Journal of hospital medicine : an official publication of the Society of Hospital Medicine
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Randomized Controlled Trial
Hospital cardiac arrest resuscitation practice in the United States: a nationally representative survey.
In-hospital cardiac arrest (IHCA) outcomes vary widely between hospitals, even after adjusting for patient characteristics, suggesting variations in practice as a potential etiology. However, little is known about the standards of IHCA resuscitation practice among US hospitals. ⋯ There is wide variability among hospitals and within practices for resuscitation care in the United States with opportunities for improvement.
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Observation medicine is a growing field with increasing involvement by hospitalists. Little has been written regarding clinical outcomes in hospitalist-run clinical decision units (CDUs). ⋯ Implementing a hospitalist-run geographic CDU was associated with a 35% decrease in observation LOS for CDU patients compared with a 3.7% decrease for medical-surgical observation patients. CDU LOS decreased without increasing ED or hospital revisit rates.
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Guidelines help inform standardization of care for quality improvement (QI). The Pediatric Research in Inpatient Settings network published a prioritization list of inpatient conditions with high prevalence, cost, and variation in resource utilization across children's hospitals. The methodological quality of guidelines for priority conditions is unknown. ⋯ We identified a group of moderate to high methodological-quality national guidelines for priority pediatric inpatient conditions. Hospitals should consider these guidelines to inform QI initiatives.