Hospitalists, busy with other pressing issues, often don't think about the amount of blood they are drawing in the course of a patient's stay. But they should, experts say. Too many blood draws can lead to hospital-acquired anemia, especially in elderly patients and those with serious diseases like heart failure and pneumonia. A growing awareness of this problem has led some hospitals to devise procedures and practices to ensure blood is taken from patients only when necessary, instead of routinely. These include using smaller vials for blood collection and modifying electronic health records so that they “second guess” some physician requests for draws. To read more about how hospitals and hospitalists are tackling this issue, turn to our cover story.
Associate Editor Stacey Butterfield spent a chunk of time last fall attending conferences, as you'll see from her coverage, which starts with a helpful overview of how to treat hypertension in different kinds of hospitalized patients, courtesy of the experts at Kidney Week 2011. Also included are an update on bundled payment initiatives and an explanation from the Medical Group Management Association's 2011 conference about why and when it's important to obtain informed consent from patients. Meanwhile, both our Perspectives section and our Q&A deal with the best way to handle transferring patients to the ICU , and our coding column covers Medicare's looming change from ICD-9 to ICD-10.
Should certain types of jokes in the hospital be off-limits? We look at what experts say should—and shouldn't—be fair game for guffaws on the wards, especially when impressionable residents are likely to overhear. And, as always, our editorial advisor/humor columnist Jamie Newman will have you in stitches over his latest holiday-themed flight of fancy. You'll never see cranberry sauce the same way again.
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Editor, ACP Hospitalist