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Abstract Number: 145
SHM Converge 2021
Background: The management of cellulitis in young infants has not been well-studied and appears to be largely variable. Infants with cellulitis often present without fever and only skin findings, with only a small minority having invasive infection. There is no consensus on the need for admission and further workup, such as a lumbar puncture. The […]
Abstract Number: 158
SHM Converge 2024
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 […]
Abstract Number: 158
SHM Converge 2021
Background: Community acquired pneumonia (CAP) is one of the leading causes of hospitalization in the United States.[1] In an effort to improve the quality of care for this resource-intensive disease, our institution implemented a clinical decision support (CDS) pathway for CAP comprised of three phases: (1) education on best practices, (2) education and a CDS […]
Abstract Number: 164
Hospital Medicine 2019, March 24-27, National Harbor, Md.
Background: Specialty wards (e.g., cardiology or oncology wards) group clinically similar hospitalized patients in efforts to improve outcomes and costs. When these wards exceed capacity, subsequent patients overflow to “geographically dispersed” alternate wards. Geographic dispersion has been associated with care inefficiency and worse outcomes on specialty wards, but has not been studied in a large, […]
Abstract Number: 172
SHM Converge 2024
Background: High flow nasal cannula (HFNC) is a non-invasive oxygen delivery system commonly used in emergency rooms, pediatric intensive care units (PICU), and pediatric wards for respiratory illnesses. Previously, HFNC was strictly managed in the ICU, but this is becoming less common as more pediatric wards have initiated its use. Questions have arisen regarding the […]
Abstract Number: 184
Hospital Medicine 2020, Virtual Competition
Background: Nearly half of hospitalized patients with bacteriuria or treated for pneumonia receive unnecessary antibiotics (non-infectious/non-bacterial syndrome, e.g., asymptomatic bacteriuria), excess duration (antibiotics prescribed for longer than necessary), or avoidable fluoroquinolones (safer alternative available) at hospital discharge.1-3 However, it is unknown whether antibiotic overuse at discharge varies between hospitals or is associated with patient outcomes. […]
Abstract Number: 186
Hospital Medicine 2020, Virtual Competition
Background: Between 2007 and 2015, inpatient fluoroquinolone use declined in U.S. Veterans Affairs (VA) hospitals. Whether fluoroquinolone use at discharge has also declined, in particular since antibiotic stewardship programs became mandated at VA hospitals in 2014, is unknown. Methods: In this retrospective cohort study of hospitalizations with infection between January 1, 2014 and December 31, […]
Abstract Number: 187
Hospital Medicine 2020, Virtual Competition
Background: Clinicians often diagnose bacterial infections such as urinary tract infection (UTI) and pneumonia in patients who are asymptomatic or have non-bacterial causes of their symptoms. Misdiagnosis of infection leads to unnecessary antibiotic use and potentially delays correct diagnoses. Interventions to improve diagnosis often focus on infections separately. However, if misdiagnosis is linked at the […]
Abstract Number: 188
SHM Converge 2024
Background: Inpatient stewardship has appropriately become a large focus of acute inpatient care. The Vizient™ Clinical Data Base contains hospital discharge data used for benchmarking, and we observed significantly elevated cardiac MRI (cMRI) use at our tertiary hospital, relative to other tertiary academic medical centers, with resource utilization percentile averaging in the top decile (figure […]
Abstract Number: 194
SHM Converge 2024
Background: Inappropriate diagnosis of urinary tract infections (UTI) contributes to antibiotic overuse. We previously validated and refined a patient safety measure that defines inappropriate diagnosis of UTI (i.e., treatment of asymptomatic bacteriuria [ASB]) and was endorsed by the National Quality Forum. Use of this measure as a pay-for-performance metric in the Michigan Hospital Medicine Safety […]