Background: Spurious hypoxemia is a very rare but known entity in patients with extreme leukocytosis. There are roughly only 15 cases that have been reported and documented spurious hypoxemia in patients with extreme leukocytosis and improvement in oxygenation with reduction of leukocyte count. There was no attempt to measure plasma oxygen in these case reports. [...]

Background: Communication of incidental radiological findings identified during hosprealization is an important part of a successful transition of care. As these are not the source of current illness but do require follow‐up, the likelihood of communication failures is high. The goal of this study was to quantitate the prevalence of incidental radiological findings in patients [...]

Background: The last 15 years have seen tremendous advances in the care of HIV‐infected children. Kourtis et al. documented a 71% decline in pebiatric hospitalizations due to HIV from 1994 through 2003, especially after the advent of HAART. The decrease was more in children < 5 years old (61% to 17% of admissions) and boys [...]

Background: Hospital readmission is a common and costly problem, with an average 30‐day readmission rate of 20% for Medicare patients. HF is the most common reason for readmission. Inattention to care across transitions is a key factor in this problem. To improve care and reduce readmissions for HF patients, the Institute for Healthcare Improvement (IHI) [...]

Background: Pressure ulcers are a significant source of morbidity in hospitalized patients. In 2006 the Centers for Medicare and Medicaid Services (CMS) identified the development of a stage 3 or 4 pressure ulcer while hospitalized as a “never event.” This designation along with the requirement that physicians take part in ulcer documentation prompted increased interest [...]

Background: Proton pump inhibitors (PPIs) are one of the most prescribed medications and are frequently used in hospitalized patients. Although PPIs have well‐defined indications for both therapy and prophylaxis, they are often overutilized. Recently, there has been increasing evidence of potential adverse effects of PPIs such as decrease absorption of thyroxine, vitamin B12, calcium, and [...]

Background: Osteoporosis, the underlying cause of most hip fractures, is underdiagnosed and underrated. The Joint Commission's recent report on osteoporosis diagnosis and management showed that only 20% of patients with fragility or low‐impact fractures are ever tested or treated for osteoporosis. Bisphasphonates are highly effective in the treatment of osteoporosis. Optimal use of bisphosphonates requires [...]

Background: Published guidelines for treatment of health care‐associated pneumonia (HCAP) recommend initial broad‐spectrum antibiotic therapy with appropriate de‐escalation based on culture results. Guideline recommendations are heavily based on data from intubated patients, in whom cultures are easily obtained. The approach to antibiotic de‐escalation for culture‐negative patients has not been addressed. There is no literature that [...]

Background: Medication discrepancies, defined as unexplained differences in documented medication regimens across different sites of care, are prevalent and an important contributor to adverse drug events (ADEs) among hospitalized and recently discharged patients. In 2006, Partners Healthcare designed an electronic tool to assist with the medication reconciliation process and implemented the tool in 2 academic [...]

Background: For light glycemic control in the intensive care unit (ICU), recent studies attribute a lack of benefit and potential harm primarily to a higher frequency of hypoglycemia. Two caloric variations, caloric interruptions and caloric boluses (such as meals), commonly account for hypoglycemic episodes in patients on certain insulin infusion protocols. Rapid downward titration in [...]