Journal of Hospital MedicineThis is an RSS file. You can use it to subscribe to this data in your favourite RSS reader, such as GoogleReader, or to display this data on your own website or blog. Subscribe to this data using MyMedWorm.Subscribe to this data using GoogleReader.Subscribe to this data using Bloglines.Subscribe to this data using MyYahoo.

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Decrease in as-needed sedative use by limiting nighttime sleep disruptions from hospital staffEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Hospital routines frequently interrupt nighttime sleep. Sedatives promote sleep, but increase the risk of delirium and falls. Few interventional trials have studied sleep promotion in medical-surgical units and little is known about its impact on sedative use.To determine causes of sleep disruption, and assess whether decreasing sleep disruptions lowers sedative use in medical-surgical patients.Interventional trial with historical controls on a medical-surgical unit of a community teaching hospital. Nurses, physicians, and patients were blinded to the measurement of as-needed sedative use.Consecutive eligible adults (n = 1...
Source: Journal of Hospital Medicine - September 18, 2009 Category: Hospital Management Authors: Melissa C. Bartick, Xia Thai, Timothy Schmidt, Amsalework Altaye, Jo M. Solet Source Type: journals

The trivialization of diagnosisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Although it is widely recognized that diagnosis plays a central role in clinical medicine, in recent years the primacy of diagnosis has come under attack from several sources. 1. "Billable terms" are replacing traditional medical diagnoses. The former are based on International Classification of Diseases lists, which include many non-diagnoses such as symptoms and signs. 2. Diagnosis often gets short shrift because of the perceived urgency of discharge. 3. The problem oriented record, in practice, has frequently led to a shift in emphasis from synthesis of findings to fragmentation of problems. 4. Presumptive diagnoses fre...
Source: Journal of Hospital Medicine - September 15, 2009 Category: Hospital Management Authors: Irving Kushner, Peter J. Greco, P.K. Saha, Shilpa Gaitonde Source Type: journals

Optimizing prevention of hospital-acquired (HA) venous thromboembolism (VTE): Prospective validation of a VTE risk assessment model (RAM)Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Hospital-acquired (HA) venous thromboembolism (VTE) is a common source of morbidity/mortality. Prophylactic measures are underutilized. Available risk assessment models/protocols are not prospectively validated.Improve VTE prophylaxis, reduce HA VTE, and prospectively validate a VTE risk-assessment model.Observational design.Academic medical center.Adult inpatients on medical/surgical services.A simple VTE risk assessment linked to a menu of preferred VTE prophylaxis methods, embedded in order sets. Education, audit/feedback, and concurrent identification of nonadherence.Randomly sampled inpatient audits determined the per...
Source: Journal of Hospital Medicine - September 14, 2009 Category: Hospital Management Authors: Gregory A. Maynard, Timothy A. Morris, Ian H. Jenkins, Sarah Stone, Joshua Lee, Marian Renvall, Ed Fink, Robert Schoenhaus Source Type: journals

Prevalence of previously unknown elevation of glycosylated hemoglobin (HbA1c) in spine surgery patients and impact on length of stay and total costEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Elevated levels of glycosylated hemoglobin (HbA1c) among spine surgery patients may have an impact on length of stay (LOS) and healthcare cost.We retrospectively reviewed the charts of 556 spine surgery patients who underwent 1 of 3 types of surgery: lumbar microdiscectomy (LMD), anterior cervical decompression and fusion (ACDF), and lumbar decompression and fusion (LDF). Information was collected about their diabetes mellitus (DM) history and HbA1c levels. We used HbA1c 6.1% as the screening cutpoint. Percentages of nondiabetic patients, those with subclinical elevation of HbA1c and those with already known DM were calcul...
Source: Journal of Hospital Medicine - September 13, 2009 Category: Hospital Management Authors: M. Sami Walid, Brooke F. Newman, Joshua C. Yelverton, Jonathan P. Nutter, Mohammed Ajjan, Joe Sam Robinson Jr. Source Type: journals

