Practice Management
- Test ordering: Balancing the good for the many with the good for the one
Three articles this month address how we order clinical tests, one on the question of treating the patient with asymptomatic bacteriuria, the others on the advantages and disadvantages of standing orders for “daily labs” for inpatients.
- Should ‘daily labs’ be a quality priority in hospital medicine?
Evidence shows that unnecessary daily testing is only a minor contributor to anemia and healthcare costs for most inpatients. The effect on patient experience has not been definitively established.
- Laboratory stewardship should be a priority in every hospital
Considerations include indirect costs, downstream testing or other workup based on minor abnormalities uncovered during daily testing, and shortages in staff and supplies.
- There should be more GOLD in the EMR
We can do better at making the clinical note a useful tool for communication in the electronic medical record.
- The underappreciated role of documentation in improving COPD care
Despite the importance of providing guideline-concordant care, there are still barriers to implementing evidence-based recommendations in providing care for patients with chronic obstructive pulmonary disease.
- Does my hospitalized patient need an NPO-after-midnight order preoperatively?
The following article in the February 2022 issue contained an error: Chapman T, Sinz E, McGillen B. Does my hospitalized patient need an NPO-after-midnight order preoperatively? Cleve Clin J Med 2022; 89(2):69–70. doi:10.3949/ccjm.89a.21061
- Does my hospitalized patient need an NPO-after-midnight order preoperatively?
Delays and postponements of surgical procedures are common, and NPO-after-midnight orders in these situations can result in prolonged periods without oral intake.
- Is it safe to start steroids at home for a COPD exacerbation after virtual assessment in the COVID-19 era?
Yes. Corticosteroids are beneficial, and virtual visits are appropriate, especially in this pandemic.
- Cleveland Clinic Journal of Medicine: Evolution and a look ahead
Cleveland Clinic is 100 years old and has had a medical journal for 90 of those years.
- The Clinic and the Journal: Respecting the past and welcoming the future
This year is the 100th anniversary of the founding of Cleveland Clinic.