Background: Hospitalists are key stakeholders in patient flow throughout the hospital and are pivotal in creating efficient patient movement. Throughput metrics are a large focus for all hospitals, and it takes collaborative effort from many disciplines to effectively shift patient flow toward efficiency. Purpose: To reduce decision to admit to bed minutes in a collaborative […]

Background: Hospitalists are key stakeholders in patient flow throughout the hospital and are pivotal in creating efficient patient movement. Throughput metrics are a large focus for all hospitals, and it takes collaborative effort from many disciplines to effectively shift patient flow toward efficiency. Purpose: To reduce decision to admit to bed minutes in a collaborative […]

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 […]

Case Presentation: Linear IgA bullous dermatosis is a rare autoimmune blistering disorder. Most cases are idiopathic but medications, infections and malignancies have also been reported. Although a variety of medications have been implicated in drug‐induced linear IgA bullous dermatosis, vancomycin is the most common associated drug. We present an 80‐year‐old woman with squamous cell cervical […]

Background: Internal medicine and hospital medicine providers are under pressure to move patients quickly through the hospital and decrease length of stay. Providers spending most of their clinical time seeing patients, documenting or coordinating care and have minimal time to disrupt workflow to perform common bedside procedures such as paracentesis, lumbar punctures, central lines, arthrocentesis […]

Case Presentation: A 36‐year‐old man was seen for preoperative assessment before wound debridement. His history included sickle cell disease previously complicated by superior vena cava (SVC) syndrome, which required surgical jugular‐vein‐to‐right‐atrium bypass grafts. He denied headache, dyspnea, or melena, but reported “food sometimes gets caught in [my] throat.” On exam, his torso veins were prominent […]

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, […]

Case Presentation: Aortoesophageal fistula is a rare but life‐threatening complication after surgical aortic repair and should be considered in patients with history of aortic graft placement who complains of unexplained gastrointestinal bleeding. The mortality rate of an unrecognized fistula is 100%. A 51‐year‐old African American woman with a history of uncontrolled hypertension, iron deficiency anemia […]