Afraid in the hospital: Parental concern for errors during a child's hospitalizationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(1) To determine the proportion of parents concerned about medical errors during a child's hospitalization; and (2) the association between this concern and parental self-efficacy with physician interactions.Cross-sectional survey.Tertiary care children's hospital.Parents of children admitted to the general medical service.Parental concern about medical errors.Parents were asked their agreement with the statement "When my child is in the hospital I feel that I have to watch over the care that he/she is receiving to make sure that mistakes aren't made." We used multivariate logistic regression to examine the association bet...
Source: Journal of Hospital Medicine - August 2, 2009 Category: Hospital Management Authors: Beth A. Tarini, Paula Lozano, Dimitri A. Christakis Source Type: journals

Patient and physician perceptions after software-assisted hospital discharge: Cluster randomized trialEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Hospital discharge software potentially improves communication and clinical outcomes.To measure patient and physician perceptions after discharge with computerized physician order entry (CPOE) software.Cluster randomized controlled trial.Tertiary care, teaching hospital in central Illinois.A total of 631 inpatients discharged to home with high risk for readmission.A total of 70 internal medicine hospital physicians randomly assigned (allocation concealed) to discharge software vs. usual care, handwritten discharge.Discharge perceptions from patients, outpatient primary care physicians, and hospital physicians.One week afte...
Source: Journal of Hospital Medicine - July 20, 2009 Category: Hospital Management Authors: James F. Graumlich, Nancy L. Novotny, G. Stephen Nace, Jean C. Aldag Source Type: journals

Public reporting of hospital quality: Recommendations to benefit patients and hospitalsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Public reporting of hospital performance holds tremendous promise for improving the care provided by hospitals. To date, however, consumers have failed to embrace public reporting, despite considerable efforts to promote it. We review a number of reasons that public reporting has failed to live up to expectations, and we make 10 recommendations to improve the value of public reporting for both patients and hospitals. We also review 3 leading performance reporting programs to evaluate how well they adhere to these recommendations. Journal of Hospital Medicine 2009. © 2009 Society of Hospital Medicine. (Source: Journal of Hospital Medicine)
Source: Journal of Hospital Medicine - June 10, 2009 Category: Hospital Management Authors: Michael B. Rothberg, Evan M. Benjamin, Peter K. Lindenauer Source Type: journals

Acute vertebral fractureEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article is an evidenced based clinical update on the evaluation and management options of acute vertebral fractures, ranging from conservative treatment to surgical intervention. Hospitalists can play an influential role in the management of osteoporosis. Journal of Hospital Medicine 2009. © 2009 Society of Hospital Medicine. (Source: Journal of Hospital Medicine)
Source: Journal of Hospital Medicine - June 8, 2009 Category: Hospital Management Authors: Abby N. Agulnek, Kevin J. O'Leary, Beatrice J. Edwards Source Type: journals

Predictors of ischemic stroke after hip operation: A population-based studyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Hip operation (total hip arthroplasty [THA] or fracture repair) is the most common noncardiac surgical procedure performed in patients age 65 years and older.To determine the predictors of ischemic stroke in patients who have undergone hip operation.Population-based historical cohort study, in which postoperative ischemic strokes were identified from medical record review for stroke diagnostic codes and brain imaging results and were confirmed by physician review.Tertiary care center in Olmsted County, Minnesota.Residents of Olmsted County who underwent hip surgical procedure.Incidence of ischemic stroke within 1 year of h...
Source: Journal of Hospital Medicine - May 31, 2009 Category: Hospital Management Authors: Alina S. Popa, Alejandro A. Rabinstein, Paul M. Huddleston, Dirk R. Larson, Rachel E. Gullerud, Jeanne M. Huddleston Source Type: journals

Transitions of Care Consensus Policy Statement: American College Of Physicians, Society of General Internal Medicine, Society of Hospital Medicine, American Geriatrics Society, American College of Emergency Physicians, and Society for Academic Emergency MedicineEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The American College of Physicians, Society of Hospital Medicine, and Society of General Internal Medicine convened a multi-stakeholder consensus conference in July 2007 to address the quality gaps in the transitions between inpatient and outpatient settings and to develop consensus standards for these transitions. Over 30 organizations sent representatives to the Transitions of Care Consensus Conference. Participating organizations included medical specialty societies from internal medicine as well as family medicine and pediatrics, governmental agencies such as the Agency for Healthcare Research and Quality and the Cente...
Source: Journal of Hospital Medicine - May 29, 2009 Category: Hospital Management Authors: Vincenza Snow, Dennis Beck, Tina Budnitz, Doriane C. Miller, Jane Potter, Robert L. Wears, Kevin B. Weiss, Mark V. Williams Source Type: journals

