Background: Imaging exams performed on hospitalized patients commonly reveal findings representing possible cancer and requiring follow-up. Our objective was to quantify how often indeterminate or suspicious masses are detected on inpatient abdominal and pelvic imaging exams by exam type and organ. Methods: Our health system uses a standardized coding scheme, similar to the Breast Imaging [...]

Background:   Congestive heart failure is a leading cause of hospitalization in adults greater than 65 years old. It is estimated that over 1 million people are hospitalized annually with a primary diagnosis of heart failure. Given the challenges of heart failure management, readmission within 30 days of hospital discharge is estimated to be 24%. [...]

Background: Although 1 in 10 people suffer from chronic insomnia, the prevalence among hospitalized patients is likely higher, due to common comorbidities such as depression and chronic pain in this population. We aimed to assess the prevalence of undiagnosed insomnia among hospitalized adults and examine the associations between severity of insomnia and in-hospital sleep duration [...]

Background: Cardiac readmissions are an ever expanding burden spanning from patients, to hospitals, all the way up to the national healthcare system. Currently, there is a lack of consensus regarding appropriate inpatient screening tests for identifying patients at high risk for readmission, as well as peri-hospitalization disease management regimens aiming to prevent readmissions. Our clinical [...]

Background: Up to 67% of patients have at least one medication error on admission to the hospital with over a quarter of hospital prescribing errors attributed to incomplete medication histories at admission. Key aspects of successful interventions to date include intensive pharmacy staff involvement. However, pharmacists are in short supply in many hospitals. Methods: A [...]

Background: The overall incidence of Clostridium difficile infection (CDI) is higher among patients with inflammatory bowel disease (IBD). The nature of this disease association is unknown but likely involves an altered gut microbiome and impaired host immune responses. Studies on CDI in IBD patients have yielded variable and conflicting results on outcome measures such as [...]

Background: Kaiser Permanente Roseville Medical Center is a 340 bed facility in Northern California.  Reducing readmissions has been a focus, and the current observed over expected rate is 0.77.  Starting from this relatively low readmission rate, our focus has been optimizing care for patients at high risk of readmission. A retrospective review of all patients [...]

Background: Sickle cell disease (SCD) causes frequent painful episodes from vaso-occlusion. As hospitalists, we identified that SCD patients occupied a large number of hospital days. Undertreatment and lack of standardization of pain management was a likely reason for this. Many of these patients are opiate dependent at baseline. Varying levels of comfort amongst hospitalists in [...]

Background: Sleep is generally poor in hospitalized patients and sleep deprivation has many harmful effects, including delirium, insulin resistance, hypertension, and impaired function of the immune system. In this quality improvement (QI) project, our goal was to delay early morning phlebotomy blood collections to improve sleep for our patients, while not negatively impacting hospitalists’ perception [...]

Background: In the inpatient setting, opioids are the most commonly prescribed medication and the 2nd most frequent cause of adverse drug events (ADE).  Identifying patients at high risk for ADEs related to narcotics is essential.  These ADEs include ileus, altered mental status, and respiratory depression. Obstructive sleep apnea, organ impairment, and other medication use (i.e. [...]