To learn more about this meeting, visit https://shmannualconference.org/

ALL STARS ALLIGNED – HEPARIN INDUCED THROMBOCYTOPENIA AND THROMBOSIS LEADING TO STROKE AND BILATERAL ADRENAL HEMORRHAGES IN A MALE WITH AN UNDIAGNOSED PATENT FORAMEN OVALE.

Case Presentation: 65 year old male presented to the ED with acute abdominal pain, nausea and vomiting. 10 days prior, he underwent left total knee replacement and was discharged home on low molecular weight heparin. [...]

By | 2019-03-18T17:52:53+00:00 March 18th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on ALL STARS ALLIGNED – HEPARIN INDUCED THROMBOCYTOPENIA AND THROMBOSIS LEADING TO STROKE AND BILATERAL ADRENAL HEMORRHAGES IN A MALE WITH AN UNDIAGNOSED PATENT FORAMEN OVALE.

A RENDEZVOUS IN THE FRENCH QUARTER – INTERNAL BILIARY DRAINAGE FOR BILIARY STRICTURES DUE TO PANCREAS DIVISUM CHRONIC PANCREATITIS

Case Presentation: A 51-year-old gentleman with a history of chronic pancreatitis likely secondary to alcohol, presented with two to three weeks of nonspecific right sided abdominal pain and jaundice. On his initial admission his total [...]

By | 2019-03-18T17:51:26+00:00 March 18th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A RENDEZVOUS IN THE FRENCH QUARTER – INTERNAL BILIARY DRAINAGE FOR BILIARY STRICTURES DUE TO PANCREAS DIVISUM CHRONIC PANCREATITIS

A CASE OF ERYTHEMA NODOSUM – HOW TO RESIST THE MILLION-DOLLAR WORKUP

Case Presentation: A 53-year-old female with a history of mild pancytopenia presented to the ED with fatigue, chills, decreased appetite, myalgias, non-productive cough, and a frontal headache that began 3 days prior. Shortly after symptom [...]

By | 2019-03-18T17:50:40+00:00 March 18th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A CASE OF ERYTHEMA NODOSUM – HOW TO RESIST THE MILLION-DOLLAR WORKUP

CEFEPIME ENCEPHALOPATHY VS. UREMIC ENCEPHALOPATHY – A DIAGNOSTIC CHALLENGE IN ACUTE RENAL FAILURE ON PROLONGED ANTIBIOTIC THERAPY

Case Presentation: A 69 year old male was brought to the emergency department from a rehabilitation facility with altered mental status. Two months ago, he had been admitted for lumbar osteomyelitis for which he was [...]

By | 2019-03-18T17:53:12+00:00 March 18th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on CEFEPIME ENCEPHALOPATHY VS. UREMIC ENCEPHALOPATHY – A DIAGNOSTIC CHALLENGE IN ACUTE RENAL FAILURE ON PROLONGED ANTIBIOTIC THERAPY

LEVAMISOLE ADULTERATED COCAINE INDUCED DIFFUSE SKIN NECROSIS – AN EMERGING CONCERN AND A DIAGNOSTIC CHALLENGE

Case Presentation: 29 y.o. female with a history of autoimmune hepatitis presented with worsening lower extremities ulceration. The onset of rash was four months ago during which she visited dermatology clinic. Vitals signs were within [...]

By | 2019-03-18T17:58:24+00:00 March 18th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on LEVAMISOLE ADULTERATED COCAINE INDUCED DIFFUSE SKIN NECROSIS – AN EMERGING CONCERN AND A DIAGNOSTIC CHALLENGE

A TALE OF TWO CITIES … DIVIDED BY A GEOPOLITICAL BORDER

Case Presentation: The logistical complexity of hospital-to-hospital transfer of care in the United States is well-documented. However, little is known about the processes involved in cross-border hospital transfer. This case illustrates the challenges and complexities [...]

By | 2019-03-18T18:55:25+00:00 March 18th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A TALE OF TWO CITIES … DIVIDED BY A GEOPOLITICAL BORDER

A STORM IS BREWING – THE LIFE-THREATENING POWER OF OUR IMMUNE SYSTEM

Case Presentation: A 70-year-old man with PMH of chronic lymphocytic leukemia (with good hematologic response to Ibrutinib, stopped three months ago due to persistent fevers of unknown etiology), nephrolithiasis (with recent ureteral stent placement), presented [...]