Patient readmissions, emergency visits, and adverse events after software-assisted discharge from hospital: Cluster randomized trialEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
One of the causes of postdischarge adverse events is poor discharge communication between hospital-based physicians, patients, and outpatient physicians. The value of hospital discharge software to improve communication and clinically relevant outcomes is unknown.To measure effects of a discharge software application of computerized physician order entry (CPOE).Cluster randomized controlled trial.Tertiary care, teaching hospital in central Illinois.A total of 631 inpatients discharged to home with high risk for readmission.Seventy internal medicine hospital physicians were randomly assigned (allocation concealed) to discha...
Source: Journal of Hospital Medicine - May 28, 2009 Category: Hospital Management Authors: James F. Graumlich, Nancy L. Novotny, G. Stephen Nace, Himangi Kaushal, Waleed Ibrahim-Ali, Shoba Theivanayagam, L. William Scheibel, Jean C. Aldag Source Type: journals

Stethoscope inspectionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
No abstract. (Source: Journal of Hospital Medicine)
Source: Journal of Hospital Medicine - April 1, 2009 Category: Hospital Management Authors: J. Willis Hurst Source Type: journals

Creating a better discharge summary: Improvement in quality and timeliness using an electronic discharge summaryEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Deficits in information transfer between inpatient and outpatient physicians are common and potentially dangerous.To evaluate the effect of a newly-created electronic discharge summary.Pre-post evaluation of discharge summaries using a survey of outpatient physicians and a medical records review.Outpatient physicians' ratings of satisfaction with discharge summaries before and after implementation of an electronic discharge summary using a 5-point Likert scale (1 = very dissatisfied; 5 = very satisfied). Additionally, 196 randomly selected discharge summaries before and after implementation were rated for timeliness and pr...
Source: Journal of Hospital Medicine - March 6, 2009 Category: Hospital Management Authors: Kevin J. O'Leary, David M. Liebovitz, Joseph Feinglass, David T. Liss, Daniel B. Evans, Nita Kulkarni, Matthew P. Landler, David W. Baker Source Type: journals

Thrombolytic therapy for venous thromboembolism: Current clinical practiceEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Venous thromboembolism (VTE) is a life-threatening condition for which thrombolytic therapy may be beneficial. The appropriate setting for the use of thrombolytic therapy remains controversial. More than 10 years ago we described the case-based practice patterns for the use of thrombolytics in VTE, and now, in the context of recent studies and guidelines, we sought to reevaluate the use of thrombolytics and to determine whether beliefs have changed.Active pulmonologists in 11 southeastern states were selected to complete a web-based questionnaire that included background questions and hypothetical case scenarios involving ...
Source: Journal of Hospital Medicine - March 5, 2009 Category: Hospital Management Authors: Gregg J. Stashenko, Charles W. Hargett, Victor F. Tapson Source Type: journals

A "routine" electrocardiogramEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
No abstract. (Source: Journal of Hospital Medicine)
Source: Journal of Hospital Medicine - March 5, 2009 Category: Hospital Management Authors: Michael A. Chen Source Type: journals

Iodinated contrast prior to evaluation for thyrotoxicosisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Radioactive iodine is useful in the diagnosis and treatment of patients with newly diagnosed thyrotoxicosis. However, in many patients these tests are not possible to obtain due to recent administration of iodinated contrast for other types of diagnostic studies, most frequently computed tomography (CT) scans.To determine the frequency of iodinated contrast use in hospital inpatients newly diagnosed with thyrotoxicosis and the utility of these studies.Retrospective chart review.Academic medical center.None.Inpatients with newly diagnosed thyrotoxicosis who were seen in consultation by the endocrinology service.The records ...
Source: Journal of Hospital Medicine - March 4, 2009 Category: Hospital Management Authors: Brian D. Phillips, James V. Hennessey Source Type: journals

