older persons is accompanied by a disproportionate risk of poor outcomes and adverse events such as functional decline, delirium, and falls. Several process measures potentially associated with increased quality of care for [...]

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HM2009 Abstract Number: 100

Does Continuity of Care during Inpatient Hospitalization Affect Patient Outcomes?

Background: Research shows that continuity of care in the outpatient setting improves care and reduces risk of rehospitalization. However, the effects of continuity of care in the inpatient setting have not been studied. We know [...]

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HM2009 Abstract Number: 99

Predictors of Early Postdischarge Mortality in Critically III Patients: Lessons for Quality Performance and Quality Assessment

Background: Assessments of intensive care unit (ICU) performance currently rely on risk‐adjusted rates of in‐hospital mortality. These rates do not account for deaths occurring shortly after hospital discharge that may be attributable to the quality [...]

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HM2009 Abstract Number: 98

Systematic Review of Hospital Time‐Motion Literature

Background: Time‐motion studies have been used since the early 20th century to provide minute‐by‐minute accounts of how time is spent in factories and office settings alike. More recently, time‐motion methodology has been used in the [...]

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HM2009 Abstract Number: 97

A Survey of Hospitalists' Experience with Palliative Care

Background: The combination of increasing numbers of hospitalists and their growing responsibility for the care of patients at the end of life (EOL) requires hospitalists to have palliative care skills. Although previous surveys have documented [...]

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HM2009 Abstract Number: 96

Automated Real‐Time Relay of Actionable Performance Data to a Medical Nursing Unit Improves Venous Thromboembolism Prophylaxis Rates

Background: Performance data in hospitals is typically derived from retrospective sampling, significantly restricting its relevance for active inpatients. If performance data could be relayed electronically in real‐time to the nursing unit, members of the frontline [...]

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HM2009 Abstract Number: 95

Incidence and Implications of Postdischarge Adverse Events

Background: Patients are vulnerable during care transitions, and adverse patient events occur frequently after hospital discharge. The incidence and impact of such events has primarily been studied at single institutions. We sought to evaluate the [...]

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HM2009 Abstract Number: 94

Relationship of Weight Loss and B‐Type Natriuretic Peptide Levels with Symptomatic Improvement in Patients with Acute Decompensated Heart Failure

Background: Weight loss is a surrogate marker of volume changes with therapy in acute heart failure. Large drops (>50%) in B‐type natriuretic peptide (BNP) levels correlate with changes in wedge pressures. Wedge pressures correlate strongly [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Relationship of Weight Loss and B‐Type Natriuretic Peptide Levels with Symptomatic Improvement in Patients with Acute Decompensated Heart Failure

HM2009 Abstract Number: 93

Quality‐of‐Life Scores, Not New York Heart Association Classification, Predict Symptomatic Improvement among Patients with Acute Decompensated Heart Failure

Background: Literature on measurement of symptomatic improvement in ADHF admitted to telemetry is sparse. Visual analog scales (VASs) are valid measures of dyspnea in ADHF. Because dyspnea is a complex psychobiologic phenomenon and the Minnesota [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Quality‐of‐Life Scores, Not New York Heart Association Classification, Predict Symptomatic Improvement among Patients with Acute Decompensated Heart Failure

HM2009 Abstract Number: 92

Venous Thromboembolism Prophylaxis in Hospitalized Patients: An Academic Medical Center Experience

Background: Venous thromboembolism (VTE) is the third‐leading cause of cardiovascular death. Approximately 60,000 people die from VTE each year; however, VTE is the most common preventable cause of hospital death. Without prophylaxis, VTE occurs in [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Venous Thromboembolism Prophylaxis in Hospitalized Patients: An Academic Medical Center Experience

HM2009 Abstract Number: 91

Is the Hospital Smoke‐Free? Chemically Verified Abstinence among Hospitalized Smokers at Discharge and One Month after Discharge

Background: The Joint Commission requires that U.S. hospitals be smoke free, creating a valuable opportunity for hospitalized smokers to quit. Smoking cessation counseling is also a quality measure for Medicare patients hospitalized with heart failure, [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Is the Hospital Smoke‐Free? Chemically Verified Abstinence among Hospitalized Smokers at Discharge and One Month after Discharge

HM2009 Abstract Number: 90

The HCAP Gap: Differences Between Physicians' Self‐Reported Practice Patterns and Published Guidelines for Treatment of Health Care‐Associated Pneumonia

Background: Health care‐associated pneumonia (HCAP) is prevalent among hospitalized patients. In contrast to community‐acquired pneumonia (CAP), patients with HCAP are at increased risk for multidrug‐resistant organisms such as methicillin‐resfstant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa. [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on The HCAP Gap: Differences Between Physicians' Self‐Reported Practice Patterns and Published Guidelines for Treatment of Health Care‐Associated Pneumonia

HM2009 Abstract Number: 89

Effects of Computerized Order Sets on Inpatient Management of Hyperglycemia: A Randomized Controlled Trial

Background: Inpatient hyperglycemia is common and associated with adverse patient outcomes. Current guidelines recommend treatment to achieve glucose levels below 180 mg/dL in the inpatient non‐ICU setting. Previous research has suggested various approaches to improving [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Effects of Computerized Order Sets on Inpatient Management of Hyperglycemia: A Randomized Controlled Trial

HM2009 Abstract Number: 88

Assessing Venous Thromboembolism Prophylaxis Strategies in Patients Who Develop a Hospital‐Acquired Deep Venous Thrombosis or Pulmonary Embolism

