Background: Although one fourth of Medicare dollars are spent during the last year of life, more than half of terminal hospitalized patients have inadequate symptom control. End‐of‐life care in hospitals is associated with uncomfortable physicians, high cost, and poor symptom control. Hospitalists are strategically positioned to address this issue, both through patient care and resident […]

Background: A recent study published in the New England Journal of Medicine showed that hospitalists only modestly reduced length of stay and observed costs. This is a finding different from that observed in prior studies. Our study aim was to compare length of stay (LOS), readmission rate, mortality rate, and observed costs between hospitalist service […]

Background: In August 2007, the FDA issued a labeling change for warfarin emphasizing the “opportunity for healthcare providers to use genetic tests to improve their initial estimate“ of warfarin dosing. This is the first FDA recommendation to consider genetic testing when initiating a commonly prescribed medication and may set a precedent for the future use […]

Background: Ethnicity has been noted to have many effects on the delivery of health care. Race has been demonstrated as a factor in the appropriate treatment of many illnesses, a marker for access to care, and an important component of disease outcomes. Although many individual diagnoses have been examined for the effect of race, no […]

Background: Early goal‐directed therapy (EGDT) for severe sepsis or septic shock requires placement of a central venous catheter (CVC) to measure central venous pressure (CVP), with the aim of maintaining CVP ≥ 8‐12 mm Hg. This requirement may delay timely resuscitation, possibly leading to worse patient outcomes, and places the patient at risk for complications related to […]

Background: Patients are at high risk for adverse events following hospital discharge. A discharge summary (DCS) helps to prevent such events but is rarely available to primary care physicians (PCPs) at follow‐up; at our institution, patients often follow up within a day of discharge, whereas internal medicine residents take a mean of 3.0 (July 2007) […]

Background: Although it is widely recognized that type II diabetes (DM) is associated with diastolic dysfunction (DD), and despite increasing evidence that diabetic lung disease is more prevalent than generally recognized, it is unknown which one of these factors contributes more to dyspnea in diabetic patients. Methods: We reviewed medical records for all adult patients […]

Background: Concern for patient safety and efficient throughput has been the impetus for the development of many initiatives aimed at improving hospital processes. It is our hypothesis that the traditional assignment of patients may adversely affect outcomes by interfering with teamwork between hospitalists, nurses, and consultants. Our hospital (450‐bed teaching institution) has implemented a partial […]

Background: There has been little work on the impact of hospitalist involvement in short‐stay or observation units. In August 2005, the University Hospital consolidated the care of medical observation patients onto a hospitalist‐run, nonteaching “clinical decision unit“ (CDU), a separate 10‐bed, 23‐hour observation unit. The rationale was that the care of patients in a dedicated […]

Background: Hospitalists are frequently the primary providers of inpatient stroke care despite an underemphasis on neurology in traditional internal medicine training. Treatment attitudes and practices of hospitalists pertaining to stroke are unclear. Methods: A survey was developed focusing on 3 areas of stroke care: (1) relationships between hospitalists and neurologists, (2) views on both intravenous […]