Background: Trauma co-management is a growing field within hospital medicine. While improvements in quality metrics have been documented in other co-management services, the impact of co-management of trauma patients is uncertain. This study aimed to determine whether a hospitalist trauma co-management program improves clinical outcomes. Methods: This was a pre- and post-implementation study comparing trauma [...]

Background: Literature regarding resident education in transitions of care is limited, particularly in geriatric populations. The University of Colorado performed a pilot of a virtual multidisciplinary conference call between providers on the geriatric inpatient unit of the University of Colorado Hospital and its Seniors Clinic. Residents rotating on the Acute Care of the Elder (ACE) [...]

Background: Delirium is a common and costly occurrence in hospitalized patients, particularly elderly patients. Diagnosing delirium can be challenging, particularly given the fluctuating nature of presentation and subtle hypoactive motor subtypes. The Brief Confusion Assessment Method (bCAM) is a delirium screening tool that has been validated for use in the med-surg clinical area. As part [...]

Background: Although many older adults will be hospitalized in their lifetime, most do not consider or plan ahead for their post-hospitalization support needs. When older adults experience a hospitalization, families often must react to the crisis leaving the older adult out of the decision process (e.g. choosing a skilled nursing facility, caregivers). With PCORI funding, [...]

Background: The relation of a patient’s age to survival in cardiac arrest is often discussed at the bedside when clinicians, patients, and families are faced with the question of whether CPR is medically appropriate for elderly individuals. Few studies are available to help guide this conversation. This study sought to evaluate in-hospital cardiac arrest (IHCA) [...]

Background: Atrial fibrillation (AF) is strongly age-dependent, and with a growing geriatric population, the incidence and prevalence of AF is expected to increase in the United States. As a result, the number of patients at risk of a thromboembolic event due to AF is also expected to increase. Although bleeding associated with mechanical falls is [...]

Background: Delirium is associated with increased morbidity, mortality and health care costs in the hospital setting secondary to increased length of stay and poor long term outcomes (1,2). A systematic review of different delirium prediction models found limitations with these models including derivation from small patient populations, lack of heterogeneity, accuracy and reliability as noted [...]

Background: More than two million people are evaluated for syncope each year in the United States, and approximately 30-40% of these patients are hospitalized for further costly investigation. Total annual cost of syncope related hospital evaluation is estimated to be over 2 billion dollars. The most common cause of syncope is reflex mediated. It does [...]

Background: Addressing the needs of the geriatric population is critical, as “baby boomers” comprise a larger proportion of hospitalized patients. Hospitalists increasingly care for these complex geriatric patients. The “BEERS Criteria” are evidence-based guidelines that encourage medication safety by describing potentially inappropriate and harmful medications (PIMS) among geriatric patients. BEERS guidelines recommend that with a [...]

Background: Syncope is usually an isolated occurrence in younger patients whereas it is multi factorial with many predisposing factors in the elderly. Medication use, co-morbidities and functional decline further complicate syncope evaluation in the elderly. Hence, elderly patients presenting with syncope must be risk stratified uniquely. San Francisco Syncope Rule (SFSR) and Evaluation of Guidelines [...]