Background: Hospitalization in older adults with cognitive impairment is a seminal event that often leads to iatrogenic complications and exacerbation of behavioral disturbances that require a higher level of observation to ensure the patient’s safety. Our study aimed to determine whether an innovative model, using Patient Engagement Specialists (PES) improves care for hospitalized older adults [...]

Background: In 2016, the Sepsis-3 taskforce posited that acute organ failure is the defining feature of sepsis. Accordingly, they recommended that an acute rise in the Sequential Organ Failure Assessment (SOFA) score by 2 points over baseline should replace the Systemic Inflammatory Response Syndrome (SIRS) score as the sepsis criteria (1). As a justification, they [...]

Background: Hospitalization in older adults with cognitive impairment is a seminal event that often leads to iatrogenic complications and exacerbation of behavioral disturbances that require a higher level of observation to ensure the patient’s safety. Our study aimed to determine whether an innovative model, using Patient Engagement Specialists (PES) improves care for hospitalized older adults [...]

Background: The United States sees over 35 million hospital discharges a year with a 20% readmission rate. Unplanned readmissions amount to 20 billion dollars annually. Efforts to prevent readmissions impact patient’s overall morbidity/mortality and alleviate the financial burden on health care systems. To that effect, the United States health care reform, under the Affordable Care [...]

Case Presentation: A 17 y.o. female with systemic lupus erythematosus (SLE) presented with several weeks of worsening migratory polyarthralgia, as well as sporadic fevers, night sweats, and chills. Prednisone was begun 3 weeks prior for a presumed SLE flare, given elevated anti double-stranded DNA (anti-dsDNA) and erythrocyte sedimentation rate (ESR) and hematuria, but provided no [...]

Background: An increasing amount of literature demonstrates the detrimental impact of discrimination and microaggressions at personal and institutional levels in the healthcare workplace (1-5). Confronting these displays of bias involves a multifaceted approach across professional disciplines and hierarchies. Residency is a time when physicians experience and learn to navigate bias (6). To address this, we [...]

Background: Use of Percutaneous Endoscopic Gastrostomy (PEG) tubes among patients with dementia is controversial, with multiple studies showing no clear benefit in terms of risks of aspiration, survival or quality of life. Despite this growing evidence, studies analyzing the trends of use of PEG tube among demented patients are lacking. We aimed to use a [...]

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: Making the hospital discharge process faster and more predictable may help improve patient flow, reduce delays in admitting new patients, and increase hospital capacity. Some hospitals have implemented initiatives to promote timelier discharges as ways to improve hospital throughput.  We conducted a national survey of academic medical centers addressing the prevalence, importance, and effectiveness [...]

Background: Academic children’s hospitals are increasingly partnering with community hospitals to provide inpatient neonatal and pediatric care in the patient’s own community. Although some academic hospitals are hesitant to form these partnerships due to concern for decreasing incoming transfers, few studies report the true effect of such collaboration. Our strategy involved such a partnership that [...]