Background: Systemic corticosteroids are a cornerstone of treatment in acute exacerbations of chronic obstructive pulmonary disease (AECOPD), yet their optimal route of administration is uncertain. Methods: We conducted a retrospective cohort study of patients hospitalized for AECOPD in 2001 at 360 hospitals throughout the United States. Patients were included in our analysis if they were […]

Background: Some clinicians may fear that disclosing adverse events (AEs) to patients will result in malpractice claims and undermine patients' perceptions of health care quality. However, little is known about hospital and patient characteristics associated with disclosure of hospital adverse events and the effect of disclosure on patients' ratings of their quality of care during […]

Background: Hand‐carried ultrasound echocardiography (HCUE) rivals the image quality and advanced capabilities of standard echocardiography (SE) but offers more portability at less cost. Though not a substitute for comprehensive SE when needed, focused HCUE can supplement cardiac exams and has the potential to help nonechocardiographers answer well‐defined questions at patients' bedsides in under 15 minutes. […]

Background: The preoperative combined risk of myocardial infarction (MI) and mortality following orthopedic surgeries is <5% (2007 ACC/AHA Perioperative Guideline). Very little is known about incidence of MI specifically following urgent hip fracture repair. Methods: The study was a population‐based retrospective cohort of 1195 patients who had hip fracture repair in Olmsted County, Minnesota, between […]

Background: Congestive heart failure remains the leading admission diagnosis in patients more than 65 years old. The treatment of these patients varies and dependent on each clinician's experience. Currently, there are not significant data reflecting the value of serial BNP monitoring in hospitalized CHF patients. Methods: This study included 24 patients in a prospective descriptive […]

Background: Hospitals are initiating new processes of care to improve compliance with CMS quality measures, often integrating electronic reminders into existing systems of care. Category P is an electronic and paper‐based algorithm to improve timing to antibiotics in the emergency department (ED) for adults with community‐acquired pneumonia (CAP). Electronic cues signal staff to place a […]

Background: Hospital‐acquired venous thromboembolism (HA VTE) is a common source of morbidity/mortality. Proven prophylactic methods are underutilized. Available risk assessment models are not prospectively validated. Methods: Participants in the study were adult inpatients on all services (excluding OB/Psych) of a 325‐bed university hospital. IRB approval was obtained. We built consensus for a simple 3‐tier VTE […]

Background: Anticoagulation with warfarin in the hospital has many challenges, including a narrow therapeutic range, variable metabolism, and drug‐related interactions. These factors, combined with illness and the complexities of hospitalization, have the potential for significant morbidity and mortality because of sub‐ and supratherapeutic effects related to warfarin dosing. The Joint Commission has made the reduction […]

Background: According to the 2007 guidelines from the Infectious Diseases Society of America and the American Thoracic Society, adult patients with community‐acquired pneumonia (CAP) should be treated for a minimum of 5 days, have no more than 1 CAP‐associated sign of clinical instability, and remain afebrile for 48‐72 hours. However, some studies have shown that […]

Background: Medication abbreviation errors account for a substantial proportion of total medication errors. National regulatory organizations have prohibited the use of certain commonly misinterpreted medication abbreviations in an effort to improve patient safety, yet physician compliance with this regulation has been poor. Educational interventions directed at physicians in training may be more successful in reducing […]