Background: Acquired inpatient venous thromboembolism (VTE) accounts for significant morbidity and mortality and is considered largely preventable with pharmacologic prophylaxis. Appropriate VTE prevention has emerged as an important hospital quality measure and has become a [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Assessing Venous Thromboembolism Prophylaxis Strategies in Patients Who Develop a Hospital‐Acquired Deep Venous Thrombosis or Pulmonary Embolism

HM2009 Abstract Number: 87

Active Resisters and Organizational Constipators: How Hospital Employees Affect Hospital‐Acquired Infection Prevention Efforts

Background: Health care–associated infection (HAI) is a common and costly patient safety problem. As of October 2008, U.S. hospitals will no longer receive Medicare reimbursement for certain types of HAI, thereby heightening the need for [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Active Resisters and Organizational Constipators: How Hospital Employees Affect Hospital‐Acquired Infection Prevention Efforts

HM2009 Abstract Number: 86

Marked Mortality Reduction over Time in Patients Hospitalized for Community‐Acquired Pneumonia

Background: Community‐acquired pneumonia (CAP) is the most common infectious cause of death in the United States and has thus been the target of numerous quality initiatives. Early administration of guideline‐concordant antibiotics, influenza and pneumo‐coccal vaccination, [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Marked Mortality Reduction over Time in Patients Hospitalized for Community‐Acquired Pneumonia

HM2009 Abstract Number: 85

Randomized Study of the Efficacy and Safety of IV Acetaminophen Compared with Oral Acetaminophen for Treatment of Fever

Background: Acetaminophen has been well known as an effective analgesic and antipyretic for more than a century. IV acetaminophen (IV APAP) is approved for the short‐term treatment of acute pain and fever in nearly 70 [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Randomized Study of the Efficacy and Safety of IV Acetaminophen Compared with Oral Acetaminophen for Treatment of Fever

HM2009 Abstract Number: 84

Randomized Study of the Efficacy and Safety of IV Acetaminophen Compared with Placebo for Treatment of Fever

Background: Acetaminophen has been well known as an effective analgesic and antipyretic for more than a century. IV acetaminophen (IV APAP) is approved for the short‐term treatment of acute pain and fever in nearly 70 [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Randomized Study of the Efficacy and Safety of IV Acetaminophen Compared with Placebo for Treatment of Fever

HM2009 Abstract Number: 83

Cancer Screening in an Urban Medical Center

Background: It is well known that there are disparities in health care for minorities in the United States. Multiple studies have shown that differences exist in all aspects of care including prevention, diagnosis, and treatment, [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Cancer Screening in an Urban Medical Center

HM2009 Abstract Number: 82

Provider Intuition Predicts Clinical Deterioration in Ward Patients

Background: In‐hospital cardiac arrest is rarely sudden and may be preventable if interventions are performed when patients are in the early stages of clinical deterioration. However, identifying high‐risk patients remains a significant challenge. Scoring tools [...]

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HM2009 Abstract Number: 81

Demographics, Productivity, and Promotion among Academic Hospitalists in 2008

Background: The number of academic hospitalists in the United States has grown rapidly, but few data exist regarding this workforce. We describe the current demographics, academic productivity, and promotion rates among academic hospitalists. Methods: We [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Demographics, Productivity, and Promotion among Academic Hospitalists in 2008

HM2009 Abstract Number: 80

National Trends of UTI Hospitalizations

Background: Outpatient management of UTI as a treatment option was firmly established by Hoberman's study in 1999 and confirmed in Cochrane reviews in 2003 and 2007. However, UTI remains a common cause of pediatric hospitalization [...]

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HM2009 Abstract Number: 79

Maintaining Glycemic Control During Transition from Infusion Insulin to Subcutaneous Insulin Safely: A Protocol‐Driven, Multidisciplinary Approach

Background: The transition from insulin infusion is problematic. A pilot study in our institution revealed that uncontrolled hyperglyce‐mia was the rule in the first 48 hours after discontinuing insulin infusion and that basal subcutaneous (SC) [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Maintaining Glycemic Control During Transition from Infusion Insulin to Subcutaneous Insulin Safely: A Protocol‐Driven, Multidisciplinary Approach

HM2009 Abstract Number: 78

PCP Awareness of Patient Hospitalization and Patient Reports of Postdischarge Complications

Background: Although communication with primary care physicians (PCPs) during patient hospitalization is recommended, it is unclear if this communication is related to patient outcomes. Communication with PCPs may be especially important for frail older adults [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on PCP Awareness of Patient Hospitalization and Patient Reports of Postdischarge Complications

HM2009 Abstract Number: 77

Teach‐to‐Goal Intervention to Teach Respiratory Inhaler Technique in Patients Hospitalized for Asthma or COPD

Background: Medications delivered through respiratory inhalers are the mainstay of treatment for patients with obstructive lung disorders (OLDs) such as asthma and chronic obstructive pulmonary disease (COPD). Unfortunately, respiratory inhalers are often used incorrectly, reducing [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Teach‐to‐Goal Intervention to Teach Respiratory Inhaler Technique in Patients Hospitalized for Asthma or COPD

HM2009 Abstract Number: 76

Improving Cross‐Cover Communication with an Intuition‐Based Scoring System

Background: Patient handoffs at physician shift changes are limited in their ability to convey the insight that the primary team has gained by longitudinal personal care of the patient. The Patient Acuity Rating (PAR) is [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Improving Cross‐Cover Communication with an Intuition‐Based Scoring System

HM2009 Abstract Number: 75

Is There a True Hispanic Paradox in Cardiovascular Risk Stratification?

