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Abstract Number: 472
Hospital Medicine 2020, Virtual Competition
Background: “Hospital at Home” (HaH) models of care have existed for over 20 years in the U.S. Recent demand for healthcare value and advances in relevant technologies have driven renewed attention to HaH models, including from the Center for Medicare and Medicaid Services (CMS), and have spawned several pilots within the U.S. Where studied, these […]
Abstract Number: 473
Hospital Medicine 2020, Virtual Competition
Background: In many urban hospitals, Emergency Department (ED) crowding and patient boarding is an increasing challenge. Admitted patients often spend prolonged periods of time in the ED while waiting for an inpatient bed. These ED boarded patients can have delayed or inadequate care, increased adverse events and increased mortality. Furthermore, these ED boarded patients place […]
Abstract Number: 477
Hospital Medicine 2020, Virtual Competition
Background: The timing of discharges of admitted patients has a significant impact on hospital efficiency and throughput. Earlier discharges are associated with improved boarding times, admissions arriving to inpatient units earlier in the day, and decreased length of stay. Discharges that occur later in the day creates a bottleneck effect, causing emergency room congestion, overcrowding, […]
Abstract Number: 483
Hospital Medicine 2020, Virtual Competition
Background: The merging of academic and community hospitals into a single large healthcare system often does not account for the differences in health care delivery between sites, despite attempts by the system to streamline care through standardized policies, common metrics, and a shared medical record system. Multi-site service lines can be an effective strategy for […]
Abstract Number: 485
Hospital Medicine 2020, Virtual Competition
Case Presentation: Our patient is a 64 year old gentleman with a history of prior cerebellar stroke who presented to the Emergency Department (ED) after being found unresponsive in his car by bystanders. On ED evaluation he was noted to be lethargic, able to follow commands but unable to recall what happened. Neurologic exam in […]
Abstract Number: 501
Hospital Medicine 2020, Virtual Competition
Case Presentation: A 54-year-old never-smoker female with hypothyroidism and rheumatoid arthritis on etanercept presented with intermittent hemoptysis. Three days prior, she reported coughing ~100mL of frank blood and clots (Figure 1) over the course of 24 hours, with smaller volumes over the next two days (~50 mL total). She recounted a similar episode of hemoptysis […]
Abstract Number: 679
Hospital Medicine 2020, Virtual Competition
Case Presentation: The patient is a 60-year-old male with chronic mixed systolic and diastolic heart failure, Chronic Obstructive Pulmonary Disease (COPD), and Obstructive Sleep Apnea (OSA) who was admitted to general medicine due to a 4-week history of progressive dyspnea and lower extremity edema, concerning for a heart failure exacerbation. Eight days into his hospital […]
Abstract Number: 758
Hospital Medicine 2020, Virtual Competition
Case Presentation: The patient was a 38 year old male with a 5 year history of ulcerative colitis (UC) who presented with a flare of symptoms during the past year, resulting in a 60 lb weight loss. He had been having up to 42 bloody bowel movements per day. The patient was found to have […]
Abstract Number: 928
Hospital Medicine 2020, Virtual Competition
Case Presentation: A 70 year-old woman with no known history was admitted with symptoms of urinary incontinence and generalized weakness. Workup was notable for a positive urinalysis, positive Influenza swab, and serum sodium of 142mmol/L. She was started on ceftriaxone, oseltamivir and isotonic fluids (normal saline). On hospital day (HD) 2, her sodium was 159mmol/L, […]
Abstract Number: 1200
Hospital Medicine 2020, Virtual Competition
Case Presentation: An 8-year-old fully vaccinated female developed fever, abdominal pain, sore throat, and vomiting 6 days prior to admission. When seen by her pediatrician 4 days prior, she had an erythematous oropharynx and was treated with amoxicillin for streptococcus pharyngitis. The following day, she developed blood-streaked emesis and was seen in a local Emergency […]