Background: We identified a number of quality, patient satisfaction, and staff satisfaction issues that all seemed to be linked to throughput challenges. We had trouble getting patients out of the hospital on discharge day, which set off a number of downstream effects including backups in the Intensive Care Unit (ICU) and Emergency Department (ED). These […]

Background: The opioid epidemic continues to exert a significant impact on our health care system. Patients with intravenous drug use (IVDU) often develop life threating infections leading to prolonged hospitalizations with poor outcomes. Traditionally, the focus of treatment during these hospitalizations is on the infectious complications with very little emphasis on the underlying substance use […]

Background: Today, Medicare patients account for approximately 50% of hospital days, costing $1 trillion annually. Despite this staggering financial burden, hospitalization often results in poor outcomes for older adults. The objective of the study was to test the feasibility and impact of using Assessing Care of Vulnerable Elders (ACOVE) Quality Indicators (QIs) as a therapeutic […]

Background: Alcohol use disorders (AUDs) are common among hospitalized patients. Naltrexone has been proved to assist patients with AUDs in maintenance of sobriety. The initiation of naltrexone has been studied in outpatient and inpatient settings. Our hospitalist program lacked a process for initiation of naltrexone for maintenance of sobriety among inpatients with AUDs. Methods: We […]

Background: Peripherally inserted central catheters (PICCs) have been associated with venous thromboembolism (VTE) and are a major cause of upper extremity deep vein thrombosis (DVT).  However, mechanisms to identify patients at greatest risk of PICC-associated VTE are limited. Methods:  Using data from the Michigan Hospital Medicine Safety consortium, patients with PICCs that experienced symptomatic, image-confirmed […]

Background: Although the national quality improvement campaigns are implemented to reduce Door-to-Balloon (DTB) time in the U.S.A., the community hospitals in Japan lack human resources and appear to be particularly challenging to implement these strategies such as 24/7 in-house cardiologists. Hospitalist is well positioned to be leaders and perform work improvement. Recently, there is increasing […]

Background: Pain is commonly reported by hospitalized patients and may be managed with opioids, which are associated with benefits and harms.  Clinicians’ perceptions of the benefit to harm ratio may differ across countries, which may lead to variability in prescribing practices.  We sought to determine whether there was an association between willingness to prescribe opioids […]

Background: Hospital-associated venous thromboembolism (HA-VTE) is a serious condition with controversy regarding ideal risk assessment and VTE prophylaxis (VTEP), especially in medical patients. We conducted a collaborative VTE quality improvement project, supported by a charitable grant from the Gordon and Betty Moore Foundation, in 35 hospitals across three states and assessed the impact on HA-VTE […]

Background: Rosiglitazone is one of the thiazolidinedione groups which enhance insulin sensitivity through stimulating peroxisome proliferator-activated receptors in the adipose tissue, liver and muscle. Resulted in decrease glucose production and enhances its utilization. Fluid retention and weight gain are major side effect which limit its use for diabetes treatment, and caution should be done while […]

Background: Hospital-acquired C. difficile colitis is associated with increased length of stay (LOS) and significant morbidity and mortality. During hospitalization, patients visit many procedural, diagnostic, and treatment areas throughout the hospital, presenting opportunities for spore contamination of surfaces and nosocomial disease transmission. We developed a novel methodology using electronic health record (EHR) data to map […]