Background: Children with leukemia, cancer, and chronic anemia require a Central Venous Catheter (CVC) for administration of medications and blood products. Because of the need for frequent access, CVCs are susceptible to a high incidence of complications. In Hurley Medical Center, all pediatric oncology and hematology patients with CVCs are cared for by a limited [...]

Background: Pediatric Hospital Medicine (PHM) has grown rapidly over the last 15 years. Previous studies of PHM work focused on reports from group leaders. To date, there is no published report describing job tasks and worklife from a large cohort of practicing pediatric hospitalists. Our objective was to describe Pediatric Hospitalist worklife. Methods: The AAP [...]

Background: It is common for total parenteral nutrition (TPN) bags for children to be custom made, starting with a base dextrose solution and then amino acids (AA) and other nutrients added. This process allows for precise delivery of individualized specific content to each patient. However, each additive presents an opportunity for error or microbial contamination [...]

Background: Children undergo painful procedures in hospitals and deserve appropriate procedural sedation (PS). Pediatric hospitalists (PH) are increasingly providing PS. We hypothesize that variability in PS practices impact resource utilization and patient care and that in hospitals where PH provides sedation, the sedations needs of children are better met and that sedation is provided with [...]

Background: Pulmonary embolism (PE) is a common complication after orthopedic surgery. As symptoms are variable and may be absent, decisions regarding which post‐surgical patients to evaluate with CT pulmonary angiography (CTPA) may not be straightforward. Clinical prediction tools, such as the Wells score, have not been validated for risk stratification in this population. D‐dimer is [...]

Background: The use of novel oral anticoagulants (NOACs) such as dabigatran and rivaroxaban has been rapidly increasing. However, there is limited experience with the periprocedural management of these agents, and uncertainty about the safety of NOACs in the setting of high risk procedures (such as neuraxial anesthesia) or renal insufficiency. The objective of our study [...]

Background: Handoffs have received increased scrutiny due to changes in ACGME guidelines for resident work hours. Studies have shown that a combination of standardized written format and face‐to‐face modalities are ideal for facilitating the handoff process. Few studies have used validated tools to critically evaluate face‐to‐face and written handoff systems after their integration in inpatient [...]

Background: Transitions of care between the inpatient ward and outpatient primary care setting are an essential process in ensuring quality patient care. One of the most important aspects of this process is communication between the discharging and accepting physician upon discharge. The quality of this communication is heavily dependent on the discharge summary, as often [...]

Background: Acute decompensated heart failure (ADHF) that develops during hospitalization is a potentially preventable problem that has not been well studied. A significant proportion of ADHF cases during hospitalization has been attributed to intravenous fluid hydration(25.5% in one study). Our purpose is to estimate the incidence of ADHF that develop during hospitalization in hospitalized medical [...]

Background: Hospital mortality rates are frequently used as indicators of quality. Patients undergoing inter‐hospital transfer represent a unique subset of patients that contribute to hospitals’ overall mortality rates. Factors associated with mortality rates following inter‐hospital transfer have not been clearly delineated. Methods: We conducted a cross sectional study of 104 academic medical centers (AMC) that [...]