Background: Venous thromboembolism (VTE) is a preventable and potentially fatal condition for which hospitalized medical patients are at risk. Compared with the more traditional option of unfractionated heparin, low molecular weight heparin (LMWH) has been shown to be superior for VTE prophylaxis with regard to both efficacy and bleeding risk, and to have a lower [...]

Background: In shared decision making models, decisional conflict is a measure of uncertainty and readiness and comfort level in making a decision. The literature examining decisional conflict is currently relatively immature. The act of a patient being readmitted is, in part, an effect of multiple small decisions a patient makes in the time between index [...]

Background: Clearly documented patient preferences for treatment at the end-of-life may help inform clinical decision-making during future hospitalizations. The electronic health record (EHR) could facilitate easier access to this information. However, little is known about current documentation practices regarding advanced care planning in the EHR. The objective of this study was to determine the prevalence [...]

Background: The Center for Disease Control (CDC) and US Preventative Services Task force recommend screening of all females younger than 25 years annually. The CDC estimates about 20 million cases of sexually transmitted infections (STIs) diagnosed annually in the United States. Adolescents carry majority of burden. The most common complication of untreated Chlamydia is pelvic [...]

Background: Little is known about the economic value of quality improvement (QI) interventions, including those related to central-line-associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI). Methods: We searched MEDLINE, Econlit, the Centre for Reviews & Dissemination Economic Evaluations, Greylit, and Worldcat from January 1, 2004 to May 15, 2015; examined lists of references; [...]

Background: Curbing antibiotic overutilization has become a priority in hospitals attempting to address the growing problem of antimicrobial resistance.  One strategy being endorsed by Antibiotic Stewardship Programs is the adoption of an “antibiotic timeout,” during which the pharmacist reviews the appropriateness of the regimen every 72 hours.  We elected to challenge hospitalists to perform a [...]

Background: Code Blue events, or in-hospital patient emergencies, often require advanced cardiac life support (ACLS) and unfortunately can end in loss of life. Defining and measuring outcomes is an essential step for improvement in any process, but especially for a process as critical as Code Blues.  In our institution, Code Blues are run by a [...]

Background: UGIB is a common cause of inpatient admissions often associated with morbidity and an overall mortality rate approaching 10%. Since therapy is different, it is important to differentiate between variceal and non-variceal GI bleeding. While both will often need volume resuscitation, proton pump inhibitors (PPI), judicious transfusion and early endoscopy, patients with variceal bleeding [...]

Background: Current guidelines and most experts recommend pharmacologic venous thromboembolism (VTE) prophylaxis for patients hospitalized with an acute inflammatory bowel disease (IBD) exacerbation.  Quality measures of physician performance further expand this mandate to include patients with a diagnosis of IBD who are hospitalized for any reason. We sought to assess the risk of VTE in [...]

Background: Healthcare costs continue to represent a growing burden on the American economy.  Current research has focused on methods to eliminate unnecessary tests or procedures to save costs and prevent waste.  Hepatitis C antibody testing represents one example of a test that, when positive, almost never needs to be repeated in a patient’s lifetime. Once [...]