Even though our base-case analysis seems to show that dalteparin 5000 U is cost effective compared with dalteparin 2500 U and UFH for prophylaxis of VTE in patients undergoing abdominal surgery, Monte Carlo simulation demonstrated that this was the case for only about 50% of the patients if the threshold for cost effectiveness is set at US50,000 dollars per QALY gained. Furthermore, there was substantial uncertainty in the cost-effectiveness results. To ensure that > or =90% patients receive the benefit of the medication, policy makers would need to commit substantially more resources than suggested by the baseline ICERs.

Enterobius vermicularis is the most common helminthic infection in the US. It is usually considered an innocuous parasite that at the most causes perianal itching. We report a case of an 84‐year‐old female patient from an assisted living facility who presented with symptoms of colitis for 2 months. On detailed history and exam, she was found to have E. vermicularis infection. All her symptoms resolved dramatically within 2 days after a single dose of albendazole. We want to emphasize the importance of including parasitic infections such as E. vermicularis in the differential diagnoses of patients presenting with symptoms of colitis. Journal of Hospital Medicine 2009;4:137–139. © 2009 Society of Hospital Medicine.

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Intensive care unit (ICU) resources are scarce, yet demand is increasing at a rapid rate. Optimizing throughput efficiency while balancing patient safety and quality of care is of utmost importance during times of high ICU utilization. Continuous improvement methodology was used to develop a multidisciplinary workflow to improve throughput in the ICU while maintaining a high quality of care and minimizing adverse outcomes. The research team was able to decrease ICU occupancy and therefore ICU length of stay by implementing this process without increasing mortality or readmissions to the ICU. By improving throughput efficiency, more patients were able to be provided with care in the ICU.

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