Background: Venous thromboembolism, unstable angina, and atrial fibrillation are diseases that utilize parenteral anticoagulant therapy, which is often associated with bleeding and thrombocytopenia that require management and a prolonged hospital stay and pose an economic burden to the health care system. Historically, unfractionated heparin (UFH) is preferred because of the low acquisition costs of UFH […]

Background: Readmission to hospital soon after discharge is a significant burden to patients and our health care system. Centers for Medicaid and Medicare services are proposing to add hospital readmissions as a quality measure by 2010. We aimed to study the characteristics of all readmissions within 30 days of discharge from our hospitalist service in […]

Background: Increased mortality has been observed for patients admitted on weekends to hospitals in several studies. The reasons for this “weekend effect” are unclear but may be related to reduced staffing levels, increased handoffs, or reduced availability of diagnostic or therapeutic services. The ability to easily and accurately assess mortality trends based on the day […]

Background: Fresh‐frozen plasma (FFP) is commonly used to correct intraoperative coagulopathies (believed to be secondary to clotting factor depletion, platelet consumption, and/or volume replacement strategies) but is associated with significant fluid volume if multiple units are given. Similar to at other institutions, volume overload and high number of ventilator days have been major issues in […]

Background: Obstructive sleep apnea (OSA) has become a recognizable disorder among medical specialists but remains a relatively unexplored topic for surgeons, anesthesiologists, and their patients in the perioperative period. Recent studies have begun to describe the negative impact of untreated OSA in the perioperative patient population, specifically in orthopedics. Guidelines from the American Society of […]

Background: Increasing work‐hour restrictions, older and sicker patients, and fragmented care may result in poorer quality care by inpatient medicine house staff. Recognizing this, the Accreditation Council for Graduate Medical Education proposes reducing noneducational work and working in multidisciplinary teams. Nurse‐practitioners (NPs) provide high‐quality care in primary care and subspecialties. Their effect on care by […]

Background: Numerous studies have shown that hospitalists in community settings reduce hospital costs primarily through reducing length of stay. Although some research in the academic setting indicates that hospitalist teaching attendings reduce mortality, little research has compared teaching services to nonteaching hospitalist care. We sought to compare patient outcomes for a nonresident hospitalist service versus […]

Background: Medically “unnecessary” hospital days pose a great concern to patients, payers, hospitals, and care providers. Increasing length of stay from delays increases costs and potentially nosocomial complications. Hospitalists at our academic medical center (AMC) manage nearly 10,000 patients annually as supervising physicians on resident teams (RTs) and on 'faculty hospitalist” teams (FHTs), without residents. […]

Background: Improving discharge planning is a high priority in hospital medicine. There are numerous studies on discharge checklists, follow‐up phone calls, standardization of communication between inpatient and outpatient physicians, and links between improved follow‐up and better outcomes. We explored the role of nonphysician extenders by adding a patient service representative (PSR) to our nonfeaching hospitalist […]

Background: Inappropriate antibiotic use is a major clinical problem in hospitals. The initial prescribing choices made by emergency department (ED) providers may be partially responsible for this situation. Unlike hospitalists, ED providers do not have the benefit of learning from their prescribing behaviors because they rarely receive feedback or follow‐up information about the patients after […]