Background: Cancer screening guidelines based on age, biological sex, and degree of risk are intended to diagnose malignancies early and in the outpatient setting. Despite these efforts, malignancies are often diagnosed while patients are admitted to the hospital. These diagnoses are made either incidentally or after the onset of a clinical condition that necessitates an [...]

Background: Tumor lysis syndrome (TLS) is a major life-threatening oncological emergency where accelerated damage of rapidly proliferating tumor cells results in critical metabolic derangements including hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia potentially leading to acute kidney injury (AKI) and multi-organ failure. TLS has been well documented in hematologic malignancies but is extremely rare in solid neoplasms, [...]

Background: Discrimination is rampant in our society and remains a persistent topic given our current political climate. A meta-analysis in 2011 documenting discrimination amongst all levels of health care providers showed a prevalence of verbal abuse of 63%, gender discrimination 54%, and racial discrimination 24%. The purpose of our study is to identify the magnitude [...]

Background: Care fragmentation is associated with a number of clinical and socio-demographic features which have been thought to increase hospital utilization as well as morbidity and mortality. Patients who receive fragmented care at the hospital level are often underinsured and uninsured. It is unclear to what degree lack of insurance and subsequently lack of continuous [...]

Background: In the US, hospitalist system has been introduced with improvement of quality and safety of care, education and value. Japan now face rapidly declining birthrate and aging population. Organ-based subspecialty system has difficulty in managing patients with multiple diseases. Patient-centered general medical care is required for inpatient management. However, in Japan, there are only [...]

Background: Fingerstick blood glucose (FSBG) testing allows inpatient providers to adjust insulin in real time to protect patients from significant hypo- or hyperglycemia. Admitted diabetic patients are often placed on sliding scale insulin with four times per day FSBG testing, regardless of home insulin use. FSBG test materials cost $9 per use (1). We estimate [...]

Background: Patients (pts) with congestive heart failure (CHF) are at an increased risk for community-acquired bacterial pneumonia (CABP) [1]. Moreover, CABP itself and macrolide antibiotics, which current guidelines recommend for CABP treatment [2], are both associated with increased risk of cardiac events, including worsening heart failure [3,4]. Lefamulin (LEF) is a first-in-class systemic pleuromutilin antibiotic [...]

Background: Physical therapy (PT) is a valuable tool to help prevent the functional decline and loss of mobility hospitalized patients experience. Yet, it is a constrained resource in most hospital settings. The AM-PAC score is a validated tool that has been used to predict discharge destination within 48 hours of admission. It has also been [...]

Background: In light of increasing healthcare costs, diagnostic stewardship is an important component of providing high-value healthcare. Order sets, a collection of orders aggregated in a single location for a given diagnosis, condition, or treatment, are designed to promote adherence to evidence-based practices and reduce variability in care—both known drivers of high-value care (Atlas SJ [...]

Background: Older adults commonly lose mobility during hospitalization. This loss of mobility may be preventable if it is identified and addressed early in a patient’s hospital course. However, currently there is no systematic method to identify these patients early, and current practices are guided by physician experience and intuition. To this end, we used machine [...]