Background: Hispanics are the fastest‐growing segment of the U.S. population. An observation that Hispanics have lower all‐cause cardiovascular morbidity and mortality despite increased risk factor rates has been termed the “Hispanic paradox.” The Framingham Heart [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Is There a True Hispanic Paradox in Cardiovascular Risk Stratification?

HM2009 Abstract Number: 74

Hospitalized Patients' Understanding of Their Plan of Care

Background: The relationship between a patient and his or her health care providers is fundamental in providing effective care. Studies in ambulatory settings have shown that agreement between patients and their physicians is associated with [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Hospitalized Patients' Understanding of Their Plan of Care

HM2009 Abstract Number: 73

Impact of Localizing Physicians to Hospital Units on Nurse‐Physician Communication and Agreement on the Plan of Care

Background: A significant barrier to communication between providers on hospital units is the fluidity and geographic dispersion of team members. Geographically localizing physicians to specific units may improve collaboration with other unit‐based team members and [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Impact of Localizing Physicians to Hospital Units on Nurse‐Physician Communication and Agreement on the Plan of Care

HM2009 Abstract Number: 72

Residents' Awareness of and Response to Medicare's Rule on Nonpayment for Hospital‐Acquired Conditions: A Little Knowledge Can Be a Dangerous Thing

Background: Medicare has selected 10 hospital‐acquired conditions for which it will not reimburse hospitals unless the condition is documented as being “present on admission.” This “no‐pay‐for‐errors” rule may have a profound effect on the clinical [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Residents' Awareness of and Response to Medicare's Rule on Nonpayment for Hospital‐Acquired Conditions: A Little Knowledge Can Be a Dangerous Thing

HM2009 Abstract Number: 71

Comparison of the Prevalence of Methicillin‐Resistant Staphylococcus aureus Colonization among Hospital Personnel Between 2004 and 2008

Background: We previously found that the prevalence of both methicillin‐resistant S. aureus (MRSA) and community‐associated me‐thicillin‐resistant 5. aureus (CA‐MRSA) among health care workers (HCWs) at an urban academic center in Camden, New Jersey, in 2004‐2005 [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Comparison of the Prevalence of Methicillin‐Resistant Staphylococcus aureus Colonization among Hospital Personnel Between 2004 and 2008

HM2009 Abstract Number: 70

Gaps in Mentorship and Impact on Scholarship Among Academic Hospitalists

Background: Previous studies suggest academic physicians with adequate mentorship conduct more research, write more papers, and are more likely to mentor others. Given the youth of their field, hospitalists may not appreciate or experience the [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Gaps in Mentorship and Impact on Scholarship Among Academic Hospitalists

HM2009 Abstract Number: 69

Transitions to No Care: Patients Lack Timely Posthospital Follow‐Up

Background: The transition between inpatient and outpatient settings is known to be a period of high risk for adverse events such as medication and laboratory‐monitoring errors. Readmission rates, up to 20% after 30 days among [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Transitions to No Care: Patients Lack Timely Posthospital Follow‐Up

HM2009 Abstract Number: 68

Declining Activity of Generalist Physicians in Hospital Care in the United States: 1980‐2005

Background: General internists and other generalist physicians have traditionally cared for their patients both in the clinic and in the hospital. Over the past decade, hospitalists have been highlighted as undermining the role of generalist [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Declining Activity of Generalist Physicians in Hospital Care in the United States: 1980‐2005

HM2009 Abstract Number: 67

Obesity in Hospitalized Pediatric Patients

Background: Childhood obesity confers a substantial risk of adult obesity, lifelong health risks, and social and economic disadvantages. BMI has been the standard as a reliable indicator of overweight and obese children. In 2005, the [...]

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HM2009 Abstract Number: 66

Effect of Time of Hospital Admission on Patient Outcomes

Background: Staffing and resource availability in hospitals diminish from day to night. Also, patients admitted at night are often passed off to a new care team in the morning. The impact of this discontinuity on [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Effect of Time of Hospital Admission on Patient Outcomes

HM2009 Abstract Number: 65

Hospitalist Communication: To Whom Are They Talking and How Much?

Background: Working without support from residents, hospitalists anecdotally spend a great deal of time and effort coordinating care planning among different physician specialties, nurses, ancillary staff, and other health care professionals. Ultimately responsible for the [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Hospitalist Communication: To Whom Are They Talking and How Much?

HM2009 Abstract Number: 64

Impact of a Nurse Care Coordinator on Hospitalist Work Flow

Background: Many large hospital medicine groups utilize nurse case managers to enhance efficiency and extend the capability of hospitalists to manage larger volumes of patients. As part of an ongoing time–work flow study, we evaluated [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Impact of a Nurse Care Coordinator on Hospitalist Work Flow

HM2009 Abstract Number: 63

A Qualitative Study of Hospitalist and Nonhospitalist Work Relationships with Staff Nurses

Background: Hospitalists have the potential to interact with inpatient staff nurses more frequently than physicians who also provide ambulatory care. Despite the existence of this specialty for more than a decade and its burgeoning numbers, [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on A Qualitative Study of Hospitalist and Nonhospitalist Work Relationships with Staff Nurses

HM2009 Abstract Number: 62

A Hospitalist‐Run Observation Service Safely Decreases Length of Stay for Low‐Risk Chest Pain Patients

Background: Our tertiary‐care academic hospital allocates low‐risk chest pain admissions without evidence of acute coronary syndrome (ACS) to either a nonteaching observation service staffed by hospitalists and nurse‐practitioners or a teaching cardiology service staffed by [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on A Hospitalist‐Run Observation Service Safely Decreases Length of Stay for Low‐Risk Chest Pain Patients

HM2009 Abstract Number: 61

The Low Number of Therapeutic Initial Vancomycin Troughs in the Intensive Care Unit

Background: Vancomycin is commonly used in an empiric antimicrobial regimen. Clinical pharmacy at our institution has defined therapeutic vancomycin troughs in accordance with the existing literature. Still, there is no centralized protocol for initiation of [...]

