Journal of hospital medicine : an official publication of the Society of Hospital Medicine
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Despite the significant burden of delirium among hospitalized adults, critical appraisal of systematic data on delirium diagnosis, pathophysiology, treatment, prevention, and outcomes is lacking. ⋯ Delirium is an acute, preventable medical condition with short- and long-term negative effects on a patient's cognitive and functional states.
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Comparative Study
Hospitalist-led medicine emergency department team: associations with throughput, timeliness of patient care, and satisfaction.
Admitted patients boarding in the emergency department (ED) leads to hospital diversion. Active bed management and care for boarded patients can improve throughput. We developed a hospital medicine ED (HMED) team to participate in active bed management, and to care for boarded patients, to decrease diversion and improve throughput. ⋯ An HMED team can improve patient flow and decrease ED diversion while providing more timely care to patients boarded in the ED.
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Enteroviral meningitis is a common cause of meningitis in children which requires only supportive care. ⋯ In-house EVPCR testing reduced test turnaround time, increased test utilization, and reduced both length of stay and duration of parenteral antibiotics for children with a positive result. Clinicians caring for children with meningitis should have access to in-hospital EVPCR testing.
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Despite the future potential of using ultrasound stethoscopes to augment the bedside cardiac physical, few data exist on a general cardiovascular imaging protocol that can be taught to physicians on a perpetual basis as a curriculum in graduate medical education. ⋯ We report our initial experience in developing and implementing a training program for bedside cardiovascular ultrasound examination that employed evidence-based techniques, set proficiency goals, and assessed resident performance. It may be feasible to teach future internist-hospitalists the technique of bedside ultrasound during residency.
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Multicenter Study Comparative Study
Pediatric observation status: are we overlooking a growing population in children's hospitals?
Inpatient administrative datasets often exclude observation stays, as observation is considered to be outpatient care. The extent to which this status is applied to pediatric hospitalizations is not known. ⋯ Children admitted under observation status make up a substantial proportion of acute care hospitalizations. Analyses of inpatient administrative databases that exclude observation stays likely result in an underestimation of hospital resource utilization for children.