Background: Acid suppressive medications, including histamine2‐receptor antagonists (H2RAs) and proton pump inhibitors (PPIs), are widely used to treat conditions associated with the overproduction of acid. Accepted indications include upper gastrointestinal bleeding, erosive esophagitis or gastritis, gastroesophageal reflux disease, ulcers, Helico‐bacter pylori eradication, Zollinger–Ellison syndrome, stress ulcer prophylaxis (SUP) in high‐risk patients, dyspepsia associated with nonsteroidal […]

Background: Unprofessional behaviors can undermine the hospital learning environment and patient care. To date, no study has examined unprofessional behaviors in hospitalists. Methods: A 35‐item survey of unprofessional behaviors adapted from prior studies was administered to hospitalists from 3 academic programs at 7 Chicago hospitals. The survey included behaviors related to interactions with others (i.e., […]

Background: Hand‐offs are a core competency of hospitalists. Although the Society of Hospital Medicine and others recommend improving hand‐offs, monitoring and improving hand‐off quality are limited by lack of reliable tools to measure hand‐off quality. This study aimed to assess the feasibility and reliability of using a paper‐based tool, “Handoff CEX (Clinical Evaluation Exercise),” to […]

Background: Postprocedural bleeding is a significant adverse outcome. Clinicians routinely assess bleeding risk by ordering coagulation labs (INR, PTT, platelets) and administer blood products to correct any discovered coagulopathies. Certain “bleeding risk” medications are also held. Although the efficacy of these steps seems intuitive, coagulation labs were not designed to assess bleeding risk, and the […]

Background: Glucagon‐like peptide‐1 (GLP‐1) receptors are present in human cardiac myocytes. Myocardial cells demonstrate insulin resistance in the setting of left ventricular dysfunction. Exenatide is a synthetic GLP‐1 mimetic molecule with insulinotropic and insulinomimetic properties. It has a favorable pharmacokinetic profile over GLP‐1. Insulin and GLP‐1 increase glucose utilization by cardiac myocytes and improve cardiac […]

Background: In‐hospital adverse events such as unplanned intensive care unit transfers (UICUTs), cardiopulmonary arrests (CAs), and unanticipated mortality are frequently preceded by clinical instabilities. Rapid response systems (RRSs) have been advocated to detect and intervene on these instabilities with the goal of preventing serious adverse events. Although call criteria have been established based on retrospective […]

Background: Limited access to interventional radiology (IR) services may delay placement of long‐term central venous catheters (LT‐CVCs). This can impair hospital throughput and escalate costs by increasing length of stay. We developed and implemented a hospital medicine procedure service to decrease delays in LT‐CVC placements. Methods: We performed a pre–post study at our university‐affiliated public […]

Background: The Universal Protocol was created by the Joint Commission to eliminate the occurrence of wrong‐site, wrong‐procedure, and wrong‐person surgery. This study evaluated the effects of an innovative reengineered process for bedside procedures with an aim of improving compliance with the Universal Protocol (specifically, time‐out) and increasing nursing and physician communication during bedside procedures. Methods: […]

Background: Consistent and accurate documentation with proper coding for physician services is the fiscal foundation of a successful medical practice. There may be, however, significant variability in interpretation of the Centers for Medicare and Medicaid Evaluation and Management (CMS E/M) guidelines as they apply to clinical practice. In 2000, Zuber et al. reviewed 1069 patient […]

Background: Matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) are involved in cardiac remodeling through regulation of extracellular matrix and eventually development of heart failure. We explored their association with heart failure (HF)‐related hospital length of stay (LOS‐HF). Methods: We prospectively examined the association of baseline serum levels of MMP ‐1, ‐2, and ‐9 and […]