Characteristics of a Frequently Readmitted Patient Population on an Inpatient Medical Service

Background: Patients frequently admitted to the hospital use a disproportionate amount of healthcare resources. However, scant information exists about the clinical and social characteristics of this population, as well as the quality of their transitions [...]

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Hospitalistpharmacist Collaborative at a Regional Cancer Center Decreases Hospital Acquired Vte Events

Background: According to the guidelines of the American Society of Chest Physicians, medical, and surgical oncology patients continue to be at increased risk for venous thromboembolic events (VTE). Undiagnosed and untreated pulmonary embolism is a [...]

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Identifying Predictors of a Safe Attending Physician Workload: Results from a Survey of an Online Community of Hospitalists

Background: We examined the relationship between workload and patient safety via a survey of an online community of Hospitalists. This analysis examines the predictors of providers reporting an "unsafe" workload, identifying potential targets for quality [...]

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Treatment of Positive Urine Cultures in Hospitalized Patients: A Driver of Antimicrobial Misuse

Background: Obtaining a urine culture in hospitalized patients is extremely common. Positive cultures frequently trigger antimicrobial therapy, but the appropriateness of this treatment remains unclear. We sought to describe physician management of positive urine cultures [...]

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Validation of a Predictive Rule for Severe Acute Lower Intestinal Bleeding

Background: Acute lower gastrointestinal bleeding (LGIB) accounts for about 30 percent of episodes of gastrointestinal bleeding. It encompasses a wide spectrum of symptoms ranging from trivial hematochezia to massive hemorrhage with shock. Identifying those who [...]

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Effect of Patient Preference in Medical Decision Making on Inpatient Care

Background: Patients with a higher level of education, more access to medical information, and generous health insurance coverage may be more likely to participate in their medical decision making process. However, few studies directly measure [...]

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Hospital Variation in Use of Postoperative Medicine Consultations

Background: Medicare payments around episodes of inpatient surgery vary as much as 40–70% across hospitals. Although such variation is attributable to multiple factors, differential use of physician services is one key component. In this context, [...]

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Dronedaroneinduced Henochschonlein Purpura

Background: Dronedarone is an antiarrhythmic drug approved by the FDA in 2009.Small–vessel vasculitis has not been previously reported in association with dronedarone.Methods: 71 year old male was admitted with 1 week history of generalized skin [...]

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Experience Using an Electronic Medical Record (Emr) to Improve Communication Around the Time of Interhospital Transfer

Background: Inter–hospital transfer (IHT) is a high–risk transition of care that often involves patients with complex and worsening medical problems. Ineffective hand–offs between providers may contribute to errors and adverse events during IHTs. Even within [...]

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Impact of Employing College Students to Make Limited Postdischarge Phone Calls for Hospitalists

Background: Hospital discharge represents a "voltage drop" in care that can lead to unexpected problems including costly readmission. Post–discharge phone calling is a strategy advocated by national and local organizations to improve the quality of [...]

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Improving the Inpatient Management of Neonatal Jaundice: Followup from Year 1

Background: Neonatal jaundice is a common condition that can result in acute bilirubin encephalopathy if not treated appropriately. Despite evidence–based guidelines for monitoring and treating hyperbilirubinemia, variation in care persists. Previously published quality improvement efforts [...]

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Embedding the Concepts of Waste and Systems Failure Reduction in an Innovative Quality Curriculum for Resident Education

Background: Integrating healthcare quality into the Internal Medicine resident training curriculum has been a focus of our institution's Educational Innovations Program of the ACGME. Five years ago, at Baystate Medical Center we began a PGY2 [...]

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Developement of Medical Simulation Training for Practicing Hospitalists: Fundamentals of Implementation

Background: Medical simulation training has rapidly emerged as an effective model of clinical skill development. A validated educational approach, this technique allows practitioners the ability to gain proficiency and confidence in ongoing professional practices such [...]

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Ayurvedic Remedy for Diabetes As a Cause of Lead Poisoningcase Report

Case Presentation: We present a 56–year–old male, who came to the emergency room with diffuse abdominal pain, decreased oral intake and constipation. Laboratory values showed that hemoglobin had dropped to 9.7 grams per deciliter (from [...]

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