Background: Measuring the quality of hospital care for elderly patients is important since elderly patients are at risk for certain hospital‐related hazards, such as delirium. The Assessing Care of the Vulnerable Elders (ACOVE) Project has developed quality indicators (QIs), that have been endorsed for use in pay‐for‐performance (P4P) programs, to measure the quality of care […]

Background: Discussions of care preferences, such as wishes for cardiopulmonary resuscitation or invasive procedures, are of critical importance at the time of hospital admission ‐ a time when patients are sickest and plans for hospital care are being formulated. However, there are few recent data to describe patient factors asssociated with whether or not doctors […]

Background: The healthcare marketplace has changed substantially since the last assessment of demand for internal medicine physicians in 1996. Method: We reviewed internal medicine employment advertisements published in 4 major medical journals between 1996 and 2004. The number of positions, specialty, and other practice characteristics (e.g., location) were collected from each advertisement. We then used […]

Background: The use of perioperative beta‐blockers improves outcomes after surgery. Recent studies have shown promising preliminary results suggesting perioperative statins may also benefit patients. We sought to ascertain if the use of these drugs was associated with a reduction in mortality after surgery. Method: We conducted a retrospective cohort study of patients presenting for vascular […]

Background: Emergency Department (ED) overcrowding is a widespread problem. Since hospitalists are expert at navigating complex systems of care, we hypothesized that early involvement of hospitalists in the ED could decrease overcrowding. We present data on ambulance diversion time as a marker of the impact of our intervention. Method: In July 2005, we implemented a […]

Background: Anesthesia and surgery both affect the architecture of sleep. Aside from the postoperative effects of anesthesia and surgery, sleep deprivation and fragmentation have been shown to produce apneas or desaturations even in patients without presumed sleep apnea. Adverse surgical outcomes appear to be more frequent in Obstructive Sleep Apnea Syndrome (OSAS) patients. Immediate postoperative […]

Background: Inpatient Residency Programs are often seen as expensive care models with poor utilization. Literature reviews, comparing Academic Medical Centers (AMCs) to Community Hospitals, do not support this. Many Internal Medicine Residencies, however, are Community‐based with variable associations with AMCs. Little empirical data is available to support or refute the assertion that Community‐based Resident exposure […]

Background: Acute exacerbations of COPD are one of the ten leading causes of hospitalization among adults in the United States yet little is known about the quality of inpatient care or whether hospital and paitent characteristics influence treatment. Methods: We conducted a retrospective cohort study involving 69,820 patients hospitalized for acute exacerbations of COPD at […]

Background: Computerized physician order entry (CPOE) is a widely advocated patient safety intervention yet little is known about its adoption by attending physicians or at community hospitals. Method: We measured order entry rates of attending physicians at 2 hospitals that shared a commercially available CPOE system and paired these findings with the results of a […]

Background: The elderly population is particularly vulnerable to adverse drug events. As the population ages preventing these ADEs will become increasingly important. Our objective was to decrease the use of potentially inappropriate medication in hospitalized elders (65 years or older) using a computerized drug warning system. Method: We performed an observational study on the inpatient […]