Background: Central line-associated bloodstream infection (CLABSI) is a preventable complication. In the United States, there are more than 20,000 CLABSI per year, resulting in a cost of about $30,000 per infection. A number of interventions have been employed to decrease the risk of CLABSI. Previous studies have documented the importance of simulation-based training. There is [...]

Background: Proton pump inhibitors (PPIs) have been associated with adverse events and increased mortality in patients diagnosed with cirrhosis (1). PPIs are commonly prescribed to patients with cirrhosis who present to the hospital with gastrointestinal bleeds (2). However, guidelines do not suggest routine usage of PPI in patients with cirrhosis without gastroesophageal reflux disease (GERD) [...]

Background: Continuous multiparameter, physiologic monitoring may improve patient outcomes in the medical-surgical wards by identifying patients who need clinical evaluation and or intervention. Alarms may be actionable or non-actionable dependent on whether the alarm is technical in nature or represents a substantive change in patient condition. Alarms will enhance patient care when followed by provider [...]

Background: Patients with increasing age and medical complexity are undergoing colorectal surgery. Medical complications are not uncommon, and may contribute to higher mortality. We implemented a unique surgical co-management (SCM) model in July 2014 at our institution where two SCM hospitalists were dedicated to Colorectal surgery year round. Each patient was screened daily by a [...]

Background: Morbidity and Mortality (M&M) conferences are common practice among internal medicine (IM) residency programs, but their effect on education and patient safety (PS) is inconsistent.[1,2] Existing research reports have struggled to identify best practices for implementing M&M conferences due to inherent variability in personnel and adverse event analysis processes. We need interventions that account [...]

Background: There is some observational evidence for the benefit of having an infectious diseases (ID) physician provide consultative support in the care of patients with Staphylococcus aureus bacteremia (SAB). A recent randomized trial was unable to document a similar benefit, although the control group received a concurrent stewardship intervention. We wanted to determine the effect [...]

Background: UC Davis Medical Center is a 646-bed tertiary care center and level 1 pediatric and adult trauma center, serving over 33 counties. Most inpatient internal medicine consultations originate from orthopedic and trauma services, with a significant subset of fragility fractures and geriatric patients. We established a co-management service to provide additional assistance for the [...]

Background: Kidney injury significantly reduces renal clearance, posing unique challenges for patients with type II diabetes, particularly those on insulin. This reduced clearance can lead to elevated insulin levels, increasing the risk of hypoglycemia and subsequent complications, which often extend the patient’s length of stay (LOS). Chronic kidney disease (CKD) itself is an independent risk [...]