Background: When patients are transferred between hospitals (interhospital transfer, IHT), incomplete information exchange between electronic health records (EHRs) poses a barrier to continuity of care. As a result, diagnostic tests may be repeated after transfer, exposing patients to additional risk and adding to costs of care. Shared clinical data between EHRs presents a possible solution. [...]

Background: Hospital readmission rate is viewed as an indirect indicator of quality of care provided by a hospital. We completed a small pilot study looking at a multidisciplinary bedside huddle in the 24 – 48 hours before discharge which decreased readmission rates in high risk patients from 36% to 20% in a small pilot study. [...]

Background: Wilson Disease (WD) is a known cause of liver test abnormalities. Guidelines have been established to help clinicians avoid routine testing. According to the American Association for the Study of Liver Diseases (AASLD) Guideline, screening for WD—with serum ceruloplasmin, 24-hour urinary copper excretion, and slit-lamp examination for Kayser-Fleischer rings—is warranted in any patient with [...]

Background: One of the Society of Hospital Medicine (SHM) core competencies (listed as Principle 7) is that Hospitalists provide effective clinical resource utilization. Examples: cost effective care, high-value care, and designing processes that address cost per stay and readmissions. Optimized inpatient throughput has been shown as a strategy to improve overall hospital flow, including streamlined [...]

Case Presentation: A 14-year-old male presented to an emergency department with 6 days of left thigh pain and inability to bear weight following a fall from bed. Associated symptoms included nausea, diaphoresis and weakness. Review of systems revealed pallor, easy bruising and yellow eyes. history was negative except for developmental delay, described as auditory processing [...]

Case Presentation: A 12 year-old girl with a history of asthma and migraine headaches presented to the ED with a one week history of headaches and bloody tears. She first developed headache and left eye pain and pruritis one week prior, followed by blurry vision and bloody discharge from the left eye. She presented to [...]

Case Presentation: A 14yo girl presented with syncope and 4 days of URI symptoms. She had no past medical or family history. On presentation, she was hypotensive with mildly elevated lactate, troponin, and BNP, and an unremarkable ECG and chest radiograph. Initial echocardiogram showed normal LV function. Cardiac MRI revealed a pericardial effusion and increased [...]

Case Presentation: A five-year-old boy with autism presented to the hospital with two-months of fatigue, lower extremity pain, and a petechial rash. Review of systems was notable for a two-kilogram weight loss, intermittent gingival bleeding and refusal to walk for one week. On admission he was afebrile with a heart rate of 160 beats per [...]

Case Presentation: Almost 3 yo female presented to the ED) with multiple contusions, finger fractures and abrasions. Mother sought care for evaluation of a left occipital swelling that she noticed following the patient’s stay with a respite-care. The worker denied injury. When questioned by the social worker, the mother mentioned that her daughter did not [...]

Case Presentation: 11 y/o M presenting with 2 months of worsening headache and 2-3 days of rapidly progressive blurry vision. Patient initially presented to his school nurse after complaining in class of blurry vision. He was seen by a local optometrist and then transferred to the emergency department for further evaluation. Ophthalmologic evaluation in the [...]