Mental Illness and Substance Abuse Increase Risk for Preventable Hospital Readmission

Background: Readmissions after hospital discharge are a common and costly occurrence in our health care system. Published models describing risk factors for hospital readmission inadequately stratify low–risk and high–risk patients. Patients with psychiatric illness or [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Mental Illness and Substance Abuse Increase Risk for Preventable Hospital Readmission

Evolution of Endoflife Care at United States Hospitals in the New Millennium

Background: The use of hospice care has increased in the United States over the past decade. However, data for hospitalizations preceding hospice remains sparse. The objective of this study is to examine the clinical and [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Evolution of Endoflife Care at United States Hospitals in the New Millennium

Comparison of Manual Abstraction to Data Warehouse Facilitated Abstraction for Identifying Hospital Adverse Events

Background: Research suggests the optimal method for identifying hospital adverse events (AEs) is a two stage approach using manual chart abstraction. First, clinicians abstract the entire medical record to identify potential AEs using screening criteria. [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Comparison of Manual Abstraction to Data Warehouse Facilitated Abstraction for Identifying Hospital Adverse Events

Veterans Administration Acute Care 30Day Mortality Model: Development, Validation, and Performance Variation

Background: Hospital performance measurement efforts often use risk adjusted mortality data. Most existing risk models use administrative data and are disease specific. Importantly, administrative data models increase chances for measurement bias whereas disease specific models [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Veterans Administration Acute Care 30Day Mortality Model: Development, Validation, and Performance Variation

Simulationbased Education Improves Clinical Knowledge and Confidence in Management of Common Urgent Inpatient Conditions

Background: Simulation–based training has been extensively evaluated in non–medical disciplines, and has been shown to have value in procedure–based medical education. However, fewer data are available with respect to the role of simulation in teaching [...]

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Care Pathway Disparities in Patients with Cocaine Induced Myocardial Infarction: A Preliminary Report from the Cpac Study Group

Background: Cocaine is a well known risk factor for the development of early atherosclerosis and myocardial infarction (MI). Several studies in the medical literature have reported the increasing incidence of cocaine use in the American [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Care Pathway Disparities in Patients with Cocaine Induced Myocardial Infarction: A Preliminary Report from the Cpac Study Group

The Modified Wells Score Accurately Excludes Acute Pulmonary Embolism in Patients with an Inr of = 2 on Warfarin

Background: The incidence of new or recurrent acute pulmonary embolism in patients on warfarin with an INR of = 2 is unknown. Also, the utility of using a modified Wells score in diagnosing acute pulmonary [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on The Modified Wells Score Accurately Excludes Acute Pulmonary Embolism in Patients with an Inr of = 2 on Warfarin

Effect of Roflumilast Treatment on Dyspnea in Patients with Chronic Obstructive Pulmonary Disease

Background: Roflumilast, a once–daily oral selective phosphodiesterase–4 inhibitor, has been shown to reduce the risk of chronic obstructive pulmonary disease (COPD) exacerbations in patients with severe COPD associated with chronic bronchitis and a history of [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Effect of Roflumilast Treatment on Dyspnea in Patients with Chronic Obstructive Pulmonary Disease

Standardization of Discharge Documentation to Post Acute Care (Pac) Facilities R Shaaban, Do, P Owusugriffin, Md Baystate Medical Center

Background: Hospital discharge documentation are the primary documents communicating a patient's care plan to the post–hospital care team. Usually, it is the only form of communication that accompanies a patient to the next setting of [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Standardization of Discharge Documentation to Post Acute Care (Pac) Facilities R Shaaban, Do, P Owusugriffin, Md Baystate Medical Center

Rn and Md Communication: A Lean Performance Improvement Project at Baystate Medical Center

Background: Communication between hospitalists and nurses can lead to frustration on both sides when it is fragmented, incomplete and complicates patient care. As part of a year long LEAN project at our institution to improve [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Rn and Md Communication: A Lean Performance Improvement Project at Baystate Medical Center

Hospitalist Management of Vasoocclusive Pain Crisis

Background: Sickle cell vaso–occlusive pain crises (VOC) are associated with considerable morbidity and mortality, prolonged hospital stays and significant resource utilization. Suboptimal treatment of pain during VOC is associated with increased morbidity and mortality. Standardized [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Hospitalist Management of Vasoocclusive Pain Crisis

Accountable Care Unit on a Medical Ward in a Teaching Hospital: A New Care Model Designed to Improve Patient and Hospital Outcomes

Background: Properly designed, hospital units have potential to optimize outcomes for patients, staff, and trainees. Such units would be of great value if they converge high high–performing teams with active management while promoting principles of [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Accountable Care Unit on a Medical Ward in a Teaching Hospital: A New Care Model Designed to Improve Patient and Hospital Outcomes

Hospitalist As Medical Director of a Telemedicine Supported Stroke Center: Identifying Key Roles for Success

Background: Approximately 795,000 strokes occur each year in the United States; Stroke is a leading cause of death nationally and remains the leading cause of long–term disability. Only ten percent of the hospitals in the [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Hospitalist As Medical Director of a Telemedicine Supported Stroke Center: Identifying Key Roles for Success

Put a Leash on It Severe Sepsis and Shock Following Canine Attack

Case Presentation: A 28–year–old man presented with a 4–day history of progressively worsening left calf pain and swelling that began after he was bitten by a dog. He also complained of fevers and rigors. Initial [...]

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Congestive Heart Failure: When a Compact Differential Falls Short

Case Presentation: A 63–year–old man presented with four 4 days of palpitations, progressive dyspnea on exertion, and orthopnea. He denied chest pain, cough, or fever. He had no personal history of arrhythmia or ischemic heart [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Congestive Heart Failure: When a Compact Differential Falls Short