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HM2009 Abstract Number: 60

Quality of Physician–Patient Communication During Hospitalization

Background: Patients often do not understand or recall information presented during their hospitalization. Poor physician–patient communication in the hospital setting is related to adverse events and readmissions. In outpatient research, health literacy is strongly associated [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Quality of Physician–Patient Communication During Hospitalization

HM2009 Abstract Number: 59

Effect of a Pharmacy‐Based Health Literacy Intervention on Medication Refill Adherence in an Inner‐City Health System

Background: Low health literacy is associated with poor understanding of medication instructions and, in some studies, with lower medication adherence, We developed and evaluated a 3‐part system intervention intended to increase refill adherence through attention [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Effect of a Pharmacy‐Based Health Literacy Intervention on Medication Refill Adherence in an Inner‐City Health System

HM2009 Abstract Number: 58

Hyperuricemia and Its Clinical Correlates in Hispanic Patients with Metabolic Syndrome

Background: Beyond the well‐known complication of gout and nephroiithiasis, there is a mounting body of evidence that hyperuricemia is associated with hypertension and chronic renal disease and is an independent risk factor for coronary artery [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Hyperuricemia and Its Clinical Correlates in Hispanic Patients with Metabolic Syndrome

HM2009 Abstract Number: 57

Improving Antibiotic Utilization in the Emergency Department via Academic Detailing by Hospitalists 57

Background: Inappropriate antibiotic use is a major clinical problem in hospitals. The initial prescribing choices made by emergency department (ED) providers may be partially responsible for this situation. Unlike hospitalists, ED providers do not have [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Improving Antibiotic Utilization in the Emergency Department via Academic Detailing by Hospitalists 57

HM2009 Abstract Number: 56

Impact of a Patient Service Representative on Quality of Care on a Nonteaching Hospitalist Service

Background: Improving discharge planning is a high priority in hospital medicine. There are numerous studies on discharge checklists, follow‐up phone calls, standardization of communication between inpatient and outpatient physicians, and links between improved follow‐up and [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Impact of a Patient Service Representative on Quality of Care on a Nonteaching Hospitalist Service

HM2009 Abstract Number: 55

Unnecessary Hospital Days in an Academic Medical Center: A Survey of Hospitalists and Discharge Planners

Background: Medically “unnecessary” hospital days pose a great concern to patients, payers, hospitals, and care providers. Increasing length of stay from delays increases costs and potentially nosocomial complications. Hospitalists at our academic medical center (AMC) [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Unnecessary Hospital Days in an Academic Medical Center: A Survey of Hospitalists and Discharge Planners

HM2009 Abstract Number: 54

Effect of Admission to a Hospitalist Service Compared with Admission to a Teaching Service on Inpatient Outcomes

Background: Numerous studies have shown that hospitalists in community settings reduce hospital costs primarily through reducing length of stay. Although some research in the academic setting indicates that hospitalist teaching attendings reduce mortality, little research [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Effect of Admission to a Hospitalist Service Compared with Admission to a Teaching Service on Inpatient Outcomes

HM2009 Abstract Number: 53

Effect of Nurse‐Practitioners on Quality of Care Delivered by an Inpatient Medicine House Staff Team

Background: Increasing work‐hour restrictions, older and sicker patients, and fragmented care may result in poorer quality care by inpatient medicine house staff. Recognizing this, the Accreditation Council for Graduate Medical Education proposes reducing noneducational work [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Effect of Nurse‐Practitioners on Quality of Care Delivered by an Inpatient Medicine House Staff Team

HM2009 Abstract Number: 52

Is the Berlin Questionnaire an Effective Screening Tool for Obstructive Sleep Apnea in the Total Joint Replacement Population?

Background: Obstructive sleep apnea (OSA) has become a recognizable disorder among medical specialists but remains a relatively unexplored topic for surgeons, anesthesiologists, and their patients in the perioperative period. Recent studies have begun to describe [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Is the Berlin Questionnaire an Effective Screening Tool for Obstructive Sleep Apnea in the Total Joint Replacement Population?

