Background: Our institution’s rate of hospital acquired Clostridioides difficile (C. diff) infection (CDI) is higher than expected based on documented severity of illness of our patients. The C. diff testing algorithm at our institution utilizes a multi-step approach. It begins with two tests (antigen EIA and toxin A/B EIA). If the results of these two […]

Background: Our institution’s rate of hospital acquired Clostridioides difficile (C. diff) infection (CDI) is higher than expected based on documented severity of illness of our patients. The C. diff testing algorithm at our institution utilizes a multi-step approach. It begins with two tests (antigen EIA and toxin A/B EIA). If the results of these two […]

Background: Up to 12% of hospitalized patients require high dose parenteral thiamine treatment to prevent Wernicke’s Encephalopathy, a devastating and easily preventable neurologic disorder that can lead to death. Despite the fact that it is as simple and relatively inexpensive therapy with no known side effects, high dose thiamine continues to be underutilized. Attempts to […]

Case Presentation: An 82‐year‐old woman came to the emergency department with pleuritic chest pain, cough, and fever. On arrival, she was found to have aphasia and right‐sided hemiparesis. Her family noted that she was normal just hours before. CT scan and MRI of her brain demonstrated only chronic ischemic changes consistent with her previous lacunar […]

Case Presentation: A lovely 56‐year‐old woman was admitted with ongoing issues pertaining to a recently diagnosed lower‐extremity deep vein thrombosis (DVT). She was originally diagnosed with heparin‐induced thrombocytopenia, but re‐presented with a new DVT despite adequate outpatient anticoagulation. On admission, the patient was initially managed with intravenous bivalirudin; however, during the hospitalization she experienced issues […]

Background: The electronic health record (EHR) is a major focus of a hospitalist’s daily work but is also often a frustration. Organizations offer providers the chance to recommend improvements to the system, but frequently there are significant delays in implementation or the request does not even cross the threshold for institutional action. Additionally, of those […]