Background: Pharmacist-led peri-discharge interventions reduce adverse drug events. However, evidence is lacking as to whether there is a business case to fund these non-billable interventions. To test whether such interventions could drive reductions in post-discharge health care utilization to help build a business case, we conducted a pragmatic randomized controlled trial (RCT). Methods: The PHARMacist [...]

Background: Administrative harm (AH), defined as negative consequences arising from administrative processes and decisions within healthcare, is pervasive in medicine, yet poorly understood and described. Methods: We sought to explore common AHs experienced by hospitalist clinicians, administrative leaders, researchers, and patient and family advisory council members that were part of two national consortiums for hospitalists [...]

Background: Post hospital discharge review during the transition from hospital to skilled nursing facility (SNF) is critical to avoid medication errors, improve patient outcomes and reduce hospital readmissions (1-3). Despite increased integration of electronic health records (EHR) across health entities, communication gaps and discharge-related medication errors still persist (2,4). These challenges can be more predominant [...]

Background: Administrative harm (AH), defined as negative consequences arising from administrative processes and decisions within healthcare, is pervasive in medicine, yet poorly understood and described. Methods: We sought to explore common AHs experienced by hospitalist clinicians, administrative leaders, researchers, and patient and family advisory council members that were part of two national consortiums for hospitalists [...]

Background: Post hospital discharge review during the transition from hospital to skilled nursing facility (SNF) is critical to avoid medication errors, improve patient outcomes and reduce hospital readmissions (1-3). Despite increased integration of electronic health records (EHR) across health entities, communication gaps and discharge-related medication errors still persist (2,4). These challenges can be more predominant [...]

Background: The American opioid epidemic is a public health emergency, with over 100,000 opioid-related overdose deaths occurring in 2021 (1). Harm reduction treatment models, formulated with the goal of reducing the negative consequences of opioid use, have been implemented as an alternative approach in minimizing opioid overdose and mortality (2). With approximately 4-11% of hospitalized [...]

Background: In medical care for older patients, the presence of potentially inappropriate medications (PIMs) is associated with increased adverse outcomes [1, 2]. A wide range of medications with anticholinergic properties affects cognitive states of older patients have been regarded as PIMs [1, 3]. We purposed to assess clinical impact of anticholinergic cognitive burden on clinical [...]

Background: Mechanically ventilated patients are often administered analgesic medications such as dexmedetomidine (DEX) and lorazepam (LZP) to reduce pain and anxiety. Studies have suggested that benzodiazepines may increase the risk of developing acute brain dysfunction, mechanical ventilation time, and length of stay (LOS) (Pandharipande PP, et al. JAMA 2007). Although Clinical Practice Guidelines recommend use [...]

Background: Patients with end stage renal disease (ESRD) are at significantly increased risk for both thrombosis and bleeding relative to those with normal renal function, which makes anticoagulation particularly challenging. Evidence suggests that rivaroxaban and dabigatran are associated with a higher risk of bleeding in ESRD patients. To date, no large national cohort studies have [...]

Background: Systemic muscle relaxant prescriptions have risen in United States. Baclofen is a commonly prescribed muscle relaxant that is gamma-aminobutyric acid (GABA) agonist and renally cleared. We aimed to determine the risk of encephalopathy and mortality associated with baclofen compared to an alternate muscle relaxant cyclobenzaprine in a real-world setting. Methods: We conducted a retrospective [...]