HM2009 Abstract Number: 51

Intraoperative Coagulopathy: A Low‐Volume Treatment Protocol That Completely Replaces Fresh‐Frozen Plasma

Background: Fresh‐frozen plasma (FFP) is commonly used to correct intraoperative coagulopathies (believed to be secondary to clotting factor depletion, platelet consumption, and/or volume replacement strategies) but is associated with significant fluid volume if multiple units [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Intraoperative Coagulopathy: A Low‐Volume Treatment Protocol That Completely Replaces Fresh‐Frozen Plasma

HM2009 Abstract Number: 50

Risk‐Adjusted Administrative Data Can Be Used as a Tool to Monitor the “Weekend Effect” on Inpatient Mortality

Background: Increased mortality has been observed for patients admitted on weekends to hospitals in several studies. The reasons for this “weekend effect” are unclear but may be related to reduced staffing levels, increased handoffs, or [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Risk‐Adjusted Administrative Data Can Be Used as a Tool to Monitor the “Weekend Effect” on Inpatient Mortality

HM2009 Abstract Number: 49

Hospital Readmissions within 30 Days after Discharge: A Review of All Readmissions to Hospitalists in One Year

Background: Readmission to hospital soon after discharge is a significant burden to patients and our health care system. Centers for Medicaid and Medicare services are proposing to add hospital readmissions as a quality measure by [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Hospital Readmissions within 30 Days after Discharge: A Review of All Readmissions to Hospitalists in One Year

HM2009 Abstract Number: 48

Hospital‐Based Health Care Utilization of Unfractionated and Low‐Molecular‐Weight Heparin

Background: Venous thromboembolism, unstable angina, and atrial fibrillation are diseases that utilize parenteral anticoagulant therapy, which is often associated with bleeding and thrombocytopenia that require management and a prolonged hospital stay and pose an economic [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Hospital‐Based Health Care Utilization of Unfractionated and Low‐Molecular‐Weight Heparin

HM2009 Abstract Number: 47

Increased Utilization of Guideline‐Recommended Antibiotics for Health Care–Associated Pneumonia Following an Educational Intervention

Background: In 2005, the Infectious Diseases Society of America and the American Thoracic Society published guidelines regarding treatment of health care–associated pneumonia (HCAP). These guidelines recommend MRSA coverage as well as 2 antipseudo‐monal antibiotics for [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Increased Utilization of Guideline‐Recommended Antibiotics for Health Care–Associated Pneumonia Following an Educational Intervention

HM2009 Abstract Number: 46

Relational Care Coordination among Providers in a Comanagement Model of Care

Background: Coordination is a critical aspect of care involving multiple interdependent providers. The characteristics of care coordination among providers in a comanagement model have never been examined. Methods: Between April and October 2008, hospitalists, midlevels, [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Relational Care Coordination among Providers in a Comanagement Model of Care

HM2009 Abstract Number: 45

Expectations and Experiences of Provider Management Structure on a Medical Coman

Background: Although comanagement models of care are proliferating, the management structures of comanaging providers have not been characterized. Methods: Between April and October 2008, all eligible providers on a novel medical comanagement service (described elsewhere) [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Expectations and Experiences of Provider Management Structure on a Medical Coman

HM2009 Abstract Number: 44

Aiming for a Therapeutic INR: Success of the Pharmacy‐Assisted Anticoagulation Inpatient Management (AIM) Team

Background: The Joint Commission's National Patient Safety Goals for 2008 and 2009 include numerous anticoagulation elements requiring hospitals to use approved protocols for the initiation and maintenance of anticoagulant therapy. Additionally, at our hospital, patients [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Aiming for a Therapeutic INR: Success of the Pharmacy‐Assisted Anticoagulation Inpatient Management (AIM) Team

HM2009 Abstract Number: 43

Use of Evidence‐Based Strategies to Reduce Door‐to‐Balloon Time in the Setting of the D2B Alliance

Background: Although substantial effort has been made to understand uptake of evidence‐based practice among participants in national quality campaigns, little attention has been directed toward hospitals that elect not to join these efforts. Methods: We [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Use of Evidence‐Based Strategies to Reduce Door‐to‐Balloon Time in the Setting of the D2B Alliance

HM2009 Abstract Number: 42

Innovative Strategies That Improve Clinical Handoff (I‐Switch) Phase II: Randomized Controlled Trial Evaluating Educational Modalities Including Cognitive Simulation

Background: Few studies have investigated how to optimally educate physicians on the cognitive skills required for effective clinical handoffs. Methods: A single‐institution, prospective, randomized, controlled trial was conducted to explore the effectiveness of different educational [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Innovative Strategies That Improve Clinical Handoff (I‐Switch) Phase II: Randomized Controlled Trial Evaluating Educational Modalities Including Cognitive Simulation

HM2009 Abstract Number: 41

As Length of Stay Fell, Did 15‐Day Hospital Readmission Rate Increase in Veterans Administration Hospitals 1997‐2007?

Background: Increasing hospital efficiency has resulted in lower hospital length of stay (LOS); however, the impact of reduced LOS and hospital readmission rates has not been well described. Our objective was to determine trends in [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on As Length of Stay Fell, Did 15‐Day Hospital Readmission Rate Increase in Veterans Administration Hospitals 1997‐2007?

HM2009 Abstract Number: 40

Do Hospitalists Affect Clinical Outcomes and Efficiency for Patients with Acute Upper Gastrointestinal Hemorrhage?

Background: Care by hospitalists has, in general, been associated with improved or similar cfinical outcomes and improved efficiency. However, less is known about the affect of hospitalists on conditions that may be dependent on consultants [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Do Hospitalists Affect Clinical Outcomes and Efficiency for Patients with Acute Upper Gastrointestinal Hemorrhage?

