Improving Patient Outcomes Using Measures to Increase Discharge Rates to Home.

Background Post-acute care (PAC) centers are facilities used for recuperation, rehabilitation, and symptom management in an effort to improve the long-term outcomes of patients. PAC centers include skilled nursing facilities, inpatient rehabilitation facilities, and long-term care hospitals. In the 1990s, Medicare payment reforms significantly increased the discharge rates to PAC centers and subsequently increased the length of stay (LOS) among these patient populations.

The Utilization of 15-Minute Multidisciplinary Rounds to Reduce Length of Stay in Patients under Observation Status.

With the recent change to value-based care, institutions have struggled with the appropriate management of patients under observation. Observation status can have a huge impact on hospital and patient expenses. Institutions have implemented specialized observation units to provide better care for these patients.

Predictors of chronic COVID-19 symptoms in a community-based cohort of adults.

Background: COVID-19 can cause some individuals to experience chronic symptoms. Rates and predictors of chronic COVID-19 symptoms are not fully elucidated.

Objective: To examine occurrence and patterns of post-acute sequelae of SARS-CoV2 infection (PASC) symptomatology and their relationship with demographics, acute COVID-19 symptoms and anti-SARS-CoV-2 IgG antibody responses.

Association of Varying Clinical Manifestations and Positive Anti-SARS-CoV-2 IgG Antibodies: A Cross-Sectional Observational Study.

Background: The complex relationship between clinical manifestations of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and individual immune responses is not fully elucidated.

Objective: To examine phenotypes of symptomatology and their relationship with positive anti-SARS-CoV-2 IgG antibody responses.

Methods: An observational study was performed of adults (≥18 years) from 5 US states.

Improving Hospital Length of Stay: Results of a Retrospective Cohort Study.

(1) Background: Jersey Shore University Medical Center (JSUMC) is a 646-bed tertiary medical center located in central New Jersey. Over the past several years, development and maturation of tertiary services at JSUMC has resulted in tremendous growth, with the inpatient volume increasing by 17% between 2016 and 2018. As hospital floors functioned at maximum capacity, the medical center was frequently forced into crisis mode with substantial increases in emergency department (ED) waiting times and a paradoxical increase in-hospital length of stay (hLOS).

SARS-CoV-2 Seroprevalence and Symptom Onset in Culturally Linked Orthodox Jewish Communities Across Multiple Regions in the United States.

Importance: Data on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seroprevalence in the United States are still emerging.

Objective: To elucidate SARS-CoV-2 seroprevalence and symptom onset in a culturally linked community across 5 states in the United States.

Design, Setting, And Participants: This cross-sectional study included adults (aged ≥18 years) recruited from the orthodox Jewish community across 5 states (California, Connecticut, Michigan, New Jersey, and New York) in 3 geographically distinct areas of the United States between May 13 and July 6, 2020.

Examining why patients with attention-deficit/hyperactivity disorder lack adherence to medication over the long term: a review and analysis.

Objective: To investigate the reasons why patients with attention-deficit/hyperactivity disorder (ADHD) adhere poorly to medications over the long term (≥ 1 year).

Data Sources: PubMed was reviewed for studies between 1997 and January 2015 citing the reasons for medication nonadherence using these main keywords: ADHD, amphetamine, methylphenidate, atomoxetine, guanfacine, clonidine, long term, and adverse effects. Non-English language articles were excluded as were those that had a follow-up of < 1 year.

Predictors of renal recovery in patients with pre-orthotopic liver transplant (OLT) renal dysfunction.

Background: Renal dysfunction occurs commonly in patients awaiting orthotopic liver transplantation (OLT) for end-stage liver disease. The use of simultaneous liver-kidney transplantation has increased in the MELD scoring era. As patients may recover renal function after OLT, identifying factors predictive of renal recovery is a critical issue, especially given the scarcity of available organs.

Finegoldia magna (formerly Peptostreptococcus magnus): an overlooked etiology for toxic shock syndrome?

Finegoldia magna is an anaerobic Gram positive coccus, previously classified as Peptostreoptococcus magnus. It is normal flora of the gastrointestinal and genitourinary tract, and can be isolated from skin and the oral cavity and is often regarded as a contaminant in cultures. As the most frequently isolated anaerobic coccus, it is implicated in a range of mono- and polymicrobial infections, including skin and skin structure, bone and joint (native and prosthetic joints), infective endocarditis (native and prosthetic valves), necrotizing pneumonia, mediastinitis and meningitis.

Hospitalists at an academic medical center, part 2: guidelines and suggestions for the successful expansion of a voluntary pilot hospitalist program.

Previously, the authors discussed the successful introduction of a pilot hospitalist program at an academic medical center. Here they examine best practices for the expansion of such a program. Many studies have shown hospitalists to be associated with improvements in hospital quality indicators such as decreased length of stay, but the conditions necessary for the expansion of a hospitalist program have received considerably less attention.

Hospitalists at an academic medical center, part 1: impact of a voluntary pilot hospitalist program.

The use of hospitalists-physicians who limit their practice largely or exclusively to hospital inpatient care-has been a growing trend in the United States. The authors examine some pressures affecting an academic medical center and present the results of a hospitalist pilot project there. Based on the criteria of reduced patient length of hospital stay, hospital financial savings, physician satisfaction, and payer interest, the pilot hospitalist program was successful within 6 months.

The first description of severe anemia associated with acute kidney injury and adult minimal change disease: a case report.

Introduction: Acute kidney injury in the setting of adult minimal change disease is associated with proteinuria, hypertension and hyperlipidemia but anemia is usually absent. Renal biopsies exhibit foot process effacement as well as tubular interstitial inflammation, acute tubular necrosis or intratubular obstruction. We recently managed a patient with unique clinical and pathological features of minimal change disease, who presented with severe anemia and acute kidney injury, an association not previously reported in the literature.

Person-to-person transmission of Pseudomonas pneumonia in the community: documentation by pulsed-field electrophoresis.

Pseudomonas aeruginosa is a rare cause of community-acquired infection. The source of this organism has usually been inapparent or environmental (ie, contaminated humidifiers). We documented transmission of P aeruginosa leading to cavitary pneumonia and lung abscess from daughter to mother and confirmed the clonal identity of our two patients' isolates using pulsed-field electrophoresis.