Background: Enteral eosinophilia may manifest from an infectious trigger or a primary inflammatory process. Parasitic infections may mimic eosinophilic gastroenteritis clinically and pathologically with eosinophilic infiltration of the gut wall. Management sharply differs depending on etiology. We present a case of a patient with risk factors for both infectious and reactive eosinophilic gastroenteritis. Methods: A […]

Background: Transitions out of the hospital and into the next setting of care are a vulnerable time for patients and caregivers.  Targeted process improvement efforts to facilitate safe, efficient and effective transitions can reduce the chance of unnecessary readmission and improve the patient experience.  Systematic review of readmission cases through root cause analysis (RCA) is […]

Background: Insurance companies often require a mandated pre surgical weight loss program prior to bariatric surgery. It is debated whether this would improve weight loss after surgery. We argue that the authority deciding the indications, duration and type of preoperative program should be the operating bariatric surgeon, who may be able to tailor these programs […]

Background: Telemetry is overused in hospitals and continues to be a significant source of health system waste.  It is considered a leading issue in quality initiatives, as highlighted by its presence in the top five recommendations by the Society of Hospital Medicine to the ABIM Choosing Wisely Campaign.  The overuse of telemetry is likely due […]

Background: Recent guidelines support restrictive blood transfusion practices in the majority of patients.  However, the National Comprehensive Cancer Network continues to recommend a goal hemoglobin (Hgb) range of 7-9 g/dL in the oncology patient population.  The oncology services at our institution typically use a Hgb threshold of 8 g/dL to dictate need for transfusion. Transfusion-associated […]

Background: As consumers, hospitals, and health systems have rapidly adopted health technology, entrepreneurs have begun to focus more in this space.  Hospitals and healthcare systems can shape entrepreneurial activities, and positively influence new technologies, by developing their own internal innovations and by fostering partnerships with external entities. However, many physicians lack expertise and training in […]

Background: Current approaches to addressing central venous catheter (CVC) identification and discontinuation in the general medicine population remain largely ineffective. A recently published observational study reported that 26% of teaching physicians and 31% of hospitalists were not able to accurately identify the presence of a CVC in a patient under their care. Since preventable line-related […]

Background: In academic medicine, the first presentation of a scholarly product is often a poster or oral presentation at national conferences. Only about half of these presentations are eventually published, suggesting the conference may be the author’s only opportunity to disseminate information about their work. Studies have shown that posters have the most impact when combined […]

Background: It has been nearly a decade since the National Academy of Engineering and the Institute of Medicine recommended the application of systems engineering approaches in order to deliver healthcare that is efficient, effective, and patient-centered, yet large academic medical centers remain highly complex systems that are rife with inefficiencies.  One area that has been […]

Background: Pulmonary embolism (PE) is a morbid condition with sequelae including death and chronic pulmonary hypertension.  As a consulting hospitalist in the post-operative period, diagnostic algorithms including d-dimer testing are of limited utility as invasive procedures cause an elevation in d-dimer levels.  Because of its availability, sensitivity and specificity, spiral computed tomography is the test […]