HM2009 Abstract Number: 39

Rates, Predictors and Consequences of Low Career Satisfaction and Burnout in Academic Hospital Medicine

Background: The number of hospitalists in academic medical centers has grown rapidly. We evaluated the rates of satisfaction and burnout and the predictors and consequences of each in academic hospitalists. Methods: We performed a cross‐sectional [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Rates, Predictors and Consequences of Low Career Satisfaction and Burnout in Academic Hospital Medicine

HM2009 Abstract Number: 38

Discharge Documentation of Patients Discharged to Subacute Facilities: Results of a Three‐Year Quality Improvement Process Across an Integrated Health Care System

Background: Effective communication among physicians during the hospital discharge process is critical to patient care. Since 2004 the Joint Commission has provided a set of necessary information to be included in all discharge documentation. Beyond [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Discharge Documentation of Patients Discharged to Subacute Facilities: Results of a Three‐Year Quality Improvement Process Across an Integrated Health Care System

HM2009 Abstract Number: 37

Patient Communication: Quality or Quantity?

Background: Effective communication between a hospitalist and his or her patients is essential. In the United States, the Accreditation Council for Graduate Medical Education and the American Board of Medical Specialties have recognized interpersonal and [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Patient Communication: Quality or Quantity?

HM2009 Abstract Number: 36

Higher Quality of Care for Hospitalized Frail Older Adults Is Associated with Improved Survival One Year after Discharge

Background: There is an increased focus on measuring and improving quality of care for hospitalized older patients. Ideally, adherence to quality measures is associated with improved outcomes for these patients. This study aimed to assess [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Higher Quality of Care for Hospitalized Frail Older Adults Is Associated with Improved Survival One Year after Discharge

HM2009 Abstract Number: 35

How Well Do Hospitalists Communicate? The Patient's Perspective

Background: Effective communication and interpersonal skills are essential for delivering quality patient care and have been identified as a core competency for physicians. The Communication Assessment Tool (CAT) is a psychometrically validated instrument for patient [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on How Well Do Hospitalists Communicate? The Patient's Perspective

HM2009 Abstract Number: 34

Patterns of Peripherally Inserted Central Catheter Use Among Hospitalized Patients in a Community Hospital

Background: Peripherally inserted central catheters (PICCs) have become an increasingly attractive option for short‐term vascular access in hospitalized patients. PICC placement is a minimally invasive procedure and provides a convenient, dependable intravenous access. These advantages, [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Patterns of Peripherally Inserted Central Catheter Use Among Hospitalized Patients in a Community Hospital

HM2009 Abstract Number: 33

Relationship Between Hospitalist Workload and Time Spent in Daily Activities

Background: Since our program conducted a time study to see how hospitalists spend their time 4 years ago, we have significantly increased our daytime coverage as well as our average daily census (more than doubled). [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Relationship Between Hospitalist Workload and Time Spent in Daily Activities

HM2009 Abstract Number: 32

Real‐Time Ultrasound Central Line Placement to Replace Postprocedural Chest X‐Ray: Is Post–Central Line Placement Chest X‐Ray Still Considered the Gold Standard?

Background: Central line placement is a common ICU procedure that aids in hemodynamic monitoring, as well as delivery of medical treatment and nutritional support. In the United States alone, more than 5 million central venous [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Real‐Time Ultrasound Central Line Placement to Replace Postprocedural Chest X‐Ray: Is Post–Central Line Placement Chest X‐Ray Still Considered the Gold Standard?

HM2009 Abstract Number: 31

Diagnostic Efficacy of Tagged White Blood Cell Scans in the Workup of Occult Infection

Background: Tagged white blood cell scans (TWBCSs) are often used as a diagnostic study when searching for an occult infection after most other studies have been performed. These studies are not inexpensive, averaging near $400 [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Diagnostic Efficacy of Tagged White Blood Cell Scans in the Workup of Occult Infection

HM2009 Abstract Number: 30

Lessons Learned from Implementation of a Results Management Application for Tests Finalized after Hospital Discharge

Background: Patients are often discharged from hospitals before test results are finalized. Physician awareness of test results finalized after hospital discharge is poor and is an important patient safety concern. We aimed to determine the [...]

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HM2009 Abstract Number: 29

Inpatient Stroke Alert Program Improves Response Times for Ischemic Strokes Occurring During Hospitalization

Background: It is estimated that 7%–15% of all strokes occur in the hospital, yet these strokes have slower response times and longer time to thrombolysis compared with strokes that occur outside the hospital. We initiated [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Inpatient Stroke Alert Program Improves Response Times for Ischemic Strokes Occurring During Hospitalization

HM2009 Abstract Number: 28

Predicting Skilled Nursing Facility Placement after Hospital Discharge for Elderly Patients

Background: The Vulnerable Elders Survey (VES‐13) was developed to identify community dwelling elders at risk for functional decline or death. It consists of a 10‐point score based on age, self‐reported health status, and ability to [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Predicting Skilled Nursing Facility Placement after Hospital Discharge for Elderly Patients

HM2009 Abstract Number: 27

Patients Lack Knowledge of Their Hospital Medications

Background: Medication errors represent an important hospital safety issue, yet patients are largely excluded from active involvement in detecting and preventing these events. The magnitude of the problem is staggering, with 1 review finding almost [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Patients Lack Knowledge of Their Hospital Medications

HM2009 Abstract Number: 26

Effect of a Faculty Development Program on Bedside Teaching Behavior of Academic Hospitalists

Background: Bedside teaching is the ideal venue for teaching interpersonal skills and physical examination techniques and modeling professionalism. Hospitalists have an increasing influence on the inpatient education of internal medicine residents and medicine clerkship students [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Effect of a Faculty Development Program on Bedside Teaching Behavior of Academic Hospitalists

