Background: Complex patients represent a challenge in the health care system, as they are frequently associated with high health care utilization, longer hospital stays, and higher costs. Nonetheless, the characteristics of the complex patients in the hospital setting are not well known, and tools to help hospitals to identify them early in the process of [...]

Background: While anticoagulants are the core treatment plan for preventing strokes in patients with atrial fibrillation and managing patients with thromboembolic disease, there is a dichotomy of efficacy and harm with their use. Rapid inpatient reversal protocols are important for patient safety. Four factor prothrombin complex concentrate (4FPCC) is approved for reversal of warfarin-induced coagulopathy. [...]

Background: In 2014, the organization created the RRT, a multidisciplinary team that reviews care of frequently admitted patients, strategizes how to help these patients, and coordinates care to develop a treatment plan. Of the patients reviewed, the team delivered a 47% decrease in readmissions. Purpose: The RRT addresses the needs of complex, chronically ill patients [...]

Background: Due to the complexity of patient discharge needs leading to increased length of stay within a large academic medical center, a specialized inpatient unit became a priority. Purpose: The University of Kentucky Healthcare created the Complex Discharge team to identify and manage patients who may have a long length of stay, a challenging placement [...]

Case Presentation: A 2-year-old girl with a past medical history of hypertension and anterior mediastinal mass of unclear etiology presents to the ED with acute bruising. 2 months prior, she was admitted to PICU for fever and lethargy, AKI, hyperuricemia and electrolyte abnormalities concerning for tumor lysis syndrome (TLS), and was found to have a [...]

Case Presentation: 54 years old man with a history of hypertension was hospitalized due to elevated BUN/creatinine of 33/4.6 mg/dL and Hb of 9.9 mg/dL (baseline 15). He endorsed dyspnea on exertion, anorexia and weight loss of 15 pounds in 6 months. One month ago, he was treated for acute bronchitis with levofloxacin and was [...]

Case Presentation: A 41-year-old female presented with non-productive cough and worsening exertional shortness of breath for 3 weeks. She denied fever, night sweats, orthopnea, paroxysmal nocturnal dyspnea. There was no history of recent travel, smoking, or illicit drug use. She did not have any significant past medical or family history. On physical exam, there was [...]

Case Presentation: 64-year-old female with non-insulin-dependent type 2 diabetes mellitus presented to the emergency room with a 2-week history of progressive pain and swelling of her left index finger. Prior outpatient evaluation with X-rays and MRI resulted negative, and a Cortisone injection and anti-inflammatories provided no relief. She reported difficulty moving her finger, increased warmth [...]