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: 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: 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: 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:  The Society of Hospital Medicine considers stroke care to be a core competency in hospital medicine.  Hospitalists must be prepared to lead inpatient stroke alerts, as neurologists may not be readily available outside of academic medical centers.  However, even graduates of hospitalist training programs may report insufficient experience in leading these complex, time-pressured, high-stakes [...]

Background: At its 2014 peak, the opioid overdose crisis claimed nearly 30,000 lives, but many hospitals and health systems have small opioid-related initiatives working in disjointed fashion rather than a cohesive response.  Purpose: We created a hospital-wide initiative called the “Brigham Comprehensive Opioid Response and Education” (B-CORE) program to reduce opioid-related morbidity and mortality in [...]

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: Practical and financial pressures have placed a renewed focus on improving the human experience of healthcare from both the patient and provider perspective. Despite this, aligning patients and interdisciplinary providers around meaningful experience improvement in the inpatient setting remains elusive. We sought to develop an innovative interdisciplinary design process for experience improvement on a [...]

Case Presentation: This is a 76 year-old female with no significant past medical history who presented to her primary care physician for evaluation of changes in visual acuity and color perception. Two months after initial presentation she was referred to see an ophthalmologist who noted bilateral papilledema. An MRA, MRV, and MRI were obtained without [...]

Case Presentation: A 31 year old male with no significant past medical history presented with recurrent fevers, nausea, vomiting and headaches.  He denied travel outside the U.S, camping, or hiking.  Temperature was 103F associated with tachycardia. Physical examination was unremarkable except for mild scleral icterus.Initial labs showed transaminitis, hyperbilirubinemia, leukocytosis, thrombocytopenia, and elevated ferritin > [...]