Background: Today’s care of patients in hospitals inevitably involves multiple providers who must coordinate and communicate effectively in an environment that is uncertain and in constant flux. Unfortunately, traditional communication systems, such as pagers or landlines, have limitations that lead to frequent interruptions, inability to indicate the urgency of a message, delay in contacting the […]

Background: A lack of effective physician-nurse collaboration has long been recognized to adversely impact patient and organizational outcomes.  Despite substantial efforts towards developing strategies to improve interprofessional collaboration (IPC) in the acute care setting, consistent realization of this ideal remains elusive.  Some studies have suggested that nurses and physicians have different perceptions of IPC and […]

Background: Interprofessional collaboration (IPC) between nurses and physicians can be defined as shared responsibility and decision making in working towards the common goal of quality patient care. The positive effect of greater IPC on patient outcomes and job satisfaction has been described.  Studies have shown discrepancies between nurses’ and physicians’ assessment of their own collaboration. […]

Background:    There is little evidence that systemic improvements in hospital quality, safety, and cost of care have occurred in the U.S over the last 15 years despite calls to action and intense local efforts.1,2 Ongoing work by The Joint Commission shows that “best practices” from one hospital are unlikely to translate directly to another.3 […]

Background: There is a growing appreciation of the increasing prevalence of CREs, but limited data exists on the prevalence of invasive infections due to CRE among adult, hospitalized patients in the various geographic regions of the United States (US). Cognizant of this data gap, the study objective was to quantify the prevalence of carbapenem resistance […]

Background: Despite the wide use of warfarin therapy this drug is associated with the largest number of serious adverse event reports by the FDA with 86% of warfarin-associated bleeds resulting in serious outcomes, and 10% in fatal outcomes.  The American College of Chest Physicians Evidence-Based Clinical Practice Guidelines recommend rapid reversal with 4-factor prothrombin complex […]

Background: As part of the ABIM Choosing Wisely initiative, the Society of Hospital Medicine has emphasized repetitive complete blood count (CBC) and chemistry testing among its top 5 practices that physicians and patients should question. Reduction of unnecessary laboratory testing is important not only for cost containment, but also for improved patient experience and avoidance […]

Background: A recent nationwide recall for large glass evacuated containers has led to new innovations performing large volume paracentesis (LVP). Compared to the individually manufactured evacuated containers traditionally used in the past, wall suction systems are relatively inexpensive and readily available on most inpatient floors. The ease of access and cost savings makes a wall […]

Background: Patient is a previously healthy 7-week old Hispanic female who presented to an emergency department with cough, congestion and decreased PO intake x 7 days. Baby had an unremarkable prenatal course and normal delivery. Mother was strictly breastfeeding the patient had normal growth and development. One week prior to the ED visit, mother had […]

Case Presentation: A 31-year-old woman with a history of rheumatic heart disease and a murmur presented with two months of intermittent subjective fevers, diffuse malaise and inability to walk. Physical exam revealed a systolic 2/6 murmur heard best at the apex, 3 out of 5 strength with right knee extension and flexion and 3 out […]