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Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine

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https://www.readbyqxmd.com/read/29694462/physiologic-monitor-alarm-rates-at-5-children-s-hospitals
#1
Amanda C Schondelmeyer, Patrick W Brady, Veena V Goel, Maria Cvach, Nancy Blake, Colleen Mangeot, Christopher P Bonafide
Alarm fatigue has been linked to patient morbidity and mortality in hospitals due to delayed or absent responses to monitor alarms. We sought to describe alarm rates at 5 freestanding children's hospitals during a single day and the types of alarms and proportions of patients monitored by using a point-prevalence, cross-sectional study design. We collected audible alarms on all inpatient units and calculated overall alarm rates and rates by alarm type per monitored patient per day. We found a total of 147,213 alarms during the study period, with 3-fold variation in alarm rates across hospitals among similar unit types...
April 25, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29694461/value-based-purchasing-for-hospital-acquired-venous-thromboembolism-too-much-too-soon
#2
Christopher G Roy
No abstract text is available yet for this article.
April 25, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29694460/development-of-hospitalization-resource-intensity-scores-for-kids-h-risk-and-comparison-across-pediatric-populations
#3
Troy Richardson, Jonathan Rodean, Mitch Harris, Jay Berry, James C Gay, Matt Hall
BACKGROUND: In the Medicare population, measures of relative severity of illness (SOI) for hospitalized patents have been used in prospective payment models. Similar measures for pediatric populations have not been fully developed. OBJECTIVE: To develop hospitalization resource intensity scores for kids (H-RISK) using pediatric relative weights (RWs) for SOI and to compare hospital types on case-mix index (CMI). DESIGN/METHODS: Using the 2012 Kids' Inpatient Database (KID), we developed RWs for each All Patient Refined Diagnosis Related Group (APR-DRG) and SOI level...
April 25, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29694459/characterizing-hospitalizations-for-pediatric-concussion-and-trends-in-care
#4
Tara Rhine, Terri Byczkowski, Mekibib Altaye, Shari L Wade, Lynn Babcock
BACKGROUND: Children hospitalized for concussion may be at a higher risk for persistent symptoms, but little is known about this subset of children. OBJECTIVE: Delineate a cohort of children admitted for concussion, describe care practices received, examine factors associated with prolonged length of stay (LOS) or emergency department (ED) readmission, and investigate changes in care over time. DESIGN, SETTING: Retrospective analysis of data submitted by 40 pediatric hospitals to the Pediatric Health Information System...
April 25, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29694458/hospital-readmissions-in-patients-with-cirrhosis-a-systematic-review
#5
Eric S Orman, Marwan Ghabril, Thomas W Emmett, Naga Chalasani
BACKGROUND: Hospital readmission is a significant problem for patients with complex chronic illnesses such as liver cirrhosis. PURPOSE: We aimed to describe the range of readmission risk in patients with cirrhosis and the impact of the model for end-stage liver disease (MELD) score. DATA SOURCES: We conducted a systematic review of studies identified in Ovid MEDLINE, PubMed, EMBASE, CINAHL, the Cochrane Library, Scopus, Google Scholar, and ClinicalTrials...
April 25, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29694457/tissue-isn-t-the-issue
#6
Lekshmi Santhosh, Laura Koth, Thomas E Baudendistel, Bradley Sharpe, Bradley Monash
No abstract text is available yet for this article.
April 25, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29694456/a-matter-of-urgency-reducing-clinical-text-message-interruptions-during-educational-sessions
#7
Arielle Mendel, Anthony Lott, Lisha Lo, Robert Wu
BACKGROUND: Text messaging is increasingly replacing paging as a tool to reach physicians on medical wards. However, this phenomenon has resulted in high volumes of nonurgent messages that can disrupt the learning climate. OBJECTIVE: Our objective was to reduce nonurgent educational interruptions to residents on general internal medicine. DESIGN, SETTING, PATIENTS: This was a quality improvement project conducted at an academic hospital network...
April 25, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29694455/relative-weights-for-pediatric-inpatients-children-now-have-a-scale-of-their-own
#8
Evan Fieldston
No abstract text is available yet for this article.
April 25, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29694454/-we-ve-learned-it-s-a-medical-illness-not-a-moral-choice-qualitative-study-of-the-effects-of-a-multicomponent-addiction-intervention-on-hospital-providers-attitudes-and-experiences
#9
Honora Englander, Devin Collins, Sylvia Peterson Perry, Molly Rabinowitz, Elena Phoutrides, Christina Nicolaidis
BACKGROUND: Substance use disorders (SUD) represent a national epidemic with increasing rates of SUD-related hospitalizations. However, most hospitals lack expertise or systems to directly address SUD. Healthcare professionals feel underprepared and commonly hold negative views toward patients with SUD. Little is known about how hospital interventions may affect providers' attitudes and experiences toward patients with SUD. OBJECTIVE: To explore interprofessional hospital providers' perspectives on how integrating SUD treatment and care systems affect providers' attitudes, beliefs, and experiences...