HM2009 Abstract Number: 25

Hospitalist Comanagement of Elderly Patients with Traumatic Falls

Background: There is an increase in opportunities for hospitalists to comanage hospitalized patients. The benefits in regard to LOS, costs, and utilization of manpower are still being evaluated. As the elderly population with multiple comorbidities [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Hospitalist Comanagement of Elderly Patients with Traumatic Falls

HM2009 Abstract Number: 24

Teaching the Teachers: Evolution of an Academic Medical Center's Handoff Program

Background: Medical errors commonly occur during patient handoffs. Discontinuous care results in medical complications, redundant testing, and prolonged hospital stays. Teaching of handoffs is underemphasized in most residency training programs, and few supervising physicians are [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Teaching the Teachers: Evolution of an Academic Medical Center's Handoff Program

HM2009 Abstract Number: 23

Reducing Central Line–Associated Bloodstream Infections on the Ward by Prompting Removal of Unnecessary Central Venous Catheters

Background: Central line‐associated bloodstream infections (CLABSIs) cause significant morbidity, mortality, and cost to patients and the health care system. Because duration of use is a major risk factor for infection, the rate of CLABSI could [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Reducing Central Line–Associated Bloodstream Infections on the Ward by Prompting Removal of Unnecessary Central Venous Catheters

HM2009 Abstract Number: 22

Outcome of Patient‐Directed Scheduling of Discharge Appointments after One Year

Background: The transition from hospitalization to ambulatory care can be a stressful and confusing experience for the nearly 10,000 patients who are discharged every year at our institution. The maturation of the hospitalist field has [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Outcome of Patient‐Directed Scheduling of Discharge Appointments after One Year

HM2009 Abstract Number: 21

Hospitalist Preferences and Practices in End‐of‐Shift Sign‐Out

Background: Information is frequently lost during in‐hospital transitions of care. An effective and timely sign‐out between providers relaying critical information may reduce errors. However, little is known about provider preferences and practices (or sign‐out. We [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Hospitalist Preferences and Practices in End‐of‐Shift Sign‐Out

HM2009 Abstract Number: 20

Identifying Overweight Children during Hospitalization: Does It Make a Difference?

Background: Obesity has been identified by the World Health Organization as a global epidemic of adults and children. In 2003–2004, the NHANES found that 17% of all children ages 2–9 years were overweight/obese (BMI ≥ [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Identifying Overweight Children during Hospitalization: Does It Make a Difference?

HM2009 Abstract Number: 19

Predicting B12 Deficiency from Hematologic Indices

Background: Vitamin B12 deficiency is associated with variations in red blood cell and white blood cell morphologies. These changes are also reflected in automated red cell measures. Are such changes of sufficient strength to influence [...]

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HM2009 Abstract Number: 18

Risk Factors for Clostridium difficile‐Associated Disease in the Hospital

Background: Environmental exposure to other patients carrying an agent is an important risk for many serious infections. This so‐called “colonization pressure” has been implicated in the acquisition of Clostridium difficile‐associated disease (CDAD) in the ICU [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Risk Factors for Clostridium difficile‐Associated Disease in the Hospital

HM2009 Abstract Number: 17

Risk Factors for the Development of Severe Hyponatremia

Background: Hyponatremia can be associated with substantial morbidity and mortality. Identification of elements associated with the development of symptomatic hyponatremia is important in determining preventive strategies. This research sought a comprehensive list of risk factors [...]

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HM2009 Abstract Number: 16

Profound Hyponatremia: Presenting Symptoms, Etiology, and Outcome

Background: Hyponatremia is a commonly identified electrolyte abnormality. In general, the lower is the serum sodium, the greater is the likelihood of serious sequelae. Published data on profound hyponatremia is lacking. The goal of this [...]

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HM2009 Abstract Number: 15

Testing for Factor V Leiden and Prothrombin Gene 20210a Mutations in Patients with Venous Thromboembolism: A Systematic Review and Meta‐Analysis

Background: Factor V Leiden (FVL) and prothrombin (PT20210A) gene mutations are common genetic polymorphisms that have been associated with first‐time venous thromboembolism (VTE). These mutations have been associated with recurrent thromboses in some but not [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Testing for Factor V Leiden and Prothrombin Gene 20210a Mutations in Patients with Venous Thromboembolism: A Systematic Review and Meta‐Analysis

HM2009 Abstract Number: 14

Cystatin C and Prognosis Following Hospital Admission for Acute Congestive Heart Failure: A Prospective Cohort Study

Background: Cystatin C is a cysteine proteinase inhibitor that is produced by almost all cells of the human body and is freely filtered by the glomerulus. In some settings, it may be a better marker [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Cystatin C and Prognosis Following Hospital Admission for Acute Congestive Heart Failure: A Prospective Cohort Study

HM2009 Abstract Number: 13

Treatment of Substance Dependence after Hospital Discharge

Background: Despite effective treatments, many hospitals lack systems to facilitate treatment for substance use disorders after hospital discharge. We provided infrastructure to increase substance dependence treatment after hospital discharge and evaluated predictors of addiction treatment [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Treatment of Substance Dependence after Hospital Discharge

HM2009 Abstract Number: 12

Simulation‐Based Education Reduces Complications from Central Venous Catheter Insertion

Background: Invasive medical procedures are the second most common cause of preventable adverse events in hospitalized patients. Central venous catheter (CVC) insertion is associated with life‐threatening complications such as arterial puncture, pneumothorax, and catheter‐related bloodstream [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Simulation‐Based Education Reduces Complications from Central Venous Catheter Insertion

HM2009 Abstract Number: 11

Use of an Insulin Infusion to Improve Glycemic Control and Decrease Surgical Site Infections on a General Medical/Surgical Floor

