Background: Anemia is the most commonly encountered hematologic abnormality in preoperative evaluations and has been associated with major adverse outcomes in surgical procedures but often ignored during preoperative evaluation.  The purpose of this study is to examine the prevalence of preoperative anemia and its relationship to postoperative transfusion requirements in patients undergoing elective joint replacement […]

Background: Patients with diabetes and comorbid cardiovascular disease may be at particularly high risk for medication non-adherence and adverse outcomes after hospital discharge. The objective of this study was to design, implement, and evaluate an intensive discharge intervention for inpatients with type 2 diabetes.  Methods: We randomly assigned inpatients on medicine and cardiology services with […]

Case Presentation: A 31-year-old African American woman with past medical history of hypertension (HTN), gastro esophageal reflux disease (GERD), bronchial asthma and a diagnosis of Irritable Bowel Syndrome (IBS) for 10 years presented with complaints of exacerbation of chronic abdominal pain and non-bloody diarrhea for 2 weeks prior to presentation. Physical examination was unremarkable except […]

Case Presentation: A 27 year-old male called 911 after intentional ingestion of 3g of lamotrigine and 3g of hydroxyzine.   Upon arrival to the ER, approximately one hour after ingestion, the patient had slurred speech and was lethargic, but was able to provide his own history.  The patient subsequently began to speak incoherently and became increasingly […]

Background:  Hospitalization identifies patients who are particularly costly to the Medicare system and current policy efforts to reduce costs focus on the 30 days after discharge; however, much less is known about which patients will have the greatest long-term Medicare costs.  Given the prevalence of functional impairment in Medicare seniors and impact on clinical outcomes […]

Background: Ward rounds at our hospital traditionally have been performed by a team of physicians and medical students outside of patients’ rooms, with minimal involvement of nursing staff and limited time spent with patients. As part of a care redesign initiative that included regionalization of clinicians and staff to unit-based care teams in June 2013, […]

Background: Venous thromboembolism (VTE) is considered the most common preventable hospital complication and VTE prophylaxis rates are benchmarks of hospital quality. Hospital-acquired VTE (HA-VTE) is defined as VTE that occurs during hospitalization or within 90 days of discharge. Recent studies, however, have shown that higher VTE prophylaxis rates in hospitalized medical patients do not correlate […]

Background:  As mobile health and technologies to engage patients in self-care gain increasing attention, it is critical to understand not only access to, but also ability and willingness of, underserved populations to use these resources, to avoid widening the digital divide. While studies estimate up to 80% of adults have internet access, no study to […]

Background: Though commonly used in the outpatient setting, patient portals have not been routinely used in hospital settings and their impact on patients’ knowledge and activation is largely unknown. Methods: We created a patient portal mobile application which included pictures, names, and role descriptions of primary team members, scheduled tests and procedures, and a list […]

Background: In an effort to improve pediatric inpatient asthma care, the Joint Commission developed standards for hospital management in 2003. Despite this initiative, inpatient management of asthma exacerbations and adherence to these guidelines varies by institution.  Such differences have an impact on hospital cost, length of stay, and readmission rates.  Based on data from the […]