Background: Prior studies of public reporting on risk‐adjusted mortality for coronary artery bypass grafting (CABG) have found that public reports have strong predictive validity and likely encourage poor‐quality surgeons to leave practice. However, except for CABG surgery, there are few data on the predictive accuracy of public reports or their impact on providers’ practice. We […]

Background: Regional variation in critical care use has been described, but the reason for this variation remains unclear. Multiple factors contribute to the decision to admit patients to the intensive care unit (ICU), including local expertise, bed availability, and the perceived need for ICU care. We used retrospective data from a national sample of Veterans […]

Background: Although central line (CVC) dwell time is a major risk factor for central line‐associated bloodstream infections (CLABSIs), there is little information about how often CVCs are retained when not needed (“idle”). We describe the use patterns of CVCs on medical wards. Methods: A retrospective chart review focused on daily CVC justification was obtained on […]

Background: Hepatic congestion leading to abnormal liver function tests (LFTs) is a common finding in patients with acute decompensated heart failure. The aim of this study was to determine the prognostic significance, if any, of abnormal LFTs in acute decompensated heart failure, as this has not been extensively studied so far. Methods: A retrospective chart […]

Background: Urinary tract infections (UTIs) are the most common type of hospital‐acquired infection, and 80% are associated with indwelling urinary catheters. The relatively high frequency of catheter‐associated UTIs (CAUTIs) leads to significant clinical and financial concerns for both patients and hospitals. Because Medicare no longer covers the costs of treating CAUTIs, the development of cost‐effective […]

Background: Physician awareness of tests pending at discharge (TPADs) is poor (∼40%). We designed and implemented an automated e‐mail notification system to “push” the finalized results of selected TPADs to responsible inpatient physicians. The aim of this study was to evaluate the impact of our automated e‐mail notification system on inpatient physician awareness of the […]

Background: Although many studies have described patients who frequently utilize emergency department and psychiatry services, little is known of the population frequently admitted to inpatient medicine services. This study characterized the frequently hospitalized group in terms of demographics, length of stay, costs, comorbidities, 1‐year mortality, and reason for hospitalization. Methods: During a 6‐month period (January […]

Background: The Centers for Medicare and Medicaid Services (CMS) executed a policy denying reimbursement for hospital‐acquired conditions (HACs)—“never events.” Venous thromboembolism (VTE) was identified as a HAC in patients undergoing total hip/knee replacement, partial hip replacement, or hip resurfacing as part of this policy in fiscal year 2009. This study estimated the projected financial impact […]

Background: Readmission rates are becoming an important quality and reimbursement metric in our health care system. Hospitalists are held accountable for patients who require premature readmission. Little is known about the impact of hyponatremia (HN) on inpatient readmission rates, even though HN is the leading electrolyte abnormality among hospitalized patients. This study was designed to […]

Background: In an effort to standardize health care delivery and improve outcomes, agencies such as the AHA and ILCOR have developed guidelines for the initial care of the out‐of‐hospital cardiac arrest patient. These guidelines are limited in directing subsequent patient care. In the United States, such patients are always admitted to the ICU, an environment […]