Background: Aggressive glycemic control using insulin infusion has been associated with decreased mortality in subsets of surgical and medical ICU patients. There has been little published on safety or efficacy for insulin infusion use on [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Use of an Insulin Infusion to Improve Glycemic Control and Decrease Surgical Site Infections on a General Medical/Surgical Floor

HM2009 Abstract Number: 10

Lack of Recognition and Treatment of Osteoporosis in Post‐Hip Fracture Patients

Background: Approximately 300,000 hip fractures occur in the United States each year with 1‐year refracture and mortality rates as high as 12% and 25%, respectively. Bisphosphonate use after hip fracture reduces morbidity and mortality. Expert [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Lack of Recognition and Treatment of Osteoporosis in Post‐Hip Fracture Patients

HM2009 Abstract Number: 9

Internal Medicine Residents' Knowledge of Asthma Management, Respiratory Inhaler Technique, and Inhaler Policy Change

Background: Hospitalization rates in Chicago are double the national average for asthma and triple that among African Americans compared with whites in Chicago. In 2009, to protect the ozone layer, the familiar easy‐to‐use metered dose [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Internal Medicine Residents' Knowledge of Asthma Management, Respiratory Inhaler Technique, and Inhaler Policy Change

HM2009 Abstract Number: 8

Provider Knowledge and Practices Regarding Inpatient Hypertension Management

Background: Hypertension (HTN) is a highly prevalent cardiovascular risk factor affecting more than 65 million Americans. Studies suggest that HTN is particularly prevalent among inpatient populations. Little is known about provider knowledge and practices regarding [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Provider Knowledge and Practices Regarding Inpatient Hypertension Management

HM2009 Abstract Number: 7

Clinical Outcomes in Patients at Risk for Venous Thromboembolism Receiving Appropriate Enoxaparin or Unfractionated Heparin Prophylaxis

Background: Venous thromboembolism (VTE) is responsible for up to 600,000 hospitalizations per year in the United States. The appropriate use of evidence‐based VTE prophylaxis regimens, such as unfractionated heparin (UFH) or low‐molecular‐weight heparins (LMWHs), can [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Clinical Outcomes in Patients at Risk for Venous Thromboembolism Receiving Appropriate Enoxaparin or Unfractionated Heparin Prophylaxis

HM2009 Abstract Number: 6

Can Inpatient Providers or an Algorithm Predict General Medicine Readmissions?

Background: Readmissions cause significant distress to patients and caregivers in addition to considerable financial costs. A key component of reducing readmissions is identification of at‐risk patients prior to discharge. This determination currently is commonplace, as [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Can Inpatient Providers or an Algorithm Predict General Medicine Readmissions?

HM2009 Abstract Number: 5

Appropriateness of Using Stress Echocardiography and Other Stress Modalities for Evaluating Suspected Coronary Ischemia in Patients Presenting to a Tertiary‐Care Chest Pain Unit

Background: The assessment of patients with acute chest pain (CP) remains a continuing clinical problem, with major logistic and financial implications for health care providers. Although appropriateness criteria for stress echocardiography (SE) were unavailable at [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Appropriateness of Using Stress Echocardiography and Other Stress Modalities for Evaluating Suspected Coronary Ischemia in Patients Presenting to a Tertiary‐Care Chest Pain Unit

HM2009 Abstract Number: 4

Attitudes and Satisfactions of Primary Care Physicians and Hospitalists in Communication Regarding Hospitalized Patient Care

Background: Poor communication on hospital discharge between hospitalists and primary care physicians (PCPs) may result in worse patient outcomes, adverse medication events, decreased patient and physician satisfaction, and increased costs. Conversely, excellent communication may improve [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Attitudes and Satisfactions of Primary Care Physicians and Hospitalists in Communication Regarding Hospitalized Patient Care

HM2009 Abstract Number: 3

Critically III “Medical” Patients in the Coronary Care Unit: Does It Make a Difference?

Background: Coronary care units (CCUs) are uniquely designed and staffed to care for critically ill patients with cardiovascular disease, whereas medical intensive care units (MICUs) are specially organized and staffed for the care of patients [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Critically III “Medical” Patients in the Coronary Care Unit: Does It Make a Difference?

HM2009 Abstract Number: 2

Recognition and Treatment of Chronic Kidney Disease by Hospitalists Post‐Electronic GFR Reporting

Background: Recognition of chronic kidney disease (CKD) may be improved by electronic glomerular filtration rate (eGFR) reporting. The National Kidney Foundation Kidney Disease Outcomes Quality Initiative (K/DOQI) provides recommendations on quantitative evaluation for proteinuria, prescription [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Recognition and Treatment of Chronic Kidney Disease by Hospitalists Post‐Electronic GFR Reporting

HM2009 Abstract Number: 1

Prevalence and Use of Antibiotics in Community Associated Methicillin‐Resistant Staphylococcus aureus Infections (CA‐MRSA) in a Community Hospital

Background: CA‐MRSA is a growing epidemic infection that has resulted in a transformation of the approach to skin and soft‐tissue infections. Although, CA‐MRSA differs from other MRSA infections in many ways, one difference that affects [...]

By | 2009-05-14T12:00:07-04:00 May 14th, 2009|Uncategorized|Comments Off on Prevalence and Use of Antibiotics in Community Associated Methicillin‐Resistant Staphylococcus aureus Infections (CA‐MRSA) in a Community Hospital