A Remote Management-Centric Post-Discharge Pathway for Patients Admitted to GIM with Heart Failure.

Background: Few GIM-specific heart failure transition of care (TOC) programs exist. We thus piloted a TOC program for heart failure patients discharged from GIM that incorporates a remote patient management program, Medly.

Methods: This single-centre, prospective proof-of-concept study described sociodemographic and medical characteristics of included patients, and computed summary statistics to describe clinical and workload outcomes.

Characterizing medical patients with delirium: A cohort study comparing ICD-10 codes and a validated chart review method.

Background: Delirium is a major cause of preventable mortality and morbidity in hospitalized adults, but accurately determining rates of delirium remains a challenge.

Objective: To characterize and compare medical inpatients identified as having delirium using two common methods, administrative data and retrospective chart review.

Methods: We conducted a retrospective study of 3881 randomly selected internal medicine hospital admissions from six acute care hospitals in Toronto and Mississauga, Ontario, Canada.

Applying an equity lens to hospital safety monitoring: a critical interpretive synthesis protocol.

Introduction: Hospital safety monitoring systems are foundational to how adverse events are identified and addressed. They are well positioned to bring equity-related safety issues to the forefront for action. However, there is uncertainty about how they have been, and can be, used to achieve this goal.

Data-driven approach to identifying potential laboratory overuse in general internal medicine (GIM) inpatients.

Background: Reducing laboratory test overuse is important for high quality, patient-centred care. Identifying priorities to reduce low value testing remains a challenge.

Objective: To develop a simple, data-driven approach to identify potential sources of laboratory overuse by combining the total cost, proportion of abnormal results and physician-level variation in use of laboratory tests.

Using the Hospital Frailty Risk Score to assess mortality risk in older medical patients admitted to the intensive care unit.

Background: Prognostic information at the time of hospital discharge can help guide goals-of-care discussions for future care. We sought to assess the association between the Hospital Frailty Risk Score (HFRS), which may highlight patients' risk of adverse outcomes at the time of hospital discharge, and in-hospital death among patients admitted to the intensive care unit (ICU) within 12 months of a previous hospital discharge.

Methods: We conducted a multicentre retrospective cohort study that included patients aged 75 years or older admitted at least twice over a 12-month period to the general medicine service at 7 academic centres and large community-based teaching hospitals in Toronto and Mississauga, Ontario, Canada, from Apr.

Analysis of Resident and Attending Physician End-of-Rotation Changeover Days and Association With Patient Length of Stay.

Importance: End-of-rotation resident physician changeover is a key part of postgraduate training but could lead to discontinuity in patient care.

Objective: To test whether patients exposed to end-of-rotation resident changeover have longer hospital stays and whether this association is mitigated by separating resident and attending changeover days.

Design, Setting, And Participants: This retrospective cohort analysis included adult patients admitted to general internal medicine.

Migrant agricultural workers' deaths in Ontario from January 2020 to June 2021: a qualitative descriptive study.

Background: Nine migrant agricultural workers died in Ontario, Canada, between January 2020 and June 2021.

Methods: To better understand the factors that contributed to the deaths of these migrant agricultural workers, we used a modified qualitative descriptive approach. A research team of clinical and academic experts reviewed coroner files of the nine deceased workers and undertook an accompanying media scan.

Bedspacing and clinical outcomes in general internal medicine: A retrospective, multicenter cohort study.

Background: Admitting hospitalized patients to off-service wards ("bedspacing") is common and may affect quality of care and patient outcomes.

Objective: To compare in-hospital mortality, 30-day readmission to general internal medicine (GIM), and hospital length-of-stay among GIM patients admitted to GIM wards or bedspaced to off-service wards.

Design, Participants, And Measures: Retrospective cohort study including all emergency department admissions to GIM between 2015 and 2017 at six hospitals in Ontario, Canada.

Outcomes in patients with and without disability admitted to hospital with COVID-19: a retrospective cohort study.

Background: Disability-related considerations have largely been absent from the COVID-19 response, despite evidence that people with disabilities are at elevated risk for acquiring COVID-19. We evaluated clinical outcomes in patients who were admitted to hospital with COVID-19 with a disability compared with patients without a disability.

Methods: We conducted a retrospective cohort study that included adults with COVID-19 who were admitted to hospital and discharged between Jan.

Women in Medicine: The Limits of Individualism in Academic Medicine.

In the 21st century, more than ever before, issues facing women in medicine, such as pay equity and workplace harassment, are being explored and attended to by physicians and health care institutions. Discussions about women in medicine almost exclusively center around women physicians, even though most women in medicine are, in fact, not physicians. In addition, these discussions typically focus on gender, often failing to consider how race, class, and other dimensions of identity influence the experiences of women in medicine.

A Survey of Nurses' Perspectives on Delirium Screening in Older Adult Medical Inpatients With Limited English Proficiency.

The Confusion Assessment Method (CAM) is commonly used to detect delirium but its utility in patients with limited English proficiency (LEP) is not well-established. In the current study, internal medicine nurses at an acute care hospital in Canada were surveyed on the use of the CAM in older adults with LEP. Nurses' perspectives were explored with a focus on barriers to administration.

Reliability of Patient-Report, Physician-Report, and Medical Record Review to Identify Hospital-Acquired Complications: A Prospective Cohort Study.

This prospective study of internal medicine inpatients treated at 2 hospitals in Toronto, Canada, between September 1, 2016, and September 1, 2017, compared patient-report, physician-report, and detailed medical record review to identify specific hospital-acquired complications. Six complications were assessed: delirium, catheter-associated urinary tract infection, acute kidney injury, deep vein thrombosis/pulmonary embolism, hospital-acquired pneumonia, or fall. The study included 207 patients and physician responses were obtained for 156 (75%).

Association of diabetes with frequency and cost of hospital admissions: a retrospective cohort study.

Background: Acute inpatient hospital admissions account for more than half of all health care costs related to diabetes. We sought to identify the most common and costly conditions leading to hospital admission among patients with diabetes compared with patients without diabetes.

Methods: We used data from the General Internal Medicine Inpatient Initiative (GEMINI) study, a retrospective cohort study, of all patients admitted to a general internal medicine service at 7 Toronto hospitals between 2010 and 2015.

Characteristics and outcomes of hospital admissions for COVID-19 and influenza in the Toronto area.

Background: Patient characteristics, clinical care, resource use and outcomes associated with admission to hospital for coronavirus disease 2019 (COVID-19) in Canada are not well described.

Methods: We described all adults with COVID-19 or influenza discharged from inpatient medical services and medical-surgical intensive care units (ICUs) between Nov. 1, 2019, and June 30, 2020, at 7 hospitals in Toronto and Mississauga, Ontario.

Assessing the quality of clinical and administrative data extracted from hospitals: the General Medicine Inpatient Initiative (GEMINI) experience.

Objective: Large clinical databases are increasingly used for research and quality improvement. We describe an approach to data quality assessment from the General Medicine Inpatient Initiative (GEMINI), which collects and standardizes administrative and clinical data from hospitals.

Methods: The GEMINI database contained 245 559 patient admissions at 7 hospitals in Ontario, Canada from 2010 to 2017.

Accuracy of the Preferred Language Field in the Electronic Health Records of Two Canadian Hospitals.

Background: The collection of race, ethnicity, and language (REaL) data from patients is advocated as a first step to identify, monitor, and improve health inequities. As a result, many health care institutions collect patients' preferred languages in their electronic health records (EHRs). These data may be used in clinical care, research, and quality improvement.