By | 2019-03-18T17:52:00+00:00 March 18th, 2019|Adult, Clinical Vignettes, Hospital Medicine 2019|Comments Off on A STORM IS BREWING – THE LIFE-THREATENING POWER OF OUR IMMUNE SYSTEM

CHOOSING WISELY: “INPATIENT THYROID FUNCTION TESTING – A COST-EFFECTIVENESS ANALYSIS”

Background: In the US, thyroid stimulating hormone (TSH) is the 4th most commonly ordered laboratory test with thyroxine measurement being the 10th commonest. In 2016, Medicare alone spent $482 million on 21.5 million performed TSH [...]

By | 2019-03-18T17:43:29+00:00 March 18th, 2019|Hospital Medicine 2019, Research, Value in Hospital Medicine|Comments Off on CHOOSING WISELY: “INPATIENT THYROID FUNCTION TESTING – A COST-EFFECTIVENESS ANALYSIS”

THE GLYCEMIC CONTROL CLINICAL ANDON BOARD – A PUBLICLY DISPLAYED, REAL-TIME, ALGORITHM DRIVEN SIGNAL TO PROMOTE EVIDENCE BASED INSULIN PRESCRIBING PRACTICES

Background: Diabetes is common, present in up to one third of hospitalized patients and up to 50% of critically ill patients. Studies have shown that hyperglycemia among hospitalized patients leads to worse clinical outcomes and [...]

By | 2019-03-18T17:59:15+00:00 March 18th, 2019|Hospital Medicine 2019, Innovations, Technology in Hospital Medicine|Comments Off on THE GLYCEMIC CONTROL CLINICAL ANDON BOARD – A PUBLICLY DISPLAYED, REAL-TIME, ALGORITHM DRIVEN SIGNAL TO PROMOTE EVIDENCE BASED INSULIN PRESCRIBING PRACTICES

ENSURING JUDICIOUS PPI USE THROUGH AN ACTIVE SURVEILLANCE STRATEGY OF WITHDRAWAL AND DOSE – REDUCTION IN INPATIENTS IS SAFE AND STABLE OVER 90 DAYS POST-DISCHARGE

Background: Proton pump inhibitors (PPI’s) are a commonly used class of medications, whose optimal use is important. Aim: To assess if proactive surveillance in inpatients can reduce PPI use for unapproved indications and their effect [...]

By | 2019-03-18T17:55:17+00:00 March 18th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on ENSURING JUDICIOUS PPI USE THROUGH AN ACTIVE SURVEILLANCE STRATEGY OF WITHDRAWAL AND DOSE – REDUCTION IN INPATIENTS IS SAFE AND STABLE OVER 90 DAYS POST-DISCHARGE

UTILIZING HIGH VALUE CARE – REDUCING INPATIENT PHLEBOTOMY WITH USE OF THE VETERAN’S AFFAIRS NATIONAL UTILIZATION MANAGEMENT DATABASE

Background: The Society of Hospital Medicine (SHM) identifies repetitive CBC & chemistry testing as low-value, and they selected this as a Choosing Wisely Recommendation. Overuse of phlebotomy is associated with hospital-acquired anemia, decreased patient satisfaction [...]

By | 2019-03-18T18:00:19+00:00 March 18th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on UTILIZING HIGH VALUE CARE – REDUCING INPATIENT PHLEBOTOMY WITH USE OF THE VETERAN’S AFFAIRS NATIONAL UTILIZATION MANAGEMENT DATABASE

DOES EHR EFFICIENCY AFFECT QUALITY OF CARE FOR HOSPITAL MEDICINE PHYSICIANS?

Background: Hospitalists balance efficiency and quality in their daily practice. How a physician’s time management affects care quality is unknown. Accordingly, we aimed to compare the EHR efficiency of hospitalists, as measured by their time [...]

By | 2019-03-18T17:55:39+00:00 March 18th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on DOES EHR EFFICIENCY AFFECT QUALITY OF CARE FOR HOSPITAL MEDICINE PHYSICIANS?

PATIENTS’ PERSPECTIVES ON WHITEBOARDS AS BEDSIDE VISUAL TOOLS TO ENHANCE COMMUNICATION – A MIXED METHODS STUDY

Background: Inpatient bedside whiteboards enhance patient-provider communication and satisfaction with care, but little is known about patients’ perspectives on the whiteboards. Our objectives were to understand patients’ views on the usability and design/content of these [...]

By | 2019-03-18T17:58:54+00:00 March 18th, 2019|Hospital Medicine 2019, Quality Improvement, Research|Comments Off on PATIENTS’ PERSPECTIVES ON WHITEBOARDS AS BEDSIDE VISUAL TOOLS TO ENHANCE COMMUNICATION – A MIXED METHODS STUDY