Background: A recent focus on reducing rehospitalizations is motivated by the mandate to improve medical and surgical hospital care quality, and internists are increasingly involved in improving the care of surgical patients. However, little is known from the patients' perspective about the experience of postdischarge care and the causes of rehospitalization after elective surgery. Methods: […]

Case Presentation: A 68‐year‐old woman presented to the ER with 3 weeks of increased forgetfulness, confusion, headache, unsteady gait, and abdominal pain. Her medical history was significant for hypertension, depression, breast cancer, and endometrial cancer (the latter 2 both surgically resected). Current medications included losartan, escitalopram, lorazepam, pantoprazole, and up to 3 g of calcium […]

Case Presentation: A 69‐year‐old man presented with 1 week of shortness of breath associated with lower‐extremity and scrotal edema. He had elevated JVP and distended external jugular veins, an enlarged liver, and bilateral leg edema. Lung sounds were diminished at bases. White blood count was normal. Hemoglobin was 11.6 g/dL and creatinine was 3.1 mg/dL […]

Case Presentation: A 59‐year‐old otherwise healthy man initially developed mood changes 6 months prior to admission. Over the ensuing months, the patient developed decreased executive cognitive function and was noted to have difficulty walking. These symptoms rapidly worsened to the point that he could not complete his activities of daily living, and 2 weeks prior […]

Background: Defensive medicine is an unwanted side effect of the medical liability system that happens when physicians order clinically unnecessary treatment or diagnostic procedures to reduce medical liability risk. As a result, defensive medicine not only causes overutilization but also undermines patient safety. However, relatively little is known about defensive practices in the inpatient setting. […]

Background: Information on the types and causes of medical malpractice claims may help to reduce legal malpractice risk and inform patient safety efforts. Research has shown that the most common medical malpractice allegations include missed and delayed diagnoses and medication‐ and treatment‐related injuries and that an estimated 22%–56% of claims receive payment. However, no published […]

Background: Recommendations regarding administering or withholding angiotensin axis blockade (AAB) prior to orthopedic surgery are not clearly defined in the current literature. Patients presenting for surgery with AAB with either angiotensin‐converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) have an increased incidence of perioperative hypotension. The purpose of this study was to evaluate the […]

Background: ACC/AHA Appropriate Use Criteria recommend performing stress myocardial perfusion imaging (MPI) for intermediate‐ to high‐risk patients presenting with syncope (level A7), but not for low‐risk patients (level I3). However, there are limited data to support this recommendation. We investigated the yield and diagnostic utility of stress MPI for patients without a diagnosis of coronary […]

Background: How and why primary care providers (PCPs) adopt the hospitalist model is not well defined. We sought to characterize the patterns by which PCPs transition from personally caring for their hospitalized patients to referring them to hospitalists. We also examined PCP and patient factors that are associated with adopting the hospitalist model. Methods: We […]

Background: Reducing readmissions increasingly captures the attention of hospitals, yet little data exist supporting effective hospital strategies. Project BOOST (Better Outcomes by Optimizing Safe Transitions) is a patient‐centered multicomponent intervention created to enhance the hospital discharge transition. Integration of BOOST tools into the discharge process at a hospital is facilitated by physician‐mentored implementation (PMI) to […]