Background: ED visits increased to 145.59 million in 2016 (CDC 2019), resulting in an increase in hospital admissions. Chen et al. showed a correlation between the overall ED census and likelihood of admission; while, Velasquez et al. found up to 28% of hospitalists reported having admitted patients when no admission criteria were met. They described [...]

Background: Cardiovascular disease remains the leading cause of death in the United States. Approximately every 40 seconds, an American will have a myocardial infarction. The aim of this project is to assess the progress of the prevention and management of myocardial infarction by using the National Inpatient Sample (NIS) data. Methods: This is a retrospective [...]

Background: Migraine headache (MHA) is a common pediatric disorder, which frequently leads to hospital admission. Inpatient MHA treatment involves ever-increasingly complex treatment plans, including fluid resuscitation and a variety of medications. Severe Migraine headache may require more aggressive therapy such as dihydroergotamine (DHE) and sphenopalatine ganglion (SPG) block that may prolong hospital stay and increase [...]

Background: Hospital Medicine is being increasingly involved in improving various metrices of inpatient care such as length of stay and cost of care. Patients who do not meet ‘inpatient criteria’ often contribute to significant financial costs to hospitals and remain in ‘observation status’ during their hospital stay. Observations units which were introduced by emergency doctors [...]

Background: Acutely-ill and multimorbid patients are frequently exposed to unintended medication errors after admission and their impacts on patient safety are profound. Designated ward-pharmacists as team members of our Hospital Medicine Center reconcile medications of hospitalized patients by identifying discrepancies in patients’ current medications and the medication used in acute care in emergency departments or [...]

Background: Whether or not a specialty medical center provides better patient outcomes and lower cost compared to a general hospital is controversial. In addition, few studies have focused on the specialty orthopaedic centers. The objective of our study is to evaluate if hospital length of stay (LOS) and cost were improved after the building of [...]

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: While multiple organizations have recommended reducing unnecessary and repetitive lab tests in hospitalized patients, this has not resulted in a widespread change in behavior. There is agreement that unwarranted labs increase costs, but data around specific lab costs have not been readily available. At baseline, there were 125,586 labs ordered by the UNC Rex [...]

Case Presentation: A 78-year-old woman with severe persistent asthma on a maximum dose of inhaled corticosteroids (ICS) was admitted for lethargy and skin nodules on her thighs. She had three hospital admissions in the past two months for reported pneumonia. She was found to have fever, left basilar crackles, and multiple violaceous, firm, tender subcutaneous [...]

Case Presentation: A 63-year-old man with lung adenocarcinoma with multiple rib metastases and lytic spinal lesions was receiving palliative radiation treatment when computed tomography (CT) incidentally revealed a fluid collection along the anterior cecum with pneumatosis. Cultures taken during CT-guided abscess drainage were positive for piperacillin-tazobactam-sensitive enterococcus, and the patient was started on antibiotics. His [...]