Background: Effective communication between attending physicians (AP) and residents is crucial to patient care. As Pediatric Hospitalists we recognize this need further when supervising residents on general inpatient pediatric teams. To date there have been no studies attempting to overcome barriers to communication between AP and residents in the field of Pediatric Hospitalist medicine. Methods: [...]

Background: Hospital–associated venous thromboembolism (VTE) is estimated to affect up to 15% of hospitalized general medical patients and is believed to be the most preventable cause of death in the hospital. Pharmacologic prophylaxis reduces the rate of VTE and, as a result, the Agency for Healthcare Research and Quality lists VTE prophylaxis as the “number [...]

Background: Hospital performance measurement efforts often use risk adjusted mortality data. Most existing risk models use administrative data and are disease specific. Importantly, administrative data models increase chances for measurement bias whereas disease specific models reduce applicability to hospitals with small sample sizes. We therefore sought to develop a hybrid administrative/clinical risk model to apply [...]

Background: Preoperative non–invasive cardiac stress testing (NIT) is generally not indicated for asymptomatic patients undergoing intermediate–risk noncardiac surgery, such as elective total knee arthroplasty (TKA) or total hip arthroplasty (THA). Current guidelines and evidence suggest that NIT may be considered only if it will change the management of patients who are scheduled to have higher [...]

Background: Catheter associated UTI’s (CA–UTI) are preventable and high impact secondary to associated costs and poor outcomes. Our UTI prevention group has worked to prevent CA–UTIs, implementing a nursing driven foley removal protocol, prevention guidelines and education around morbidity and mortality associated with a CA–UTI. There are no studies that comprehensively look at inpatient methods [...]

Background: A “universal precaution” approach for all inpatients should be used to ensure adequate education for safe discharge home. However, identification of vulnerable, high–risk (e.g., low health literacy) patients may be necessary in resource–limited hospital settings to ensure safe care transitions. Chew et al. have validated a brief, 3–item verbal screening questionnaire to detect low [...]

Background: Venous thromboembolism (VTE) is a known complication of hospitalization; implementation of proven prophylactic modalities should reduce VTE rates. One potential strategy is the use of computerized order sets. The objective of this study is to determine the potential impact of order sets on VTE rates in VA. Methods: VA administrative data identified admissions to [...]

Background: A positive safety culture is essential to patient safety. Validated assessment tools can identify areas for improvement and highlight differences between clinical settings. Few studies have assessed medical student perceptions of safety and none have identified how those perceptions may differ for particular clerkships. Students provide a unique perspective to learn about safety across [...]

Background: 2–9% of adult patients who fall in the hospital suffer serious injury. There is little evidence–based literature to guide physicians when assessing hospitalized patients for fall–related injury. This study was designed to (1) identify demographic and/or clinical factors which predict serious fall–related injury among hospitalized adults, and (2) judge the adequacy of physician documentation [...]

Background: Little information exists about how much work individual patients actually contribute to the workload of a physician. We conducted this study to determine the amount of time internal medicine interns spend on new patient admissions. Methods: We conducted a prospective time–motion study on general internal medicine wards at a single VAMC, with IRB approval. [...]