Background: Matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) are involved in cardiac remodeling through regulation of extracellular matrix. Reports on their association with heart failure (HF) outcomes have been conflicting. Methods: We prospectively examined the association of baseline serum levels of MMP‐1, ‐2, and ‐9 and TIMP‐1, ‐2, ‐3, and ‐4 with outcomes (death, […]

Background: The prevalence of congestive heart failure (CHF) in the United States has been on the rise over the last decade. This is likely because of the standardized management of hospitalized patients with CHF decompensation, allowing patients with CHF to live longer. These patients are known to posses increased risk of developing deep vein thrombosis […]

Background: Patients hospitalized with congestive heart failure are more likely to be readmitted than any other group. We found our hospital's 30‐day readmission rate for heart failure patients to be 22% for any cause and 8.5% for the same diagnosis. Heart failure was the top readmission diagnosis, and the readmission rate had been steadily increasing. […]

Background: The quality of provider–provider and patient‐provider communication at discharge is associated with patient satisfaction, adherence to treatment plans, and clinical outcomes. However, the ways in which providers communicate with each other and with patients at discharge is unknown. Therefore, we queried hospitalists about their interactions with patients and other providers at the time of […]

Background: Hospitalists are often not aware when a patient whom they have cared for is readmitted to the hospital. However, there may be much to learn from readmissions, both in terms of clinical care and systems improvement. To this end, we asked hospitalists how they learn when a patient has been readmitted, what they do […]

Background: Heart failure is one of the most frequent causes of hospitalizations and readmissions in the United States. Several peridischarge interventions were reported to decrease the readmission rates. The objective was to assess the feasibility and effectiveness of a discharge planning intervention to decrease all‐cause readmission rates within 30 days among patients with congestive heart […]

Background: The incidence of health care–associated infections is a significant cause of morbidity and a driver of excess costs in U.S. hospitals. Compliance with contact precautions is important in reducing transmission of multidrug‐resistant organisms (MDRO) such as methicillin‐resistant Staphylococcus aureus, vancomycin‐resistant Enterococcus, Clostridium difficile, and gram‐negative organisms producing extended‐spectrum β‐lactamases. In 2009, our institution added […]

Background: The Joint Commission and Institute of Medicine have stressed that provider discontinuity of inpatient care poses many hazards to patient care. This fragmentation is thought to threaten patient safety and may influence length of stay (LOS), health care costs, and patient satisfaction. The impact of improved continuity of inpatient care is not known. Our […]

Background: Discussions with patients during work rounds and at the time of hospital discharge are encounters that require substantial skill. High‐quality execution of these interactions can improve satisfaction and quality of care. Standardized patients (SPs) provide an opportunity to identify skills gaps and to train house staff on high‐quality work rounds and discharge interactions. Methods: […]

Background: Urinary tract infection (UTI) is the most frequent hospital‐acquired infection in the United States. Bloodstream infection (BSI) secondary to UTI occurs less frequently but is associated with significant morbidity and mortality. Despite renewed interest in hospital‐acquired UTI, little is known about the epidemiology of nosocomial urinary tract–related BSI. Methods: We reviewed patients using administrative […]