Background: Prognostication of survival in advanced cancer patients has been challenging and contributes to poor illness understanding. Disagreements among providers about prognosis occur and is a less studied phenomenon. We asked the Surprise Question (SQ), “Would I be surprised if this patient died within the next 1 year, 6 months, and 1 month?” to Palliative [...]

Background: Few hospital medicine physicians receive formal instruction on coding for inpatient evaluation and management (E&M) services. When feedback on billing practice is provided, it tends to focus on coding accuracy relative to clinical documentation requirements, but with varying results. An individual physician scorecard with peer group comparisons may more reliably influence coding behavior. Methods: [...]

Background: Telemetry is an essential tool for real-time monitoring of the heart rhythm and QRS morphology of a patient. American College of Cardiology and American Heart Association had published their respective practice standards for in-hospital cardiac monitoring for the detection of cardiac arrhythmias. Nonetheless, these recommendations were mostly based on expert opinions which focused almost [...]

Background: Situated in coastal Florida, the four hospitals/1,000 beds in the Health First Integrated delivery network are located right in hurricane alley. Our hospitalist program had to plan for, communicate, and execute our hurricane staffing and disaster plan twice in one year. Purpose: Lessons learned from the implementation of our Hospitalist staffing and disaster plan [...]

Background: Millions of patients with cancer are hospitalized each year in the US for treatment or complications of their disease. Increasing numbers are cared for by hospitalists on services dedicated to patients with cancer. Little is known about the practice characteristics or working environment of this expanding pool of oncology hospitalists. Methods: Using a modified [...]

Background: Coffee is a widely consumed beverage. Evidence suggests that coffee consumption is associated with a substantially lower risk of type 2 diabetes (1). However, there is paucity of literature on whether coffee consumption has any protective effect on people who already have diabetes. We sought to examine the association between caffeine consumption and hemoglobin [...]

Background: Ultrasound-guidance has become the standard for bedside procedures in the emergency and inpatient settings due to its perceived impact on first attempt success and complications. Prior literature on paracentesis notes a 10% rate of overall complications, 5% rate of technical problems, and a 1% rate of bleeding. However, existing cohorts often include outpatients or [...]

Background: Procalcitonin (PCT) is a precursor peptide to calcitonin produced by the thyroid parafollicular cells, and the intestinal and lung neuroendocrine cells. PCT is a proinflammatoy marker specific to bacterial infections, and was initially used clinically to guide antibiotic therapy in lower respiratory tract infections. PCT has seen its role expanded to aid with initiation, [...]

Background: Patients who are frequently admitted to Medicine inpatient services comprise a distinct subset of readmitted patients about whom not much is known. A prior study collected data on characteristics of 153 frequently hospitalized patients. This was a follow-up evaluation to determine the categories of patients the original cohort belonged to, and to collect mortality [...]

Background: Vitamin K antagonists (VKA) remain widely used in the treatment of venous thromboembolism (VTE). During surgical interventions, the prevention of recurrent VTE must be weighed against the increased bleeding risk conferred by anticoagulation. There is a lack of strong evidence to guide the optimal periprocedural management of anticoagulation in patients with prior VTE, and [...]