By  | December 31, 2011 |  17
From the start of the patient safety movement, the field of commercial aviation has been our true north, and rightly so. God willing, 2011 will go down tomorrow as yet another year in which none of the 10 million trips flown by US commercial airlines ended in a fatal crash. In the galaxy of so-called […]
By  | December 29, 2011 |  0
In this large randomized trial of high risk hospitalized patients (eg >age 40 with CHF, cancer, or infection with at least 1 other risk factor for VTE), all cause mortality and major bleeding were no different between those receiving LMWH (40 qday) versus graduated compression stockings. Although this study was not designed to evaluate rate of asymptomatic or […]
By  | December 27, 2011 |  0
In this administrative database and chart review, ~half of medicine inpatients on PPIs did not have a valid indication. Ongoing overuse of PPIs in the hospital setting continues, and widespread efforts to curb this overuse is needed (abstract)
By  | December 20, 2011 |  15
A wise man once quipped that saying that we may need to ration healthcare is like saying that we may need to respect the laws of gravity. In other words, when societies have more healthcare needs and wants than resources (and all societies do), rationing is inevitable. The question of how to ration used to […]
By  | December 20, 2011 |  0
In this small study of 95 hospitalized elders at the VA, researchers validated a modified RASS screening tool to detect delirium. Patients underwent daily screening with the modified RASS and with a comprehensive assessment for delirium by a geriatric expert. The sensitivity and specificity for delirium as a single assessment was 64% and 93% respectively; […]
By  | December 18, 2011 |  1
I was reviewing some old stacks this weekend, and wonderfully, stumbled upon various old Hospitalist editions.  The most striking element, beyond the nonprofessional appearance, is the prescient positions our organization seized at the time.  It was neither about money, nor opportunism.  And we were speaking about quality improvement before half the health care world knew […]