Pediatric hospitalists and primary care providers: A communication needs assessmentEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Existing research on hospitalist-primary care provider (PCP) communication focuses mainly on adult hospitalist models with little known about the quality of current pediatric hospitalist-PCP communication. Our objective was to perform a needs assessment by exploring important issues around communication between pediatric hospitalists and PCPs.Six previously identified issues around hospitalist-PCP communication from the adult hospitalist literature were abstracted and incorporated into an open-ended and closed-ended questionnaire. The questionnaire was pretested, revised, and administered by phone to 10 pediatric hospitali...
Source: Journal of Hospital Medicine - March 4, 2009 Category: Hospital Management Authors: Gregory Harlan, Rajendu Srivastava, Lanny Harrison, Glen McBride, Christopher Maloney Source Type: journals

Challenges and opportunities in Academic Hospital Medicine: Report from the Academic Hospital Medicine SummitEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The objective was to develop consensus around key areas limiting or facilitating hospital medicine's development as an academic discipline.The design was a consensus format conference of key stakeholders in academic hospital medicine.The consensus group identified several issues impeding the development of academic hospital medicine as a recognized entity in academic settings, including extraordinarily rapid growth, increasingly preponderant nonteaching roles, and demands to perform nonclinical duties (such as quality improvement) not generally viewed as academic pursuits. The consensus group developed recommendations for ...
Source: Journal of Hospital Medicine - March 4, 2009 Category: Hospital Management Authors: Scott A. Flanders, Bob Centor, Valerie Weber, Thomas McGinn, Karen DeSalvo, Andrew Auerbach Source Type: journals

Incidence and impact of adverse effects to antibiotics in hospitalized adults with pneumoniaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This study sought to define the incidence, economic impact, and nature of adverse drug effects (ADEs) related to antibiotics in pneumonia hospitalizations in the US.Adult pneumonia hospitalizations were tabulated in statewide (New York) and national databases, respectively, from 2000 through 2005. The incidences of antibiotic related ADEs were determined by identifying antibiotic specific e-codes (external cause of injury codes). The modeled effect of the presence of antibiotic ADEs on length of stay (LOS) and total charges were also calculated. ADEs due to specific antibiotic classes, and the presence of certain cutaneous...
Source: Journal of Hospital Medicine - February 13, 2009 Category: Hospital Management Authors: Robert Y. Lin, Farzana Nuruzzaman, Shaili N. Shah Tags: Original Research Source Type: journals

Critical illness polyneuromyopathy in a patient with disseminated cryptococcal infectionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We report a case of critical illness polyneuromyopathy in a patient with disseminated cryptococcal infection in an intensive care unit. Journal of Hospital Medicine 2009;4:E3-E6. © 2009 Society of Hospital Medicine. (Source: Journal of Hospital Medicine)
Source: Journal of Hospital Medicine - February 13, 2009 Category: Hospital Management Authors: Jenn-Yu Wu, Shang-Gin Wu, Hsin-Yun Sun, Ping-Hung Kuo, Pan-Chyr Yang Tags: Case Reports Source Type: journals

Educational interventions alone are not sufficient to change outcomes in venous thromboembolismEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
No abstract. (Source: Journal of Hospital Medicine)
Source: Journal of Hospital Medicine - February 13, 2009 Category: Hospital Management Authors: Tarek Hamieh, Frank Michota Tags: Letters to the Editor Source Type: journals

Polymorphic ventricular tachycardia?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
No abstract. (Source: Journal of Hospital Medicine)
Source: Journal of Hospital Medicine - February 13, 2009 Category: Hospital Management Authors: Elizabeth Davis, Kurt Hoffmayer, Mintu Turakhia, Nora Goldschlager Tags: Images Dx Source Type: journals

Chronic diarrhea and abdominal pain: Pin the pinwormEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We report a case of an 84-year-old female patient from an assisted living facility who presented with symptoms of colitis for 2 months. On detailed history and exam, she was found to have E. vermicularis infection. All her symptoms resolved dramatically within 2 days after a single dose of albendazole. We want to emphasize the importance of including parasitic infections such as E. vermicularis in the differential diagnoses of patients presenting with symptoms of colitis. Journal of Hospital Medicine 2009;4:137-139. © 2009 Society of Hospital Medicine. (Source: Journal of Hospital Medicine)
Source: Journal of Hospital Medicine - February 13, 2009 Category: Hospital Management Authors: Anitha Rajamanickam, Ali Usmani, Sanjeev Suri, Vesselin Dimov Tags: Case Reports Source Type: journals

