Admission Handoffs: A Novel Transition of Care That Leads to Discomfort with Patient Management

Background: Recently adopted resident work hour restrictions from the Accreditation Council for Graduate Medical Education have encouraged separate day and night patient care models. Dividing day and night responsibilities results in "admission handoffs," in which [...]

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The Approach to Clostridium Difficile (C. Difficile) in a Community Hospital, How Do We Compare with Guideline Recommendations

Background: C. difficile is a predominant cause of nosocomial diarrhea. It is most commonly associated with prior antibiotics use, and seen in conjunction with other risk factors such as increasing age, severe underlying illness, impaired [...]

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Indicators of Clinical Stability in Community Acquired Pneumonia: Does the Resolution Sequence Matter?

Background: There are over 500,000 hospitalizations annually for patients with community–acquired pneumonia (CAP). While a great deal of attention has been paid to the diagnosis, assessment of severity, and selection and timing of antimicrobial therapy [...]

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Overutilization of Noninvasive Cardiac Stress Testing Prior to Elective Tka or Tha

Background: Preoperative non–invasive cardiac stress testing (NIT) is generally not indicated for asymptomatic patients undergoing intermediate–risk noncardiac surgery, such as elective total knee arthroplasty (TKA) or total hip arthroplasty (THA). Current guidelines and evidence suggest [...]

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The Prevalence of Obestiy in Asthmatic Preschool Children and the Association Between Asthma and Obesity Among Preschool Children Attending Clinic in a Large Innercity Hospital

Background: Asthma and obesity are chronic conditions with incidences that have increased substantially in the pediatric population in New York City and nationally over the past several decades. According to the New York State Department [...]

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Brainstem Reflex Score: A Novel Method for Early Prognostication in Patients After Outofhospital Cardiac Arrest

Background: Practice Parameters for prognostication after out–of–hospital cardiac arrest, set forth by the American Academy of Neurology, stress the importance of the neurologic exam findings at 72 hours after successful resuscitation. Absent pupillary or corneal [...]

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Impact on Length of Stay and Costs in Patients Admitted to an Observation Unit with Chest Pain, Syncope and Abdominal Pain

Background: Hospitals are focusing more on patient admission status as inpatient or observation due to changes in reimbursement and increased scrutiny from regulatory agencies. Observation units allow for more efficient and appropriate care for patients [...]

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An Evaluation of the Safety and Efficacy of Roflumilast for the Treatment of Chronic Obstructive Pulmonary Disease

Background: COPD is a leading cause of mortality in the US, and COPD exacerbations increase mortality risk, hospitalizations, and healthcare costs, accelerate disease progression, and decrease quality of life. Exacerbations increase in frequency with more [...]

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Development and Use of a Mass Customized Discharge Instruction Template to Standardize and Improve Discharge Instruction Content

Background: Discharging a patient from the hospital is a complex and high–risk task. Patients require clear and understandable instructions from their discharging providers in order to successfully transition from the hospital back to the home [...]

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Hospital Medicine Ipad Trial

Background: With the many workflow changes that the inpatient EHR will require of the clinical staff, the EHR Device Committee determined there was a potential need for a device that is more portable and has [...]

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Application of Clinical Microsystems to Improve Pain Relief in Sickle Cell Disease (Scd) Patients Admitted with Acute Vasoocclusive Crisis

Background: The management of acute vaso–occlusive crisis remains a challenge. Long Island Jewish Medical Center is a 500–adult bed tertiary care facility with more than 500 reported admissions for acute vaso–occlusive crisis in 2009. Suboptimal [...]

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ICU Hospitalist a Novel Method of Care for the Critically Ill Patients in Economically Lean Times

Background: ICU patients account for over 18 million patient days annually in the United States and cost 1 % of GDP. The Leapfrog group recommended that ICU patients be managed exclusively by board–certified intensivists for [...]

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Multidisciplinary Longitudinal Approach to Patients with High Admission Rates

Background: High–volume, high–cost patients pose a challenge to healthcare institutions due to fragmented care, socioeconomic issues,and lack of outpatient resources. Recently, New York's Medicaid program adopted a measure to reduce payment to hospitals with a [...]

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Chronic Hypoxemia with Ataxic Gait

Case Presentation: A 52–year year–old Caucasian female presented with history of wide based ataxic gait for four days. Head CT showed possible pontine stroke, however the MRI was interpreted as normal. Patient denied any dyspnea [...]

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