Background: Measuring the quality of hospital care for elderly patients is important since elderly patients are at risk for certain hospital‐related hazards, such as delirium. The Assessing Care of the Vulnerable Elders (ACOVE) Project has developed quality indicators (QIs), that have been endorsed for use in pay‐for‐performance (P4P) programs, to measure the quality of care […]

Background: The healthcare marketplace has changed substantially since the last assessment of demand for internal medicine physicians in 1996. Method: We reviewed internal medicine employment advertisements published in 4 major medical journals between 1996 and 2004. The number of positions, specialty, and other practice characteristics (e.g., location) were collected from each advertisement. We then used […]

Background: The use of perioperative beta‐blockers improves outcomes after surgery. Recent studies have shown promising preliminary results suggesting perioperative statins may also benefit patients. We sought to ascertain if the use of these drugs was associated with a reduction in mortality after surgery. Method: We conducted a retrospective cohort study of patients presenting for vascular […]

Background: Sign‐out, the transfer of patient information and responsibility to a cross‐coverage physician, is a necessary component of caring for hospitalized patients. The number of sign‐outs in training hospitals has increased with the Accreditation Council for Graduate Medical Education's duty hours limitations. Residents commonly use written or computerized mechanisms to track patient information, and little […]

Background: Hospitalized patients frequently show signs of clinical instability several hours before experiencing cardiac arrest or being transferred to the intensive care unit (ICU); earlier intervention and assessment might prevent adverse outcomes. This study examined whether communication barriers between nurses and physicians contribute to delays in care of clinically unstable patients on general inpatient wards […]

Background: Despite some literature on the evolution of the “scheduled discharges”, many hospital administrations and outcomes management teams perceive afternoon discharges as opportunities to improve. We challenged that concept with a hypothesis that afternoon discharges would be a sign of an efficient hospitalist program and that we would find specific barriers to the discharge process. […]

Background: The impact of parental smoking on children is enormous. Injury and illness related to parental smoking result in 6200 excess pediatric deaths per year in the US, which places smoking as the leading preventable cause of death in children. Parental smoking doubles the risk of child hospitalization for respiratory illness, therefore the pediatric hospitalist […]

Background: We previously reported on the deployment of a computerized note‐writing system, eNote on our Hospitalist Service.[1] Since its launch in February 2004, over 25,000 Hospitalist notes have been entered via eNote. Since our last report, we also developed a module in eNote for discharge summaries (DSUM Writer).[2] These documentation tools support a variety of […]

Background: Hospital throughput, which is defined as the volume of services provided in a unit time, may be targeted for quality improvement as a means of facilitating better utilization of existing inpatient bed capacity, expediting turnover, discharges, and reducing length of stay. We sought to identify factors associated with delays in hospital throughput at an […]

Background: Recent limitations on resident duty hours aim, in part, to reduce medical errors. Residents' perceptions of the impact of decreased hours on errors are unknown. Method: We surveyed internal medicine residents at the University of California, San Francisco after duty hours were reduced. Residents were asked to report the frequency and causes of sub‐optimal […]