Background: Previous studies have shown reduced costs and length of hospital with surgical comanagement performed by hospitalists. In Latin America, however, this practice of comanagement is still not standard among surgeons. The Hospital Nossa Senhora da Conceição, localized in Southern Brazil, was the pioneer of Hospital Medicine in our country. It is a public, tertiary, [...]

Background: After Libby Zion died tragically in a teaching hospital, much attention from the medical community, public and government, was directed at resident training and the number of hours worked consecutively. This marked a new era heralded by close scrutiny of the time residents spent in the hospital. Two dramatic reductions were mandated nationally by [...]

Background: Although diagnostic errors are common in hospitals, little is known about the resulting economic burden. Whether the increasing attention to patient safety has led to a decrease in diagnostic error-related claims and cost over time is also unknown. Using a publicly available dataset, we examined incidence costs and outcomes associated with diagnostic errors in [...]

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: 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: Intravenous low-molecular weight iron dextran is indicated for patients with iron deficiency who are unable to take oral iron or experience insufficient efficacy with oral replacement. Adverse effects have been reported, including anaphylaxis and death. The primary purpose of this study was to determine the proportion of patients experiencing adverse reactions in a wide [...]

Background: Hospital associated injury is the third leading cause of death in the United States. Lack of communication about patient safety issues among care team members and with patients is a key source of hospital errors and patient harm, and making errors more visible is a key strategy to reduce negative outcomes. Electronic health record [...]

Background: Given the widespread adoption of electronic health record systems, the majority of patient orders are now enacted through electronic orders. We aimed to describe the average number of electronic orders entered for medicine patients hospitalized at different levels of care and determine if electronic ordering patterns reflected patient acuity and severity of illness. Methods: [...]

Background: Medical patients with comorbid psychiatric illness comprise 20-40% of general medicine inpatient admissions. These patients often have multiple providers involved in their care which can lead to poor communication, longer lengths of stay, and increased resource utilization. Despite substantial need, no standard model of care exists for this patient population. At our academic medical [...]

Background: In the past 20 years, the “10/30” rule for blood transfusions has been replaced with conservative guidelines which have demonstrated improved patient outcomes and reduced overall healthcare costs. Hospitals across the country have enlisted transfusion subcommittees to review the appropriateness of blood transfusions. Within medical training, resident physicians rotate with different attendings who have [...]