A change of heartEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
No abstract. (Source: Journal of Hospital Medicine)
Source: Journal of Hospital Medicine - February 13, 2009 Category: Hospital Management Authors: Jonathan P. Piccini, Adrian F. Hernandez, Louis R. Dibernardo, Joseph G. Rogers, Gurpreet Dhaliwal Tags: Clinical Care Conundrums Source Type: journals

Coding and documentation: Medicare severity diagnosis-related groups and present-on-admission documentationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article will discuss the new payment system, the physician's role in ensuring that all clinically important diagnoses are captured by coding specialists, and strategies that can be employed to respond proactively to the challenge. Journal of Hospital Medicine 2009;4:124-130. © 2009 Society of Hospital Medicine. (Source: Journal of Hospital Medicine)
Source: Journal of Hospital Medicine - February 13, 2009 Category: Hospital Management Authors: Noel H. Ballentine Tags: Perplexities in Hospital Medicine Source Type: journals

Blood cultures for community-acquired pneumonia: Are they worthy of two quality measures? A systematic reviewEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Obtaining blood cultures (BCs) for patients hospitalized with community-acquired-pneumonia (CAP) has been recommended by experts and used as a measure of quality of care. However, BCs are infrequently positive in these patients and their effect on clinical management has been questioned.We performed a systematic review of the literature to determine the impact of BCs on clinical management in CAP requiring hospitalization and thus its appropriateness as a quality measure.We searched MEDLINE, MEDLINE In-Process, and the Cochrane databases for English-language studies that reported the effect of BCs on management of adults h...
Source: Journal of Hospital Medicine - February 13, 2009 Category: Hospital Management Authors: Nima Afshar, Jeffrey Tabas, Kia Afshar, Robert Silbergleit Tags: Reviews Source Type: journals

Clinical indications for newer antifungal agentsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Recent years have seen the release of multiple new systemic antifungal agents, significantly increasing options for the treatment of most serious fungal infections. Newly available drugs include those in the echinocandin class, including caspofungin, micafungin, and anidulafungin, as well as the newer generation triazoles, voriconazole and posaconazole. Ordering of these agents is variably restricted, depending on a given institution's policies, and all are costly. In this review we examine the available evidence and outline the role of newer antifungal medications in several common and/or important situations, including i...
Source: Journal of Hospital Medicine - February 13, 2009 Category: Hospital Management Authors: Nina Naeger-Murphy, James C. Pile Tags: Clinical Update Source Type: journals

Assessing the impact of an educational program on decreasing prescribing errors at a university hospitalEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This study was conducted among internal medicine residents at the 320-bed University of Toledo Medical Center.The educational intervention was conducted during a 6-month period beginning in November 2006. The intervention included an initial hour-long lecture followed by biweekly and then monthly discussions that used timely, institution-specific examples of prescribing errors.Data were collected at 5 time points: month 0 (preintervention period); months 1, 3, and 6 (intervention period); and month 7 (postintervention period). Errors were identified, transcribed, coded, and entered into a database. The primary outcome was ...
Source: Journal of Hospital Medicine - February 13, 2009 Category: Hospital Management Authors: Michael J. Peeters, Sharrel L. Pinto Tags: Innovations Source Type: journals

Standardized admission order set improves perceived quality of pediatric inpatient careEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Few studies exist on the ability of standardized preprinted order forms to improve patient care.To examine resident-perceived effects of introducing a pediatric admission order set (PAOS) on the quality of inpatient care.Cross-sectional study.University of California, Los Angeles (UCLA) Children's Hospital, a nonprofit, tertiary-care teaching hospital and major referral center with approximately 3,000 admissions per year.A total of 97 pediatric residents (PL-1, n = 34; PL-2, n = 33; and PL-3, n = 30) who did the vast majority of the inpatient admissions.Residents were asked to rate the PAOS overall and with respect to 9 sp...
Source: Journal of Hospital Medicine - February 13, 2009 Category: Hospital Management Authors: Arpi Bekmezian, Paul J. Chung, Shahram Yazdani Tags: Original Research Source Type: journals

