Teaching Residents Effective Transitions of Care: Examining the Patient Handover from Admission to Discharge

Background: Patient handovers represent vulnerable points in time during a hospitalization. Although changes in the practice of medicine and changes in residency work‐hour restrictions have led to increased patient handovers, training programs have not uniformly [...]

By | 2011-05-10T16:16:22+00:00 May 10th, 2011|Uncategorized|Comments Off on Teaching Residents Effective Transitions of Care: Examining the Patient Handover from Admission to Discharge

Development of a Balanced Scorecard in an Academic Hospitalist Group

Background: Hospitalist groups face increasing pressure to substantiate quality and efficiency of care through performance data. Academic groups are expected to advance the field through scholarly work and provide quality education to students and house [...]

By | 2011-05-10T16:16:22+00:00 May 10th, 2011|Uncategorized|Comments Off on Development of a Balanced Scorecard in an Academic Hospitalist Group

Electronic Documentation of Central Line‐Days; Validation Is Essential

Background: Beginning in January 2011, hospitals will report central line‐associated bloodstream infections (CLABSIs) to the National Healthcare Safety Network (NHSN) per Center for Medicare and Medicaid Services (CMS) payment rules. The NHSN definition of CLABSI [...]

By | 2011-05-10T16:16:22+00:00 May 10th, 2011|Uncategorized|Comments Off on Electronic Documentation of Central Line‐Days; Validation Is Essential

Plenary: Financial Impact of Presenting Lab Cost Data to Providers at the Time of Order Entry: A Randomized Controlled Clinical Trial

Background: Hospital care consumes a large percentage of U.S. health care costs, yet providers practicing in the hospital are often unaware of the actual costs of the diagnostic tests they order. We hypothesized that displaying [...]

By | 2011-05-10T16:16:22+00:00 May 10th, 2011|Uncategorized|Comments Off on Plenary: Financial Impact of Presenting Lab Cost Data to Providers at the Time of Order Entry: A Randomized Controlled Clinical Trial

Icu Bedside Assessments of Delirium: Sustainability and Reliability

Background: Delirium affects 50% of intensive care unit (ICU) patients and is associated with increased mortality and long‐term cognitive impairment. Instruments can accurately measure delirium; however, the sustainability and reliability of delirium measurement tools are [...]

By | 2011-05-10T16:16:22+00:00 May 10th, 2011|Uncategorized|Comments Off on Icu Bedside Assessments of Delirium: Sustainability and Reliability

Evaluation of the Accuracy of Information in Quality Improvement Sedation Forms in Comparison with Medical Charts

Background: Ongoing evaluation of sedation programs and individual physician performance are important elements in a successful sedation program. In our institution, quality improvement (QI) forms are used to track adverse events occurring during procedural sedation. [...]

By | 2011-05-10T16:16:22+00:00 May 10th, 2011|Uncategorized|Comments Off on Evaluation of the Accuracy of Information in Quality Improvement Sedation Forms in Comparison with Medical Charts

Comparison of Postdischarge and Experience Sampling Method Measurement of Pain in Hospitalized Patients

Background: Postdischarge assessments of pain and pain control among recently hospitalized patients are an established element of hospital quality measurement. However, retrospective assessments may not accurately measure pain because patient experience varies over time and [...]

By | 2011-05-10T16:16:22+00:00 May 10th, 2011|Uncategorized|Comments Off on Comparison of Postdischarge and Experience Sampling Method Measurement of Pain in Hospitalized Patients

Absence of Focal Neurological Signs Accurately Excludes Need for Emergent Neurosurgery Among Patients with Nontrauma Neurological Complaints

Background: A large majority of emergency cranial computed tomography (CCT) scans performed in the evaluation of nontrauma neurological complaints neither reveal clinically significant abnormalities nor result in emergent interventions. Over‐utilization of imaging modalities results in [...]

By | 2011-05-10T16:16:22+00:00 May 10th, 2011|Uncategorized|Comments Off on Absence of Focal Neurological Signs Accurately Excludes Need for Emergent Neurosurgery Among Patients with Nontrauma Neurological Complaints

Effects of Hand‐Carried Ultrasound Echocardiography by Hospitalists Among Inpatients Referred for Standard Echocardiography: A Randomized Trial

Background: The projected role of hand‐carried ultrasound echocardiography (HCUE) is not to replace state‐of‐the‐art standard echocardiography (SE) but instead to precede and, in some cases, obviate it with simple and routine assessments by frontline physicians. [...]

By | 2011-05-10T16:16:22+00:00 May 10th, 2011|Uncategorized|Comments Off on Effects of Hand‐Carried Ultrasound Echocardiography by Hospitalists Among Inpatients Referred for Standard Echocardiography: A Randomized Trial

Inappropriate Testing for Urinary Tract Infection in Hospitalized Patients: An Opportunity for Improvement

Background: Urinary tract infection (UTI) is the second most common bacterial infection leading to hospitalization, accounting for 40% of nosocomial infections. Despite the high prevalence of UTI, variability in diagnostic testing and treatment of UTI [...]

By | 2011-05-10T16:16:22+00:00 May 10th, 2011|Uncategorized|Comments Off on Inappropriate Testing for Urinary Tract Infection in Hospitalized Patients: An Opportunity for Improvement

Impact of Hyponatremia on the Readmission Rates of Hospitalized Patients

Background: Readmission rates are becoming an important quality and reimbursement metric in our health care system. Hospitalists are held accountable for patients who require premature readmission. Little is known about the impact of hyponatremia (HN) [...]

By | 2011-05-10T16:16:22+00:00 May 10th, 2011|Uncategorized|Comments Off on Impact of Hyponatremia on the Readmission Rates of Hospitalized Patients

A Multidisciplinary Approach to Reducing Heart Failure Readmissions

Background: Patients hospitalized with congestive heart failure are more likely to be readmitted than any other group. We found our hospital's 30‐day readmission rate for heart failure patients to be 22% for any cause and [...]

By | 2011-05-10T16:16:22+00:00 May 10th, 2011|Uncategorized|Comments Off on A Multidisciplinary Approach to Reducing Heart Failure Readmissions

Hospitalist Screening of Emergency Medicine Triage Decisions Does Not Improve Triage Accuracy

Background: Hospital care accounts for more than 30% of health care expenditures in the United States. In an effort to reduce inappropriate admissions, we implemented hospital medicine attending screening of non–intensive care unit (ICU) medicine [...]

By | 2011-05-10T16:16:22+00:00 May 10th, 2011|Uncategorized|Comments Off on Hospitalist Screening of Emergency Medicine Triage Decisions Does Not Improve Triage Accuracy

Coinfection with Babesiosis and Lyme Disease in a 61‐Year‐Old Woman

Case Presentation: Ms. Y. is a 61‐year‐old salad bar chef with a medical history of dyslipidemia and osteoporosis who was admitted with fever, chills, hot flushes, and extreme fatigue for 2 days. On the day [...]

By | 2011-05-10T16:16:22+00:00 May 10th, 2011|Uncategorized|Comments Off on Coinfection with Babesiosis and Lyme Disease in a 61‐Year‐Old Woman

Cryptococcal Meningitis in an Immunocompetent Patient

Case Presentation: A 38‐year old Ethiopian man with a history of HIV, tuberculosis, and malaria was admitted to our institution for evaluation of progressively altered mental status. The patient immigrated from Ethiopia 2 weeks prior [...]

By | 2011-05-10T16:16:22+00:00 May 10th, 2011|Uncategorized|Comments Off on Cryptococcal Meningitis in an Immunocompetent Patient