Background: Substance use continues to increase in the United States. Substance use has been linked to new onset cardiovascular and cerebrovascular disorders which lead to hospitalizations. We aimed to assess the association of epidemiology and racial disparities of substance use disorders (SUDs) using the National Inpatient Sample (NIS) Database. Methods: A retrospective study of the [...]

Background: Hospitalists often care for patients who have substance use disorders as well as patients who are incarcerated. Availability of medications for substance use disorders (MSUD) varies based on state law and access varies based on facility, city, and county. Since hospitalization presents a unique opportunity to prevent negative consequences of substance use disorders, it [...]

Background: Although 1 in 10 people suffer from chronic insomnia, the prevalence among hospitalized patients is likely higher, due to common comorbidities such as depression and chronic pain in this population. We aimed to assess the prevalence of undiagnosed insomnia among hospitalized adults and examine the associations between severity of insomnia and in-hospital sleep duration [...]

Background: Agency of Healthcare Research and Quality reported an increase in Opioid-related hospitalizations from 2005 to 2014. Previous studies in patients undergoing surgery have shown an increased risk of readmission with opioid dependence. This study was intended to identify the all-cause 7 and 30-day readmission rates of hospitalizations with opioid-related disorders, and potential predictors of [...]

Background: Telemetry is utilized on high risk cardiac patients for monitoring of arrthymias. Guidelines providing clear monitoring indications have been published by AHA to reduce overuse of this resource, which can lead to increased care costs and false positive alerting. Despite the above evidence, our hospital has a high volume of patients on telemetry causing [...]

Background: Laboratory testing is one of the highest volume medical activities in a health system. Despite their central role in driving clinical decision making, laboratory diagnostics are highly variable and expensive. The annual cost estimate in the U.S. for low value screening, testing, or procedures range from 17.2 billion to 27.9 billion dollars.1 Excessive laboratory [...]

Background: Choosing Wisely recommends against testing for amylase in the diagnosis and management of acute pancreatitis; however, national CMS data shows over $19 million in charges for amylase laboratory testing per year. Our hospital spent over $341,000 on roughly 38,000 amylase orders in the past year. Purpose: We developed a quality improvement project to reduce [...]

Background: Hospitalist have not previously had a primary role in the setting of eating disorders beyond stabilization in an acute care setting. Following stabilization, patients in need of further treatment are transferred to an eating disorder facility. While in inpatient or residential care for their eating disorder, patient are monitored by physicians or mid-level providers. [...]

Background: Drug overdose deaths are increasing throughout the country. Increasing naloxone availability is a cost-effective way to prevent opioid-related deaths. High-risk patients admitted in the hospital may benefit from a take-home naloxone prescription. This study aims to assess naloxone prescribing practices upon hospital discharge. Methods: An anonymous survey was distributed to attendings, residents, and advanced [...]

Case Presentation: A 24-year-old Caucasian female with a family history of multiple autoimmune disorders presented with 3 weeks of bruising, petechiae, fatigue, and outside labs that revealed significant anemia and thrombocytopenia. Admission workup showed Hgb 7.6, platelets (PLT) < 3,000, and elevated MCV. Further labs showed elevated LDH, indirect bilirubinemia, haptoglobin< 10, and positive DAT [...]