Impact of a hypoglycemia reduction bundle and a systems approach to inpatient glycemic management.

Objective: Uncontrolled hyperglycemia and iatrogenic hypoglycemia represent common and frequently preventable quality and safety issues. We sought to demonstrate the effectiveness of a hypoglycemia reduction bundle, proactive surveillance of glycemic outliers, and an interdisciplinary data-driven approach to glycemic management.

Population: all hospitalized adult non-intensive care unit (non-ICU) patients with hyperglycemia and/or a diagnosis of diabetes admitted to our 550-bed academic center across 5 calendar years (CYs).

Vegetable output and cost savings of community gardens in San Jose, California.

Urban dwellers across the United States increasingly access a variety of fresh vegetables through participation in neighborhood-level community gardens. Here we document vegetable output and cost savings of community gardens in the city of San Jose, CA, to better understand the capacity of community gardens to affect food affordability in an urban setting. A convenience sample of 83 community gardeners in San Jose completed a background survey during spring and summer 2012.

Does a history of exercise in COPD patients affect functional status? A study using a lifetime physical activity questionnaire investigates a correlation between exercise and functional status as evidenced by six-minute walk distance.

Recent studies have shown strong associations between chronic exercise and improved spirometric values. Building on these findings, we investigated whether habitual lifetime exercise influences six-minute walk test performance (6MWT) in subjects with at least 10 pack-years smoking history. The 6MWT was chosen for its correlation with performance on activities of daily living and predictive value for inactivity, morbidity and mortality in individuals with chronic obstructive pulmonary disease (COPD) versus spirometric values, which are less adept at predicting functional status.

High rates of venous thromboembolism prophylaxis did not increase the incidence of heparin-induced thrombocytopenia.

Background: Venous thromboembolism (VTE) prophlaxis is recommended for most hospitalized patients. At a 505-bed urban academic medical center, the rate of VTE prophylaxis recently increased from 50%-55% to > 95% of eligible patients. Heparin-induced thrombocytopenia (HIT) is a potentially devastating, but rare, reaction to medications commonly used for VTE prophylaxis.

CrowdED: crowding metrics and data visualization in the emergency department.

Objectives: Emergency department (ED) crowding metrics were validated in our facility and a new technique of data visualization is proposed.

Design: A sequential cross-sectional study was conducted in our ED during October 2007. Data were collected every 2 hours by a research assistant and included patient arrivals and acuity levels, available inpatient and ED beds, ambulance diversion status, staff present, and patient reneging.