Medical admission order sets to improve deep vein thrombosis prophylaxis rates and other outcomesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The value of order sets for clinical decision support has not been established.To determine whether introduction of admission order sets increases the proportion of inpatients receiving deep venous thrombosis (DVT) prophylaxis.Before-after study.Community hospital.General medical patients admitted to hospital.Paper-based admission order sets (instead of free-text orders) for voluntary use by internists, without any education or behavior change interventions.Primary outcome was proportion of medical admissions ordered DVT prophylaxis. Secondary outcomes included overall utilization of DVT prophylaxis in medical inpatients a...
Source: Journal of Hospital Medicine - February 13, 2009 Category: Hospital Management Authors: Chris O'Connor, Neill K.J. Adhikari, Katharine DeCaire, Jan O. Friedrich Tags: Original Research Source Type: journals

Medical admission order sets to improve deep vein thrombosis prevention: A model for others or a prescription for mediocrity?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
No abstract. (Source: Journal of Hospital Medicine)
Source: Journal of Hospital Medicine - February 1, 2009 Category: Hospital Management Authors: Gregory A. Maynard Tags: Editorials Source Type: journals

Doctor, my breathing is better when I lie downEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
No abstract. (Source: Journal of Hospital Medicine)
Source: Journal of Hospital Medicine - January 29, 2009 Category: Hospital Management Authors: Ravi K. Mallavarapu, Prasad S. Garimella Source Type: journals

Methicillin-resistant Staphylococcus aureus bacteremia due to prostatic abscessEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Journal of Hospital Medicine 2009;4:E9-E11. © 2009 Society of Hospital Medicine. (Source: Journal of Hospital Medicine)
Source: Journal of Hospital Medicine - January 12, 2009 Category: Hospital Management Authors: Bo H. Chao, Jason M. Kidd, Alan W. Dow Tags: Case Reports Source Type: journals

Perceptions of resident physicians about management of inpatient hyperglycemia in an urban hospitalEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Information regarding practitioner beliefs about inpatient diabetes care is limited.To assess resident physician attitudes about inpatient hyperglycemia and determine perceived barriers to optimal glycemic control in an urban hospital setting.A previously developed questionnaire was modified and administered. Residents were asked about the importance of inpatient glucose control, desirable glucose ranges, and problems encountered when managing hyperglycemia.Urban teaching hospital.Of 85 resident physicians, 66 completed the survey (mean age, 31 years; 47% men; 33% in first residency year). Most respondents categorized gluc...
Source: Journal of Hospital Medicine - January 12, 2009 Category: Hospital Management Authors: Vasundhara Cheekati, Robert C. Osburne, Kimberly A. Jameson, Curtiss B. Cook Tags: Original Research Source Type: journals

Welcome to my world [hellip] or some loose approximation thereofEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
No abstract. (Source: Journal of Hospital Medicine)
Source: Journal of Hospital Medicine - January 12, 2009 Category: Hospital Management Authors: Bradley Flansbaum Tags: View from the Hospital Bed Source Type: journals

Calcinosis universalisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
No abstract. (Source: Journal of Hospital Medicine)
Source: Journal of Hospital Medicine - January 12, 2009 Category: Hospital Management Authors: Nasim Afsarmanesh, Alan Gorn Tags: Images Dx Source Type: journals

Pericardial effusion presenting with anuric acute renal failure and hepatocellular damageEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
A 50-year-old male with anuria, creatinine of 5.5 and potassium of 6.5 was referred to our hospital for hemodialysis. Before hemodialysis could be initiated, his blood pressure dropped and liver function tests were found to be increasing rapidly. This prompted us to look for cardiac causes of liver ischemia. An echocardiogram was non-diagnostic due to the patient's obese body habitus. Pericardial fluid was documented on CT scan. Pericardiocentesis was performed and nearly 1500 ml of bloody pericardial fluid was removed. This resulted in immediate urine output, with 80 ml in the first hour, and an increase in blood pressure...
Source: Journal of Hospital Medicine - January 12, 2009 Category: Hospital Management Authors: Raza Khan, Charles Gessert, Stephen Bockhold Tags: Case Reports Source Type: journals

