Background: Limited research exists exploring the impact of nutrition interventions, including oral nutritional supplement (ONS) usage, on clinical outcomes of patients at risk/with malnutrition. We aimed to assess the impact of a hospital-based, comprehensive nutrition-focused quality improvement program (QIP) on readmission rates and length of stay of malnourished patients receiving inpatient care for oncological, gastrointestinal, [...]

Background: In Canada, as in the US, hospital medicine has become an increasingly important staffing model innovation. Canadian hospitalists are typically Family Physicians and General Internists. In an attempt to advance its hospitalist staffing model into a care model innovation as well,  the Regina Qu’Appelle Health Region (RQHR) implemented Canada’s first Accountable Care Unit (ACU) [...]

Background:   Electronic cigarettes (E-cigarettes) have grown in popularity as an alternative to traditional cigarettes especially among consumers who want to reduce the risk of morbidity and mortality associated with smoking. Nonetheless, a recent study showed that both E-cigarettes and traditional cigarettes cause an increase in oxidative stress and endothelial dysfunction, however this effect is less [...]

Background: The convergence of rising post-acute health care costs with incomparable outcomes havemade reform a priority resulting in the development of new models of care that often extend the scope of practice andjob duties among health professionals. In these new models, aimed to improve clinical and cost effectiveness of care,advance practice “transitionists” diagnose, triage, conservatively [...]

Background: The current American Society of Hematology (ASH) guideline recommends the use of thrombopoietin receptor agonists, eltrombopag or romiplostim as one of the second-line therapies for chronic immune thrombocytopenia (ITP). The efficacy and safety of those drugs have been tested in several clinical trials. However, the safety profile was not consistent throughout trials and is [...]

Background: Respiratory rate (RR) is an independent predictor of in-patient mortality, intensive care unit admission and cardiac arrest across a variety of conditions. It is also an integral component of many risk prediction calculators (such as the pneumonia severity index). Thus, accurate assessment of RR is necessary to recognize disease severity and prognosis among hospitalized [...]

Background:  Physician awareness of the finalized results of tests pending at discharge (TPAD) is poor (~40%). We previously designed and implemented a system that automatically notifies the inpatient attending and primary care physician (PCP) of finalized TPADs by email and demonstrated a two-fold increase in the rate of physician awareness of these results. The aim [...]

Background: The ACGME Clinical Learning Environment Review (CLER) has focused on six areas of trainee working and learning environments, two of which are safety and quality improvement (QI).  Exposure to practical safety and QI training has been thought to facilitate enhanced training in these areas, yet most QI and patient safety exposure during residency is [...]

Background: Sepsis is a common, costly, and mortal clinical syndrome. Many delays in sepsis recognition and intervention are due to “data latency,” the period of time between data suggestive of sepsis being entered in the EHR to identification and interpretation by a care provider. The magnitude of this delay can be significant, as the diagnostic [...]

Background: Advancements in technology have expanded accessibility to telemetry via remote monitoring and resulted in increased application in hospitalized patients. The American Heart Association (AHA) telemetry guidelines restrict use to patients with sepsis, severe electrolyte disturbances or primary cardiac conditions. Respiratory infections have emerged as a common source of hospitalization and telemetry is frequently applied [...]