Hospitalists Stare down the COVID-19 Pandemic

Hospital medicine is the country\u27s fastest growing medical specialty. The role of hospitalists has evolved greatly in the past few decades. Hospitalists have become the quarterbacks in the effort to fight against the COVID-19 pandemic. The pandemic has brought about a transformational change to the practice of Hospital Medicine

How safe is Healthcare? Perceptions within the Healthcare Community and the general public.

Objectives: Complexity of health care is progressively increasing and with that the number of medical errors and adverse events are increasing to an alarming level. The purpose of this study is to assess the perception of healthcare safety within the healthcare community and the general public and examine the association between the perception regarding healthcare safety and the prior exposure to medical errors. Methods: The study is a cross-sectional online survey. The online survey included basic demographics and a series of questions related to the knowledge and perception about healthcare safety and personal healthcare experience. Results: 504 respondent completed the survey. 78.6% were healthcare workers. 84% reported one or more exposure to medical errors or adverse events. Most respondents (81.5%) estimated the rate of medical errors to be 1:100 or less. only 29.3% of the respondents thought that medical errors are occurring more frequently than 10 years ago. 89.6% of the respondents thought that healthcare is a safe industry. Looking at Factors Predicting the Perception that Healthcare is Safe, there was no clear correlation with the exposure to medical errors except for surgical complications exposure (p-value=0.01, OR 21.4) Conclusions: There is a strong indication in our data that healthcare workers and public perception is far from the reality of the dangers of the healthcare system There is a need to educate the public regarding the medical error rate and the healthcare safety to help make patients and their families become partners in their care and to help healthcare workers better understand the limitations of healthcare processes that may affect patient safety and outcomes

How safe is Healthcare? Perceptions within the Healthcare Community and the general public

Objectives: Complexity of health care is progressively increasing and with that the number of medical errors and adverse events are increasing to an alarming level. The purpose of this study is to assess the perception of healthcare safety within the healthcare community and the general public and examine the association between the perception regarding healthcare safety and the prior exposure to medical errors. Methods: The study is a cross-sectional online survey. The online survey included basic demographics and a series of questions related to the knowledge and perception about healthcare safety and personal healthcare experience. Results: 504 respondent completed the survey. 78.6% were healthcare workers. 84% reported one or more exposure to medical errors or adverse events. Most respondents (81.5%) estimated the rate of medical errors to be 1:100 or less. only 29.3% of the respondents thought that medical errors are occurring more frequently than 10 years ago. 89.6% of the respondents thought that healthcare is a safe industry. Looking at Factors Predicting the Perception that Healthcare is Safe, there was no clear correlation with the exposure to medical errors except for surgical complications exposure (p-value=0.01, OR 21.4) Conclusions: There is a strong indication in our data that healthcare workers and public perception is far from the reality of the dangers of the healthcare system There is a need to educate the public regarding the medical error rate and the healthcare safety to help make patients and their families become partners in their care and to help healthcare workers better understand the limitations of healthcare processes that may affect patient safety and outcomes

Ammonia vs. Lactic Acid in Predicting Positivity of Microbial Culture in Sepsis: The ALPS Pilot Study

Objective: The use of serum ammonia as a novel marker for sepsis compared to lactic acid levels in intensive care unit (ICU) patients. Design and Interventions: Single arm, prospective clinical trial to collect arterial blood samples from patients with sepsis. Serial ammonia and lactic acid levels were sent every six hours for a total of three days. Measurements and results: Compare mean levels of ammonia and lactic acid in terms of diagnosing sepsis and patient outcome, including length of stay and mortality. A total of 30 patients were enrolled in the pilot study. On admission, mean ammonia level was 35.7 μmol/L and lactic acid was 3.06 mmole/L. Ammonia levels checked at the end of day 2 (ammonia 2-4) and the beginning of day 3 (ammonia 3-1) were higher in patients who had a microbial culture-proven sepsis (p-values 0.029 and 0.002, respectively) compared to those without culture-positive sepsis. Ammonia levels did predict a longer hospital stay; ammonia level of more than 40 μmol/L had a mean hospital stay of 17.6 days vs. patients with normal levels who had a mean hospital stay of 9.62 days (p-value 0.0082). Conclusion: Elevated ammonia level can be a novel biomarker for sepsis, comparable to conventional markers. Ammonia levels have a prognostic utility as elevated levels were associated with longer hospital stay

Ammonia vs. Lactic Acid in Predicting Positivity of Microbial Culture in Sepsis: The ALPS Pilot Study

Objective: The use of serum ammonia as a novel marker for sepsis compared to lactic acid levels in intensive care unit (ICU) patients. Design and Interventions: Single arm, prospective clinical trial to collect arterial blood samples from patients with sepsis. Serial ammonia and lactic acid levels were sent every six hours for a total of three days. Measurements and results: Compare mean levels of ammonia and lactic acid in terms of diagnosing sepsis and patient outcome, including length of stay and mortality. A total of 30 patients were enrolled in the pilot study. On admission, mean ammonia level was 35.7 μmol/L and lactic acid was 3.06 mmole/L. Ammonia levels checked at the end of day 2 (ammonia 2-4) and the beginning of day 3 (ammonia 3-1) were higher in patients who had a microbial culture-proven sepsis (p-values 0.029 and 0.002, respectively) compared to those without culture-positive sepsis. Ammonia levels did predict a longer hospital stay; ammonia level of more than 40 μmol/L had a mean hospital stay of 17.6 days vs. patients with normal levels who had a mean hospital stay of 9.62 days (p-value 0.0082). Conclusion: Elevated ammonia level can be a novel biomarker for sepsis, comparable to conventional markers. Ammonia levels have a prognostic utility as elevated levels were associated with longer hospital stay