Background: Venous thromboembolism (VTE) is a common inpatient condition, managed with high‐risk anticoagulants. VTE management is often suboptimal. Inpatient anticoagulation teams improve anticoagulation processes and outcomes, but many centers (including ours) lack this resource. Diverse health care systems would benefit from alternative methods to optimize VTE management in the absence of an anticoagulation team. Methods: […]

Background: The approach to managing and admitting patients with syncope in an emergency setting lacks standardization. Our study aims to investigate how regional variation in management of emergency department (ED) patients presenting with syncope impacts outcomes and resource utilization in this patient population. Methods: We used the 2006 to 2014 Nationwide Emergency Department Sample to […]

Background: In the United States, the relative incidence of diverticulitis has continued to rise and represents a significant portion of gastrointestinal related hospitalizations [1]. Management and treatment can include both medical and surgical options. Of recent, considerable attention has been given to try to decrease healthcare utilization [2]. We sought out to determine the annual […]

Background: Since the landmark IOM report “To err is human” was published in 2000, national focus has been on patient safety and preventing medical errors. Miscommunication during patient care handoffs is a particular area of concern. Because of the sheer number of handoffs that occur, the potential for these to cause harm is enormous. There […]

Case Presentation: A 56‐year‐old woman presented to the emergency room with left ear pain with sanguineous drainage for 2 days. She had a history of biopsy‐proven benign left ear mass 1 year prior, but was lost to follow‐up. She was febrile, tachycardic, hypertensive, and had leukocytosis. Initial management included volume resuscitation, analgesics and acetaminophen, and […]

Background: Asthma, bronchiolitis, and pneumonia are common pediatric inpatient diagnoses. Viral testing (VT) is not routinely necessary for these diagnoses as it often does not impact management. Our study objectives for each diagnosis are to; 1) describe trends in VT over the last 5 years including seasonal variation (respiratory season- Oct-March versus non-respiratory season- April-Sept), […]

Case Presentation: A 20‐year‐old healthy man with no significant medical history presented to the emergency department with multiple episodes of watery, bilious, nonbloody vomiting associated with nausea and poor oral intake for 3 days. He also had an episode of watery diarrhea. The patient denied any fever, chills, abdominal pain, recent respiratory tract infections, ill […]

Background: While multiple organizations have recommended reducing unnecessary and repetitive lab tests in hospitalized patients, this has not resulted in a widespread change in behavior. There is agreement that unwarranted labs increase costs, but data around specific lab costs have not been readily available. At baseline, there were 125,586 labs ordered by the UNC Rex […]

Background: Preventable ED visits account for 20-50% of ED visits. (1, 2) Though student-run free clinics (SRFCs) could play an important role in decreasing unnecessary utilization, current ED utilization in SRFCs and risk factors have not been described. Methods: We conducted a cross-sectional study of patients receiving care at a student-run free clinic. We captured […]