Systematic Review of Resident Workload and Work Activity: Impact on Resident Education and Patient Care

Background: As further limits in resident duty hours are considered, anecdotes of detrimental effects of work intensification (same amount of work in less time) and the continued reliance on residents for tasks of limited educational [...]

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Evaluating Readmission Rates: How Can We Improve?

Background: Readmission to the hospital is a burden not only to patients, families, and health care workers but also to the health care system. The U.S. government spends an estimated $12 billion a year on [...]

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Preventing Venous Thromboembolism Following Hip Replacement Surgery: Analysis of Special Populations in the United States That May Require Alterations to Anticoagulant Regimens

Background: Patients undergoing hip replacement surgery are at particularly high risk of venous thromboembolism (VTE) and require thromboprophylaxis. Unlike clinical trials, real‐world surgery includes patient populations with comorbidities or on concomitant drugs, who may require [...]

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Barriers and Facilitators to Implementing Project Boost to Improve the Discharge Process

Background: Project BOOST (Better Outcomes for Older adults through Safe Transitions) is being implemented at 30 U.S. hospitals to enhance the hospital discharge process. Pilot sites began implementing Project BOOST'S core elements in January 2009. [...]

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Blood Culture Contamination: A Cluster‐Randomized Crossover Trial Evaluating the Comparative Effectiveness of 3 Skin Antiseptic Interventions

Background: Blood cultures are one of the most commonly performed and valuable diagnostic procedures in hospitalized patients. Contaminated blood cultures, however, result in significant resource utilization and potential complications from exposure to unnecessary therapies. Various [...]

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Mental Status Assessment in the Emergency Department: Ready for Prime Time as a Quality Metric?

Background: Delirium and other forms of cognitive impairment are clinically important patient charactenistics that have been shown to be strong predictors of outcomes. Although mental status assessment is the subject of national quality indicators, considerable [...]

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Are Clinicians Using the Christopher Algorithm to Diagnose Pulmonary Embolism?

Background: The 200S CHRISTOPHER trial validated a diagnostic algorithm for pulmonary embolism (PE) using the Wells score, D‐dimer, and CT angiography (CTA). Thirty‐two percent of patients had a combination of low Wells score and negative [...]

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Are Proton Pump Inhibitors Overutilized in Hospitalized Patients Thereby Increasing Their Risk of Adverse Effects? A Community Hospital Experience

Background: Proton pump inhibitors (PPIs) are one of the most prescribed medications and are frequently used in hospitalized patients. Although PPIs have well‐defined indications for both therapy and prophylaxis, they are often overutilized. Recently, there [...]

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Not All Care Is Equal: Differences in Care of Venous Thromboembolism among Insured and Uninsured Patients

Background: Venous thromboembolism (VTE) is a common and potentially lethal problem. The 2009 Joint Commission has set new goals for the standard of care for all patients with VTE. To our knowledge, no research exists [...]

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Asymptomatic Hypertension in the Hospital: Should It Be Treated?

Background: High Wood pressure (BP) is frequently treated in patients hospitalized for reasons other than hypertension, but there are no evidence based guidelines for the management of asymptomatic high BP not associated with target organ [...]

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Reducing Discharge Times: From Orderto Door

Background: Hospital efficiency and throughput has a great impact on available bed‐days. When hospitals run at high capacity, the need to care for patients in the most efficient manner possible is of paramount importance to [...]

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Creating a Hospitalist Managed Comprehensive Sickle Cell Anemia Program

Background: In 2007 our Department QI Hospital Medicine was responsible lor the care QI more than 90% QI admissions for adults wilh sickle cell anemia (SCA), the majority of which were for sickle cell crisis. [...]

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eTriage — An Innovative Way to Improve the Hospital Admission Process

Background: Emergency department (ED) overcrowding remains a major problem in the United States, leading to ambulance diversions, treatment delays, and patients leaving prior to physician evaluation. In addition, the total number of inpatient hospital beds [...]

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Peripheral T‐Cell Lymphoma and Sutton's Law: The Need for Repeat Biopsies

Case Presentation: Mr. B is a 68‐year‐old man with a history of melanoma and histoplasmosis infection who presented with an enlarged, painful left inguinal lymph node. This dramatically increased in size over 2 months, prompting [...]

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An Abnormal Electrocardiogram That Is Shocking

Case Presentation: Our general medicine consultation service was asked to evaluate a 63‐year‐old woman who was admitted to the psychiatric ward with severe bipolar disorder. She initially presented with catatonia and severe depression. After undergoing [...]

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