Interventions to Prevent Adverse Events and Readmissions After Hospital Discharge: A Systematic Review

Background: Hospitalists are charged with addressing the gaps in transitional care, which manifest as adverse events (AEs) and readmissions after discharge. The Centers for Medicare & Medicaid Services plan to lower reimbursement to hospitals with [...]

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Active Physician Management Position As a Structural Feature to Influence Hospital Outcomes: Effect of an Explicit Physician Director Role in a Longterm Acute Care Unit

Background: Structural measures of hospital quality describe the characteristics of resources, including people, geographic locations, information technology, organizations, and systems of care. Accountable day–to–day management of inpatient unit process and performance represents a potential opportunity [...]

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Compliance with Recommended Contact Isolation Practices

Background: Data suggest that adherence to contact isolation precautions reduces transmission of multi–drug resistant organisms and C. difficile. Compliance with both hand hygiene and contact isolation precautions is suspected to be poor. This study aims [...]

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The Impact of an Electronic Order Set in Reducing Overuse of Proton Pump Inhibitors in the Inpatient Population

Background: Proton pump inhibitors (PPIs) are one of the most commonly prescribed medications. Numerous studies have shown that they are overused during inpatient admissions, despite being linked to an increased rate of pneumonia, Clostridium difficile [...]

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Comparative Effectiveness of Continuous Subcutaneous Insulin Infusion with Multiple Daily Injections Among Pregnant Women with Diabetes Mellitus: A Systematic Review

Background: For pregnant women with pre–existing diabetes, tight glycemic control is recommended to reduce the risk of fetal anomalies, macrosomia, delivery complications, stillbirth, and neonatal hypoglycemia. We performed a systematic review to determine the comparative [...]

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Management of Extended Spectrum Betalactamases Positive Urinary Tract Infections in a Community Hospital. Are There Patient Characteristics That Suggest Risk of Esbl?

Background: ESBLs are extremely broad spectrum Beta–Lactamase enzymes found in a variety of Enterobacteriaceae to include Klebsiella pneumoniae, other Klebsiella species and Escherichia coli (E.Coli). These ESBL–producing bacteria are highly effective at inactivating various Beta–Lactam [...]

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Decreased Use of Bronchodilators with Implementation of Bronchiolitis Clinical Score

Background: The 2006 American Academy of Pediatrics (AAP) management guidelines for bronchiolitis recommends reducing the misuse and over–use of short acting beta agonist bronchodilator therapy for pediatric patients with bronchiolitis. Our institution has participated in [...]

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Deconstructing Morale: The Hospitalist Morale Assessmenta Multisite Analysis

Background: Recruiting new hospitalists is expensive and turnover remains a challenge. Monitoring morale may help leaders improve retention. There are no published instruments that quantify hospitalist morale. Our study describes the Hospitalist Morale Assessment (HMA), [...]

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The Structure of Hospital Medicine Programs at Academic Medical Centers

Background: The growth of academic hospital medicine (AHM) over the past 15 years has been shaped by numerous forces. For leaders of academic hospitalist programs to keep pace, it is useful to understand the factors [...]

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A Knowledgebased Approach to Decreasing Chf Readmisssions Tailored to Individual Patients

Background: Congestive heart failure (CHF) affects nearly 5 million people in US. Thirty day re–hospitalization rate for Medicare beneficiaries hospitalized for congestive heart failure is 27% of which 90% are unplanned. The reimbursement by CMS [...]

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Patient Care Transition to Improve Patient Satisfaction on a Medical Unit

Background: Patient satisfaction is an important quality performance measure directly impacts the reputation of the hospital and long–term financial performance of the hospital. In our hospital, Press–Ganey patient satisfaction scores for medical floors/hospitalists' were in [...]

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The Design, Implementation and Impact of an Internal Medicine Resident Ultrasoundbased Procedure Service

Background: The American Board of Internal Medicine (ABIM) states that Internists who perform procedures must obtain the appropriate training to safely and competently perform that procedure. ABIM also recommends initial training in these procedures be [...]

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Daily Review of Telemetry Orders by Providers Leads to Improved Appropriateness of Use of Telemetry

Background: Christiana Care Health System (CCHS) is a 1100–bed hospital system with all telemetry enabled beds. Continuous cardiac monitoring (CCM) is ordered for a default period of 72 hours at the time of admission on [...]

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Trismus: The Phantom Menace

Case Presentation: A 73–year–old man presented with symptom of locked jaw for one day. On further enquiry, he reported that he suffered an injury to the right leg after stepping on a rusty steel object [...]

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A Spitting Headache

Case Presentation: A 55–year–old man with a history of eosinophilic esophagitis requiring repeated stricture dilations presented to the Emergency Department with headache, fevers, nuchal rigidity, nausea, vomiting, photosensitivity, and myalgias. These symptoms followed a recent [...]

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