News
Tips for Hospitalists on Improving Diagnostic Skills
November 4, 2015
Case A 67-year-old man presents to the hospital with persistent, subjective fevers and malaise for one month, subacute onset of dyspnea, and nonproductive cough for the preceding six days. The patient is a nonsmoker, denies sick contacts, and has had no foreign travel.
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Differences in Care, Outcomes for In-Hospital Versus Community-Onset Stroke
November 4, 2015
Clinical question: Are there any differences in care and outcomes for in-hospital versus community-onset stroke? Background: In-hospital stroke accounts for 4%-17% of all strokes. Hospitalists and other non-neurological services have to identify and treat subsequent stroke in their patients.
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News
Revolutionizing Quality Improvement in Hospital Medicine
November 4, 2015
As the senior physician advisor to SHM’s Center for Hospital Innovation and Improvement, Eric Howell, MD, SFHM, bridges the gap between clinical expertise and project support and development. The Hospitalist recently had a conversation with Dr.
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News
Practice Administrator Elected Vice President of SHM Maryland Chapter
November 4, 2015
When you ask Tiffani Panek, division administrator for the division of hospital medicine at Johns Hopkins Bayview Medical Center (BMC) in Baltimore, Md., about her thoughts on the future of hospital medicine, her passion and enthusiasm are immediately apparent.
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Clinical Care Pathway for Cellulitis Can Help Reduce Antibiotic Use, Cost
November 4, 2015
Clinical question: How would an evidence-based clinical pathway for cellulitis affect process metrics, patient outcomes, and clinical cost? Background: Cellulitis is a common hospital problem, but its evaluation and treatment vary widely.
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Can Low-Risk Patients with VTE Be Discharged from ED on Rivaroxabon?
November 4, 2015
Clinical question: Can a low-risk patient newly diagnosed with VTE in the ED be immediately discharged home on a direct factor Xa inhibitor? Background: Studies have shown that rivaroxaban incurs a risk of 2.1% in VTE recurrence and of 9.4% in clinically relevant major and non-major bleeding (in
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Coronary CT Angiography, Perfusion Imaging Effective for Evaluating Patients With Chest Pain
November 4, 2015
Clinical question: When evaluating the intermediate-risk patient with chest pain, should coronary computed tomography angiography (CCTA) be used instead of myocardial perfusion imaging (MPI)? Background: CCTA has been shown in prior randomized controlled trials to save time and money compared to
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ED Lung Ultrasound Useful for Differentiating Cardiogenic from Noncardiogenic Dyspnea
November 4, 2015
Clinical question: Is lung ultrasound a useful tool for helping to diagnose acute decompensated heart failure (ADHF)? Background: Lung ultrasound is an emerging bedside tool that has been promoted to help evaluate lung water content to help clinicians differentiate ADHF from other causes of dyspn
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When Should Hospitalists Order Continuous Cardiac Monitoring?
November 4, 2015
Case Two patients on continuous cardiac monitoring (CCM) are admitted to the hospital. One is a 56-year-old man with hemodynamically stable sepsis secondary to pneumonia. There is no sign of arrhythmia on initial evaluation.
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Maintenance of Certification Process Should Ensure Physicians Deliver Quality Care
November 4, 2015
[caption id="attachment_11777" align="alignright" width="295"] Image Credit: SHUTTERSTOCK.COM[/caption] When the American Board of Internal Medicine (ABIM) announced changes to its Maintenance of Certification (MOC) process in early 2014, the response was overwhelmingly negative.
