Background: Assessing vitals at regular intervals can be disruptive to a patient’s rest and unnecessary if the patient is clinically stable. These interruptions may lead to impaired sleep, parental fatigue and anxiety, delayed discharge, and increased cost of care. Moreover, alarm fatigue has been described with over-monitoring of patients, as has the overuse of staff […]

Background: Assessing vitals at regular intervals can be disruptive to a patient’s rest and unnecessary if the patient is clinically stable. These interruptions may lead to impaired sleep, parental fatigue and anxiety, delayed discharge, and increased cost of care. Moreover, alarm fatigue has been described with over-monitoring of patients, as has the overuse of staff […]

Background: One of the challenges in hospital medicine is the care of patients overnight, when the primary team is unavailable, and care is being provided by those who are not as familiar with the patient. This is compounded by the high volume of pages at night. At UNC Rex Hospital, these factors resulted in delays […]

Background: One of the challenges in hospital medicine is the care of patients overnight, when the primary team is unavailable, and care is being provided by those who are not as familiar with the patient. This is compounded by the high volume of pages at night. At UNC Rex Hospital, these factors resulted in delays […]

Background: After discharge from an acute care hospitalization, cancer patients may choose to pursue rehabilitative care in a skilled nursing facility (SNF). Our objective was to examine receipt of anti-cancer therapy, death, readmission, and hospice use of cancer patients who discharge to a SNF compared to those who discharge home or home with home health […]

Background: At this 328‐bed hospital there were 8 hospitalists rounding on up to 9 units per day. This prevented efficient and effective communication with nurses, patients, and families. Physicians spent more than 30 minutes of travel time per day. Length of stay and census per physician were high; patient satisfaction was low. With a deadline […]

Case Presentation: A 61‐year‐old visiting Trinidadian woman with squamous‐cell rectal cancer and hypertension who had received multiple courses of chemotherapy and radiation therapy beginning in May 2012 and was hospitalized in July 2012 at a New York hospital for suspected chemotherapy‐induced anemia. During this hospitalization she received 3 units of packed red blood cells (pRBCs). […]

Background: Family-centered rounds on our pediatric hospital medicine teaching service, which cares for patients in multiple units throughout the hospital, are often prolonged with unpredictable progression. This contributes to inconsistent nursing participation, inefficiencies in patient care, and variable end times. Through the implementation of scheduled-based rounding, our aims were to: 1) start 90% of rounds […]

Case Presentation: A 55‐year‐old man with history of alcohol abuse, presented with 2 days history of shortness of breath, cough, fever, chills, and confusion. He was unconscious on admission and was intubated and placed on mechanical ventilation. On examination, he was unresponsive with vitals signs significant for sinus tachycardia and hypotension. He had decreased right‐sided […]

Background: Effective nurse-physician communication is imperative to safe, patient-centered care. Poor communication can lead to adverse events, ranging from near misses to patient deaths. It is important for information to be accurate and timely. In addition to patient safety, there are financial implications to poor communication. According to a 2015 study, communication failures in the […]