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Hospital Obstruction: Reduced Throughput and Increased Cost Associated with Discharge from Step‐Down Units

Background: Step‐down units, also known as transitional care or intermediate care units, are designed to care for patients with needs that fall between the intensive care unit and the general ward. Such units are capable [...]

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From the Bedside to the Boardroom: Development of an Inter Professional Leadership Team

Background: Interprofessional healthcare teams enhance care coordination for individual patients. However, such teams do not typically have a mandate or design which promotes vision‐setting, innovation, or leadership beyond immediate clinical care delivery. Purpose: To describe [...]

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Battling ‘Note Bloat’: An Intervention to Improve Electronic Documentation Accuracy, Readability, and Compliance, While Preserving Provider Efficiency

Background: Hospitalist physicians rely on admission history and physicals and daily progress notes as important tools for communication regarding patient care and compliance with billing and coding requirements. While electronic health records facilitate ease of [...]

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Beyond Hcahps: Exploring the Patient Experience to Inform Improvement Initiatives

Background: Many industries and corporations have adopted user‐centered design methods to drive meaningful improvement in commercial products and customer experience. Healthcare has been slow to follow, relying on superficial quantitative surveys, such as HCAHPS for [...]

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Hospitals and Primary Care Physicians Partnering on Care Transitions: Lessons from a Statewide Multi‐Site Learning Collaborative

Background: Optimizing hospital care transitions continues to be a quality improvement focus for hospitals and hospitalists. As accountability for patient outcomes spreads beyond hospital walls, collaborative partnerships between hospital and community based providers are increasingly [...]

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Interactive Implementation of High Value Care

Background: Questionnaires administered to the house staff has identified a lack of high value care as a suggestion area of improvement for the program. Additionally, the attending staff has identified the practice of high value [...]

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Prenatal Unilateral Testicular Torsion

Case Presentation: A 2‐day‐old male, born at 40 weeks 5 days by emergent caesarean section due to umbilical cord prolapse (Apgar scores 4/9, birth weight 3,740g), was noted to have a right enlarged firm testicle [...]

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A Case of Teenage Weekend Confusion

Case Presentation: A 17‐year old male with a past medical history of psoriatic arthritis presented at the hospital with an acute episode of altered mental status, slurred and slowed speech, tremor, and unsteady gait. This [...]

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Cocaine: One More Cause of Transaminitis in the Thousands

Case Presentation: 51 y/o male with history of hypertension and substance abuse (alcohol, marijuana and tobacco) was found unresponsive lying down in a hotel room by EMS and brought to the Hospital. In the ED [...]

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Retiform Purpura As a Clue to Diagnosis

Case Presentation: A 50 year‐old asplenic man with a history of hypertension presented with four days of nausea, vomiting and diarrhea and one day of lower extremity burning pain and numbness. Two days prior to [...]

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Antibiotics Non‐Responsive Foot Ulcer, Returned Traveller from Bolivia

Case Presentation: My patient was a 64‐year‐old man with no significant past medical history who presented to Emergency department with a progressively worsening right dorsal foot soft tissue infection with a painless ulcer formation over [...]

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Caught in Transit. a Case of Paradoxical Embolism in Patient with a Pfo: The Role of Obstructive Sleep Apnea

Case Presentation: A 54‐year‐old male was hospitalized due to right femur fracture following a fall. Past medical history was significant for OSA, obesity and hypertension. Pelvic Computed Tomography (CT) scan demonstrated acute fractures of right [...]

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Idiopathic Ventricular Tachycardia in Pregnancy

Case Presentation: A 30‐year‐old woman, G7P4115, 14 weeks pregnant came to the ED complaining of heart racing, lightheadedness, and “feeling about to pass out”. Never had these symptoms before, including her multiple previous pregnancies. PMH [...]

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A 45 Year Old Man with Fever, Weight Loss, Anemia and Peripheral Neuropathy

Case Presentation: A 45 year old man presented to our institution after a prolonged unidentified illness. Six months prior to presentation he had been started on atenolol for an “aortic stenosis murmur” and a small [...]

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A Curious Case of Kaposi’s Sarcoma

Case Presentation: AIDS‐related Kaposi’s sarcoma (KS) is an angioproliferative malignancy that typically presents as asymptomatic, hyperpigmented, raised lesions on the skin. The disease is uncommon in individuals with CD4 counts over 200 and less often [...]

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