Short of breath, not short of diagnosesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
No abstract. (Source: Journal of Hospital Medicine)
Source: Journal of Hospital Medicine - January 12, 2009 Category: Hospital Management Authors: Lorenzo Di Francesco, Luis Mora, Kenneth Leeper, Maged Doss, James Little, Martin Sheline, Mark V. Williams, Carlos Franco-Paredes Tags: Clinical Care Conundrums Source Type: journals

Sleep in hospitalized medical patients, Part 2: Behavioral and pharmacological management of sleep disturbancesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
As described in Part 1 of this article, multiple factors lead to disrupted sleep in hospitalized medical patients. Recognizing and addressing these factors can help clinicians more effectively manage patients' sleep complaints.A PubMed search was conducted by cross-referencing the terms "sleep deprivation," "insomnia," and "sleep"; "hospitalized," "acutely ill," and "critically ill"; and "medication," "drugs," "hypnotics," "benzodiazepines," and "sedatives." The search was limited to English-language articles published between 1997 and 2008. Subsequent PubMed searches were performed to clarify the data described in the ini...
Source: Journal of Hospital Medicine - January 12, 2009 Category: Hospital Management Authors: Julie S. Young, James A. Bourgeois, Donald M. Hilty, Kimberly A. Hardin Tags: Reviews Source Type: journals

Limited communication and management of emergency department hyperglycemia in hospitalized patientsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Hyperglycemia is often overlooked and unaddressed in hospitalized patients, and early and intensive management may improve outcomes.To evaluate communication and early management of emergency department (ED) hyperglycemia.This was a retrospective cohort study of patients with an initial serum glucose [ge]140 mg/dL at an urban, academic institution. We randomly selected cases from a consecutive sample of ED visits with at least 1 serum glucose result during a 1-year period. We recorded clinical data and compared the content of inpatient and ED-written discharge instructions.Of the 27,688 initial ED glucose results during th...
Source: Journal of Hospital Medicine - January 12, 2009 Category: Hospital Management Authors: Adit A. Ginde, Davut J. Savaser, Carlos A. Camargo Jr. Tags: Brief Reports Source Type: journals

Evaluation of hospital glycemic control at US Academic Medical CentersEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
To evaluate contemporary hospital glycemic management in US academic medical centers.This retrospective cohort study was conducted on patients discharged from 37 academic medical centers between July 1 and September 30, 2004; 1,718 eligible adult patients met at least 1 of the inclusion criteria: 2 consecutive blood glucose readings >180 mg/dL within 24 hours, or insulin treatment at any time during hospitalization. We assessed 3 consecutive measurement days of glucose values, glycemic therapy, and additional clinical and laboratory characteristics.In this diverse cohort, 79% of patients had a prior diagnosis of diabetes, ...
Source: Journal of Hospital Medicine - January 12, 2009 Category: Hospital Management Authors: Jeffrey B. Boord, Robert A. Greevy, Susan S. Braithwaite, Pamela C. Arnold, Patricia M. Selig, Helga Brake, Joanne Cuny, David Baldwin Tags: Original Research Source Type: journals

Evaluation of glycemic control following discontinuation of an intensive insulin protocolEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This study demonstrates a significant increase in BG following discontinuation of an IIP. Higher insulin requirements during the last 12 hours of an IIP were identified as an independent risk factor for poor glycemic control following the IIP. A standardized insulin transition protocol may help better control BG after discontinuation of an IIP. Journal of Hospital Medicine 2009;4:28-34. © 2009 Society of Hospital Medicine. (Source: Journal of Hospital Medicine)
Source: Journal of Hospital Medicine - January 12, 2009 Category: Hospital Management Authors: Quinn A. Czosnowski, Joseph M. Swanson, Bob L. Lobo, Joyce E. Broyles, Paul R. Deaton, Christopher K. Finch Tags: Original Research Source Type: journals

Effects of a subcutaneous insulin protocol, clinical education, and computerized order set on the quality of inpatient management of hyperglycemia: Results of a clinical trialEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Inpatient hyperglycemia is associated with poor patient outcomes. It is unknown how best to implement glycemic management strategies in the non-intensive care unit (ICU) setting.To determine the effects of a multifaceted quality improvement intervention on the management of medical inpatients with diabetes mellitus or hyperglycemia.Before-after trial.Geographically localized general medical service staffed by physician's assistants (PAs) and hospitalists.Consecutively enrolled patients with type 2 diabetes or inpatient hyperglycemia.A detailed subcutaneous insulin protocol, an admission order set built into the hospital's ...
Source: Journal of Hospital Medicine - January 12, 2009 Category: Hospital Management Authors: Jeffrey L. Schnipper, Chima D. Ndumele, Catherine L. Liang, Merri L. Pendergrass Tags: Original Research Source Type: journals

