Background: Although the national quality improvement campaigns are implemented to reduce Door-to-Balloon (DTB) time in the U.S.A., the community hospitals in Japan lack human resources and appear to be particularly challenging to implement these strategies such as 24/7 in-house cardiologists. Hospitalist is well positioned to be leaders and perform work improvement. Recently, there is increasing [...]

Background: Dichotomous outcomes—such as mortality—rarely capture the range of potential outcomes important to patients and clinicians. To address this limitation, the Desirability of Outcome Ranking (DOOR) score was created to rank potential outcomes from least to most desirable. Currently, there is no standardized method to develop a DOOR score and data are limited on whether [...]

Background: Acute decompensated heart failure exacerbations remain a leading cause of morbidity and mortality and are associated with high rates of admissions and healthcare cost. Both the initial dose of intravenous (IV) diuretic and time to administration affect inpatient outcomes. Adequate diuresis prior to discharge is associated with a reduced likelihood of readmission. As part [...]