Background: It has been reported that vaccination rates with pneumococcal vaccine are low in elderly persons in Japan. The primary aim of this study was to examine whether introduction of a vaccination status checkbox in electronic medical records increased the vaccination rates. Methods: Subjects were inpatients and outpatients in the Department of General Medicine at [...]

Background: Many hospitalized patients spend most of their admission laying in their hospital beds. This can lead to in-hospital complications such as skeletal muscle atrophy, bedsores, and venous thromboembolism. In-hospital decline in ability to perform ADLs is associated with need for post-acute facility placement and readmission. We aimed to increase the percentage of patients admitted [...]

Background: The insurance authorization process for Inpatient Rehab Facility (IRF) and Skilled Nursing Facility placement is lengthy. It takes several days for insurance companies to make decisions regarding patient disposition. This creates increased length of stay (LOS) for otherwise medically stable patients. Several factors contribute to delays and include the lack of weekend authorization staff [...]

Background: Description of problem/Background: Annually, there are 300,000 hip fractures and 95% are due to low impact trauma in patients with osteoporosis. The risk of recurrent hip fractures is 9% within 5 years. Treatment with bisphosphonates decreases this risk by 35%. However, less than 10% of these patients receive osteoporosis treatment after discharge.At our hospital, [...]

Background: Anywhere from 20-50% of all hospitalized adult patients are impacted by malnourishment on admission. Although malnutrition has a worldwide impact on patient outcomes, it is frequently under documented. This proves detrimental to patient outcomes as the average length of stay is 1.5 times greater than those not affected by malnutrition. This is further exemplified [...]

Background: Collaboration is essential to providing high quality care. Clinicians on primary medical services frequently consult specialists, yet little is known about the quality of collaboration between services. In our 800-bed teaching hospital, 58% of patients on general medicine units in 2017 had at least 1 consultant team, with the average patient receiving 4.8 consults. [...]

Background: Pneumocystis jirovecii pneumonia (PJP) is an opportunistic infection associated with lymphopenic conditions including HIV/AIDS, hematologic malignancy1, organ transplantation2, and lymphocyte-suppressive therapies such as high dose glucocorticoids3,4. PJP prophylaxis, which is highly effective, is indicated when the incidence of PJP exceeds the rate of adverse events due to prophylaxis.4,7 Guidelines from the American Thoracic Society [...]

Background: Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), constitute a major health problem in the United States Health System, with a reported high mortality rate and significant economic toll. Despite the prevalence of VTE and associated mortality, clinicians have struggled in prescribing appropriate VTE prophylaxis for the inpatient population, often [...]

Background: Hospitalized patients are often kept fasting for various reasons, including clinical conditions, procedures and imaging, or dysphagia (1). Studies have demonstrated the harm of excessive fasting, including increased post-operative delirium (2), thirst and hunger, and patient dissatisfaction. Accordingly, recent guidelines have promoted a more liberal preoperative fasting strategy, namely, allowing clear liquids up to [...]

Background: Diabetes is a chronic disease that has turned into a global healthcare epidemic. With time, the focus in diabetes care has shifted to patient education and empowerment. Diabetes educators are professionals who focus on educating individuals with and at risk for diabetes to become effective self-managers. Diabetes educators do not only provide information and [...]