Background: Many guidelines recommend aspirin for primary prevention of myocardial infarction and cerebrovascular accidents in high‐risk patients. Aspirin use has increased in indicated populations; however, the percentage is still suboptimal. Currently, data from the 1993 to 2003 U.S. National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey estimates the proportion of patient [...]

Background: The discharge summary is an important tool for communicating essential information as patients transition from the hospital, yet it frequently does not arrive for outpatient physicians in a timely manner Furthermore, residents are often responsible for dictating discharge summaries but receive little instruction in doing so. Delayed availability and poor quality of the discharge [...]

Background: Providing efficient, interdisciplinary care in academic centers today is greatly challenged by work‐hour restrictions, the resulting fragmented team structures, and frequent geographic discontinuity of physician teams. Our objective was to geographically localize physician teams to maximize rounding efficiency and promote inter‐professional communication. Methods: Our teaching service admissions were restructured from admitting to 8 different [...]

Background: Delirium and other forms of cognitive impairment are clinically important patient charactenistics that have been shown to be strong predictors of outcomes. Although mental status assessment is the subject of national quality indicators, considerable heterogeneity exists in mental status assessment, and little is known about screening effectiveness. One common mental status exam involves assessing [...]

Background: Several studies have found that hospitalists reduce cost and length of stay compared to nonhospitalists, with no adverse effect on quality of care or inpatient outcomes. However reduced length of stay could be accomplished by shifting care to the period after discharge. Our aim was to investigate differences after discharge in hospital readmissions, emergency [...]

Background: Congestive heart failure (CHF) is characterized by multiple hospital readmissions and increased risk of death. Some studies suggest using serial changes in N‐terminal probrain natriuretic peptide (NT‐proBNP) as a predictor of adverse events in CHF patients, but these have been limited. Our study assessed acute change in NT‐proBNP and its association with 1‐year mortality [...]

Background: Evidence‐based order sets have been shown to improve clinical and financial outcomes. However, most order set studies have been conducted in academic medical centers or stand‐alone hospitals. The Iowa Health System (IHS) is an integrated health system consisting of relationships with 26 community hospitals in Iowa and western Illinois. IHS has developed evidence‐based order [...]

Background: Recent studies suggest that there is an increase in cardiovascular disease after pneumonia; however, there is little information on incidence of a new diagnosis of congestive heart failure (CHF) after pneumonia. The aim of this study was to assess the incidence of a new diagnosis of CHF during and after hospitalization for pneumonia in [...]

Background: Academic medical centers face new challenges in providing access to safe and efficient inpatient procedures while balancing house staff autonomy and education. Internal medicine residents at many medical centers perform invasive bedside procedures without a standardized approach to training, supervision, or assessment. We sought to evaluate the impact of a 2‐week hospilalist procedure service [...]

Background: A better understanding of how resident physicians allocate their time is critical to making informed changes in resident schedules, given duty‐hour restrictions. Little is known about how much work residents defer to their off hours. We tracked the timing, frequency, and duration of time spent in dictating discharge summaries in order to determine how [...]