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Abstract Number: 268
Hospital Medicine 2018; April 8-11; Orlando, Fla.
Background: Opening new residency programs in community hospitals is one strategy to address physician shortage. Previous reports showed better outcomes in university based hospitals. However, less is known about teaching community hospitals. Disrupting well- established workflows in community hospitals is feared to cause an increased cost and possibly a slide in quality of care. Our […]
Abstract Number: 279
Hospital Medicine 2018; April 8-11; Orlando, Fla.
Background: Currently, patients admitted to the hospital are assigned specific levels of care such as intermediate intensive care or acute care. Differences among care at these levels largely differ through nursing ratio as well as frequency of nursing assessment. Costs per day for patients at different levels of care differ significantly as well. Little is […]
Abstract Number: 284
Hospital Medicine 2017, May 1-4, 2017; Las Vegas, Nev.
Background: Unnecessary diagnostic testing contributes to the escalating cost of health care in the US and can cause harm to patients. Daily blood work has become a routine part of care for hospitalized adults though only a fraction of tests change diagnosis or management decisions. At academic medical centers, residents are responsible for ordering most […]
Abstract Number: 288
Hospital Medicine 2017, May 1-4, 2017; Las Vegas, Nev.
Background: The healthcare system in the United States is often times costly and inefficient. Some estimates suggest that 20-34% of healthcare dollars are spent ineffectively. Despite efforts such as the Choosing Wisely Campaign to limit preoperative testing prior to low risk surgery, preoperative cardiac testing before low risk procedures remains common. This study assesses the […]
Abstract Number: 289
Hospital Medicine 2017, May 1-4, 2017; Las Vegas, Nev.
Background: Chest pain accounts for 2-5% of all Emergency Room (ER) visits. Tools like TIMI score and HEART score exist to risk stratify patients, but a low threshold for admission has been traditional because the risk of inadvertent discharge of patients with true ACS. In this study, we evaluate the yield of myocardial perfusion scan […]
Abstract Number: 290
Hospital Medicine 2017, May 1-4, 2017; Las Vegas, Nev.
Background: Diabetic ketoacidosis (DKA) is a serious, acute complication of diabetes mellitus caused by a state of insulin deficiency requiring exogenous insulin administration. Significant variation in intensive care unit (ICU) admission rates for DKA exists among hospitals, due to patient- and institution-specific factors, with rates ranging from 16-81%. Patients with DKA admitted to an ICU […]
Abstract Number: 291
Hospital Medicine 2017, May 1-4, 2017; Las Vegas, Nev.
Background: The Choosing Wisely Campaign encourages physicians to avoid over-utilizing routine labs in hospitalized patients with clinical and laboratory stability. A number of studies have shown adverse effects on hospitalized patients from lab overutilization. In previous research, we observed that internal medicine physicians at our center often order a daily complete blood count (CBC) and […]
Abstract Number: 295
Hospital Medicine 2017, May 1-4, 2017; Las Vegas, Nev.
Background: Thrombotic thrombocytopenic purpura (TTP) is a rare but deadly thrombotic microangiopathy (TMA) that is caused by ADAMTS13 deficiency. The PLASMIC clinical scoring system was developed and validated to determine the pretest probability of severe ADAMTS13 deficiency in cases of suspected TTP. We studied the role of the PLASMIC score in guiding use of the […]
Abstract Number: 298
Hospital Medicine 2017, May 1-4, 2017; Las Vegas, Nev.
Background: Misuse of laboratory tests can be difficult to determine unless tests are clearly overused or repeated routinely. However, excessive testing of chronically critically ill patients treated in long-term acute care hospitals (LTACHs) can be potentially harmful. A previously reported quality improvement initiative designed to increase physician awareness of their patterns of lab utilization in […]
Abstract Number: 302
Hospital Medicine 2017, May 1-4, 2017; Las Vegas, Nev.
Background: Up to forty-five percent of Americans do not fill prescriptions secondary to cost. Medication non-adherence leads to morbidity and mortality (~$100-300B annually). The majority of physicians cannot price medications within 25% of cost. Our institution alone sees more than 600 prescription-cash-pay patients (under/uninsured or no Part D) each month. Purpose: To empower clinicians to […]