Background: Acquired inpatient venous thromboembolism (VTE) accounts for significant morbidity and mortality and is considered largely preventable with pharmacologic prophylaxis. Appropriate VTE prevention has emerged as an important hospital quality measure and has become a factor influencing third‐party payer reimbursement. In addition to failure to initiate prophylaxis, inadequate prophylaxis based on patient‐specific risk factors for [...]

Background: Inpatient hyperglycemia is common and associated with adverse patient outcomes. Current guidelines recommend treatment to achieve glucose levels below 180 mg/dL in the inpatient non‐ICU setting. Previous research has suggested various approaches to improving inpatient glucose management. However, few studies have rigorously evaluated the ability of specific, low‐cost interventions to increase adherence with guidelines [...]

Background: Health care‐associated pneumonia (HCAP) is prevalent among hospitalized patients. In contrast to community‐acquired pneumonia (CAP), patients with HCAP are at increased risk for multidrug‐resistant organisms such as methicillin‐resfstant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa. Appropriate initial antibiotic therapy for patients with pneumonia is associated with reduced mortality, and published guidelines for both CAP and [...]

Background: The Joint Commission requires that U.S. hospitals be smoke free, creating a valuable opportunity for hospitalized smokers to quit. Smoking cessation counseling is also a quality measure for Medicare patients hospitalized with heart failure, myo‐cardiai infarction, or pneumonia. However, rates of chemically verified abstinence during and after hospitalization are currently unknown. The aim of [...]

Background: Venous thromboembolism (VTE) is the third‐leading cause of cardiovascular death. Approximately 60,000 people die from VTE each year; however, VTE is the most common preventable cause of hospital death. Without prophylaxis, VTE occurs in 10%–26% of medicine patients. This study assessed rates of pharmacologic and mechanical venous thromboembolism prophylaxis at an academic medical center. [...]

Background: Literature on measurement of symptomatic improvement in ADHF admitted to telemetry is sparse. Visual analog scales (VASs) are valid measures of dyspnea in ADHF. Because dyspnea is a complex psychobiologic phenomenon and the Minnesota Living With Heart Failure Questionnaire (MLWHFQ) is a global measure of quality of life, we hypothesized that worse quality‐of‐life (QOL) [...]

Background: Weight loss is a surrogate marker of volume changes with therapy in acute heart failure. Large drops (>50%) in B‐type natriuretic peptide (BNP) levels correlate with changes in wedge pressures. Wedge pressures correlate strongly with orthopnea. Pre‐discharge BNP levels < 250 pg/ml predict excellent 6‐month outcomes. We determined relationships between symptomatic improvement and changes [...]

Background: Patients are vulnerable during care transitions, and adverse patient events occur frequently after hospital discharge. The incidence and impact of such events has primarily been studied at single institutions. We sought to evaluate the incidence of events posthospital discharge and their impact on rehospitalization. Methods: We analyzed data prospectively gathered from patients discharged between [...]

Background: Performance data in hospitals is typically derived from retrospective sampling, significantly restricting its relevance for active inpatients. If performance data could be relayed electronically in real‐time to the nursing unit, members of the frontline clinical team could actively use the information to rapidly identify and correct missed opportunities in quality of care for individual [...]

Background: The combination of increasing numbers of hospitalists and their growing responsibility for the care of patients at the end of life (EOL) requires hospitalists to have palliative care skills. Although previous surveys have documented the desire for more palliative care training, no study has evaluated a cohort of hospitalists' experiences with and confidence to [...]