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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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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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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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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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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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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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 [...]

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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 [...]

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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 [...]

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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 [...]

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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 [...]

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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 [...]

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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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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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