Time Value Analysis of Inpatient Endoscopy Workflow

Aims for Improvement Our aim was to evaluate the variables involved in room turnover and identify any delays that lead to the time difference found between inpatient and outpatient rooms. We planned to design an intervention to improve efficiency in the endoscopy suite and complete more inpatient cases. We predicted that completion of more inpatient cases would subsequently decrease the need for cancellation and rescheduling of medically necessary cases on a daily basis

Abdomen Actin’ Up: A Unique Presentation of Disseminated Abdominal Actinomycosis

INTRODUCTION Abdominal actinomycosis is a chronic, indolent disease characterized by nonspecific symptoms such as fatigue, weight loss, fever, and abdominal pain. Actinomyces is a genus of fastidious, gram-positive, non-acid-fast, branching filamentous bacilli characterized by sulfur granules that is normally found in oral flora and inhabits the gastrointestinal (GI) tract. Actinomyces infections are relatively rare, however when present, they have the ability to invade multiple organs and disseminate throughout multiple body cavities. Factors that increase the risk of developing actinomycosis include poor oral hygiene, alcoholism, and preexisting dental disease. Intrauterine devices (IUDs) also increase the risk of developing pelvic actinomycosis. Over the past 10-20 years, actinomycosis is being diagnosed with increasing frequency and should be considered in the differential for patients presenting with indolent abdominal symptoms along with risk factors. KEY POINTS While still rare, the incidence of abdominal actinomycosis is increasing. Abdominal actinomycosis presents with a chronic, indolent course of nonspecific symptoms similar to other, more common conditions and, should be considered in patients with indolent abdominal symptoms and risk factors including poor dental hygiene, dental disease, and alcoholism. The diagnosis is based on abscess fluid culture growing Actinomyces. Treatment of actinomycosis is generally with a long course of IV Penicillin G later transitioned to oral Amoxicillin

The Opioid Epidemic – Addressing Provider Roles and Responsibilities

INTRODUCTION This year marks the 19th volume of Jefferson’s annual publication spearheaded by Internal Medicine residents and supported by its fellows. Our Editorial Board includes Neha, Debbie, Anita, Brianna, and myself. Our mission is to further medical knowledge by sharing each other’s observations and studies both through our publication, which you can find online, as well as through annual discussion at Grand Rounds. This year, we’ve chosen to focus on our roles as providers in the midst of the National Opioid Epidemic. The National Institute on Drug Abuse has reported that the number of opioid-related overdose deaths from both illegal and prescription opioids has risen in our state over the last 15 years. This information is available for each state online. While addiction has been a nationwide issue for centuries, provider practices and societal attitudes in relation to opioids has greatly varied. We’ll introduce you to our panelists, giving a very brief overview of the history of opioid use in our country, then turning the discussion over to them

From the Editors

We are delighted to present you with the 19th annual edition of The Medicine Forum. Here in the birthplace of our nation, we like to think of The Medicine Forum as being of the housestaff, by the housestaff and for the housestaff. Undeniably, this publication would not be possible without the countless hours dedicated by our residents, students, fellows and faculty

From the Editors

We are delighted to present you with the 20th annual edition of The Medicine Forum. Here in the birthplace of our nation, we like to think of The Medicine Forum as being of the housestaff, by the housestaff and for the housestaff. Undeniably, this publication would not be possible without the countless hours dedicated by our residents, students, fellows and faculty

Improving Transitions of Care for Inpatients with an eGFR \u3c 20ml/min

In this study we conducted an analysis of 22 inpatients with an eGFR\u3c20 that revealed there was a greater prevalence of patients without permanent AV access for HD initiation when compared to national data. These findings demonstrated the need for improved transitions of care and timely creation of AV access for this patient population, thus we sought to improve this. This is the first inpatient initiative that our group is aware with the aim of improving timely AV access and transitions of care for an inpatient population (Figure 1).https://jdc.jefferson.edu/patientsafetyposters/1090/thumbnail.jp