Background: Bronchiolitis is one of the most common conditions for which infants and young children are evaluated in the emergency department (ED). Recent practice guidelines from the American Academy of Pediatrics recommend limiting the use of bronchodilators, steroids, and diagnostic testing for patients with bronchiolitis. We sought to determine the association of the publication of [...]

Background: Current health care reform calls for an increase of 46,000 full‐time equivalent primary care providers by 2025, requiring a significant expansion of teaching and training venues. Questions arise as to whether there are sufficient physician faculty to teach medical students. Willingness of physicians to teach depends in part on the patients’ attitudes toward medical [...]

Background: Hypomagnesemia is often neither adequately replaced nor appropriately followed in hospitalized patients. In particular, because the average magnesium deficiency in hypomagnesemia is 50–100 mEq, a single parenteral dose of 2 g of magnesium sulfate is woefully inadequate, not only because it contains just 16.2 mEq of magnesium, but also because half of it will typically [...]

Background: Access to care is a critical issue for child health. Although most of the focus on access is availability of primary care, the availability of hospital care for children is an underappreciated issue. Data from various sources indicate that the national pediatric bed census is falling, with losses in particular from general hospitals. HCUP [...]

Background: Carbapenemresistant Klebsiella pneumoniae (KPC‐KP) has become a major nosocomial pathogen over the past decade. The first KPC‐KP was isolated in an Emory University–affiliated hospital in 2006, and since then the number of isolates has increased annually, including 36 isolates in 2009. The treatment of this multidrug‐resistant infection is challenging, given that KPC‐KP confers resistant [...]

Background: Severe neurological impairment is a tragic outcome in survivors of sudden cardiac arrest (SCA). Standard practice to assess neurological recovery requires clinical and diagnostic evaluation 3–4 days after SCA. It is unclear whether this standard of practice is implemented or whether physicians advise or families choose to withdraw care at earlier intervals. We examined [...]

Background: Transfer of accurate medication information across patient care settings is crucial to preventing medication errors and promoting patient safety. Patient participation is a key factor in obtaining complete and accurate medication information as patients frequently self‐medicate or alter adherence to prescribed therapy. Encouraging and empowering patients to manage their medication information and engage them [...]

Background: Medication reconciliation is a process whereby medication lists are crosschecked and verified at significant points of contact with the health care system, so that a record of which medications are appropriately stopped, changed, or added is clear to caregivers and patients alike. Clinically meaningful medication reconciliation requires changes in work flow, organizational management, and [...]

Background: Pneumothorax is a known potential complication of thoracentesis, with an estimated incidence rate of 6.0% according to a recent meta‐analysis. Several interventions can reduce this accidental iatrogenic complication. At Jackson Memorial Hospital (JMH), in Miami, Florida, we created and implemented a simulation‐based curriculum in procedural instruction in July 2007. It encompasses standardized training, a [...]

Background: Hospital medicine is growing rapidly across the nation, with more than 10,000 hospitalists in practice today. Although initially focused in the community sector, hospitalists have had an increasing presence within academic centers. The University Hospital Consortium 2007 survey found that prior to instituting work‐hour restrictions, 57% of university hospitals had hospitalists, whereas afterward, hospitalists [...]