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Mindfulness-Based Laboratory Reduction: Reducing Utilization Through Trainee-Led Daily ‘Time Outs’

Overuse of laboratory investigations is widely prevalent in hospitalized patients, leads to discomfort, and increases direct and indirect costs. Objective We implemented a simple, inexpensive, mindfulness strategy on our inpatient medical clinical teaching unit to reduce unnecessary laboratory orders through education, a forcing function, and daily structured laboratory “time outs.” Methods On a 26-bed unit […]

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Advancing High-Value Health Care: A New AJM Column Dedicated to Cost-Conscious Care Quality Improvement

Despite the very high cost of health care in the US, expenditure continues to rise. According to the Centers for Medicare & Medicaid Services, health care expenditures for 2016 are projected to be $3.4 trillion, and the percentage of the gross domestic product spent on health care will increase from 17.4% in 2013 to 19.6% […]

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doctor talking on cell phone stting at his desk, looking at computer

The New Trend in Medicine

During the 4 decades of my clinical training and practice of medicine, I always felt a sense of ownership and full responsibility in caring for my patients. What I have noticed over the past decade is a gradual transformation in our health care delivery system and in the attitude of our trainees. Hospitals are being governed […]

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Absence of Oral Anticoagulation and Subsequent Outcomes Among Outpatients with AF (video)

Prior studies have shown a treatment gap in oral anticoagulation (OAC) use among patients with atrial fibrillation yet have incompletely characterized factors associated with failure to treat and subsequent outcomes in contemporary practice. Methods Using data collected between June 2010 and August 2011 from 174 ambulatory care sites in the Outcomes Registry for Better Informed […]

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30-Day Readmissions After an Acute Kidney Injury Hospitalization

The risk of hospital readmission in acute kidney injury survivors is not well understood. We estimated the proportion of acute kidney injury patients who were rehospitalized within 30 days and identified characteristics associated with hospital readmission. Methods We conducted a population-based study of patients who survived a hospitalization complicated by acute kidney injury from 2003-2013 […]

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