Improved inpatient use of basal insulin, reduced hypoglycemia, and improved glycemic control: Effect of structured subcutaneous insulin orders and an insulin management algorithmEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Structured subcutaneous insulin order sets and insulin protocols are widely advocated. The intervention effects are not well reported.Assess the impact of these interventions on insulin use patterns, hypoglycemia, and glycemic control.Prospective observational.400-bed academic center.Adult non-critical care inpatients with diabetes or hyperglycemia and point-of-care (POC) glucose testing.Structured insulin orders, insulin management algorithm.Percent of insulin orders with basal insulin. Percent uncontrolled patient-stays (day-weighted mean glucose [ge]180 mg/dL) and uncontrolled patient-days (patient-day mean glucose [ge]...
Source: Journal of Hospital Medicine - January 12, 2009 Category: Hospital Management Authors: Greg Maynard, Joshua Lee, Gerard Phillips, Ed Fink, Marian Renvall Tags: Original Research Source Type: journals

Paging goldilocks: How much glycemic control is just right?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
No abstract. (Source: Journal of Hospital Medicine)
Source: Journal of Hospital Medicine - January 1, 2009 Category: Hospital Management Authors: Daniel J. Brotman Tags: Editorials Source Type: journals

Practical strategies for developing the business case for hospital glycemic control teamsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Many business models may be used to make the business case for support of a multidisciplinary team to implement targeted glucose control in the hospital. Models may be hospital-supported or self-supporting. In the former, the hospital provides financial support based on improved documentation opportunities, reduction in length of stay, and improved resource utilization. In the latter, clinical revenues for diabetes management offsets costs of salary, fringe benefits, and overheads. A combination of these strategies may also be used.The business plan presented to administration must justify return on investment. It is imper...
Source: Journal of Hospital Medicine - October 24, 2008 Category: Hospital Management Authors: Michelle F. Magee, Adam Beck Tags: Reviews Source Type: journals

Society of hospital medicine glycemic control task force summary: Practical recommendations for assessing the impact of glycemic control effortsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
No abstract. (Source: Journal of Hospital Medicine)
Source: Journal of Hospital Medicine - October 24, 2008 Category: Hospital Management Authors: Jeffrey L. Schnipper, Michelle Magee, Kevin Larsen, Silvio E. Inzucchi, Greg Maynard Tags: Reviews Source Type: journals

Bridge over troubled waters: Safe and effective transitions of the inpatient with hyperglycemiaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
No abstract. (Source: Journal of Hospital Medicine)
Source: Journal of Hospital Medicine - October 24, 2008 Category: Hospital Management Authors: Cheryl W. O'Malley, Maryann Emanuele, Lakshmi Halasyamani, Alpesh N. Amin Tags: Reviews Source Type: journals

Designing and implementing insulin infusion protocols and order setsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Influential trials and guidelines supporting the value of glucose control in hospital settings, particularly in the intensive care and postoperative settings, has led to the widespread adoption of intravenous infusions of human regular insulin. As groups have attempted to study the outcomes or to explore improved methods for improved glucose control, a number of insulin infusion protocols (IIPs) have been reported and validated. Now, many institutions are attempting to translate this experience into clinical practice in a systematic manner. The intent of this discussion is to highlight the authors' practical view of best p...
Source: Journal of Hospital Medicine - October 24, 2008 Category: Hospital Management Authors: Andrew J. Ahmann, Greg Maynard Tags: Reviews Source Type: journals

Subcutaneous insulin order sets and protocols: Effective design and implementation strategiesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
No abstract. (Source: Journal of Hospital Medicine)
Source: Journal of Hospital Medicine - October 24, 2008 Category: Hospital Management Authors: Greg Maynard, David H. Wesorick, Cheryl O'Malley, Silvio E. Inzucchi Tags: Reviews Source Type: journals