November 2009


A deviant approach to hospital challenges

Positive deviance is a bottom-up, rather than top-down, approach to solving seemingly intractable problems in an institution or a community. It's based on the observation that certain individuals or groups (positive deviants) have found better solutions to these problems than their peers have.

Is it observation or inpatient?

The question of "observation or inpatient" has perplexed hospital physicians for some time, but it's recently acquired greater financial significance. Recovery audit contractors paid by Medicare will be looking at hospitals' one-day admissions to determine whether patients were appropriately admitted or should have been under observation status.

Homemade computer program improves glucose control

The Medical University of South Carolina Medical Center in Charleston, S.C., developed a nurse-driven Web-based insulin infusion protocol to manage blood glucose in the intensive care unit, as well as in the rest of the hospital

Letter from the Editor

This issue features the results of our second annual Top Hospitalists competition. The 10 hospitalists in our cover feature, chosen by our editorial advisory board, are a varied group of professionals working in different ways to make the field of hospital medicine better. You may recognize some of the names and faces of our Top Ten, but we also hope that some will be new to you.

Fight the noise

We all know the difficulty in functioning within a noisy hospital. But in hospitals we don't always have the option of suggesting that we move our discussion to a quiet coffee shop instead. Noise pollution in hospitals is an issue that confronts us all as hospital workers.

The hazards of invasive arterial pressure monitoring

Our columnist outlines 10 possible sources of error.

Using observation services

Hospitals often struggle to achieve compliance with CMS regulations for determining whether a patient should be classified as an inpatient or an outpatient with observation services.

MKSAP: Hematology/oncology

The following cases and commentary, which address hematology/oncology, are excerpted from ACP's Medical Knowledge Self-Assessment Program (MKSAP15).

Tracheal tubes, catheters, defibrillators recalled; lymphoma drug approved

Tracheal tubes, catheters, defibrillators recalled; lymphoma drug approved

Journal watch: Recent studies of note

Recent studies about induced hypothermia after cardiac arrest, atherosclerosis before ACS hospitalization, and other topics

In the News

Test result documentation in discharge summaries, and more.