April 25, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29694453/cardiac-troponins-in-low-risk-pulmonary-embolism-patients-a-systematic-review-and-meta-analysis
#10
Omar S Darwish, Abdullah Mahayni, Mukti Patel, Alpesh Amin
BACKGROUND: Patients with low-risk pulmonary embolism (PE) should be considered as per current scoring systems for ambulatory treatment. However, there is uncertainty whether patients with low scores and positive troponins should require hospitalization. METHODS: We searched MEDLINE, SCOPUS, and Cochrane Library databases from inception to December 2016 and collected longitudinal studies that evaluated the prognostic value of troponins in patients with low-risk PE...
April 25, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29694452/current-perspectives-on-transport-medicine-in-pediatric-hospital-medicine-fellowships
#11
Mark H Corden, Thanh Huynh, Purnima Mandal, Sanjay Chand, Jennifer Maniscalco
Transport medicine (TM) is a Pediatric Hospital Medicine (PHM) Core Competency and part of the proposed PHM fellowship curricular framework. No published TM curricula are available. This cross-sectional study was designed to determine attitudes toward TM training among PHM fellowship stakeholders and conduct a TM curriculum needs assessment. Unique, web-based, anonymous surveys for PHM fellows, graduates, and program directors (PDs) were administered, with response rates of 57%, 37%, and 44%, respectively. Fellows' interest in completing a TM rotation is greater than their perceived interest by PDs (P = ...
April 25, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29694451/continuous-physiologic-monitoring-false-alarms-and-overdiagnosis
#12
Eric R Coon, H Gilbert Welch
No abstract text is available yet for this article.
April 25, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29694450/focused-ethnography-of-diagnosis-in-academic-medical-centers
#13
Vineet Chopra, Molly Harrod, Suzanna Winter, Jane Forman, Martha Quinn, Sarah Krein, Karen E Fowler, Hardeep Singh, Sanjay Saint
BACKGROUND: Approaches of trainees to diagnosis in teaching hospitals are poorly understood. Identifying cognitive and system-based barriers and facilitators to diagnosis may improve diagnosis in these settings. METHODS: We conducted a focused ethnography of trainees at 2 academic medical centers to understand the barriers and facilitators to diagnosis. Field notes regarding the diagnostic process (eg, information gathering, integration and interpretation, working diagnosis) and the work system (eg, team members, organization, technology and tools, physical environment, tasks) were recorded...
April 25, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29694449/appraising-the-evidence-supporting-choosing-wisely%C3%A2-recommendations
#14
Andrew J Admon, Ashwin Gupta, Margaret Williams, Thomas S Valley, Michael W Sjoding, Renda Soylemez Wiener, Colin R Cooke
Despite the growing enthusiasm surrounding the Choosing Wisely® campaign, little is known regarding the evidence underlying these recommendations. We extracted references for all 320 recommendations published through August, 2014, including the 10 adult and pediatric recommendations published by the Society for Hospital Medicine. We then categorized each item by evidence strength, and then assessed a sample of referenced clinical practice guidelines (CPGs) using the validated Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument...
April 25, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29578554/it-is-what-it-is-for-now
#15
Jeffrey G Wiese
No abstract text is available yet for this article.
March 26, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29578553/trends-in-inpatient-admission-comorbidity-and-electronic-health-data-implications-for-resident-workload-intensity
#16
Amanda V Clark, Charles M LoPresti, Todd I Smith
In the era of duty hour regulations, there is increasing concern regarding resident workload compression. We conducted a retrospective, observational assessment of all internal medicine resident admissions to a Veterans Affairs hospital over a 15-year period to evaluate several admission components that impact resident workload and workload intensity, including electronic health record (EHR) data burden and patient comorbidity. A total of 67,346 admissions were included in the analysis. Mean patient comorbidity, as measured by the Charlson Comorbidity Index, increased throughout the study period...
March 26, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29578552/focusing-on-inattention-the-diagnostic-accuracy-of-brief-measures-of-inattention-for-detecting-delirium
#17
Annachiara Marra, James C Jackson, E Wesley Ely, Amy J Graves, John F Schnelle, Robert S Dittus, Amanda Wilson, Jin H Han
BACKGROUND: Delirium is frequently missed in most clinical settings. Brief delirium assessments are needed. OBJECTIVE: To determine the diagnostic accuracy of reciting the months of year backwards (MOTYB) from December to July (MOTYB-6) and December to January (MOTYB-12) for delirium as diagnosed by a psychiatrist and to explore the diagnostic accuracies of the following other brief attention tasks: (1) spell the word "LUNCH" backwards, (2) recite the days of the week backwards, (3) 10-letter vigilance "A" task, and (4) 5 picture recognition task...
March 26, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29578551/the-influence-of-hospitalist-continuity-on-the-likelihood-of-patient-discharge-in-general-medicine-patients
#18
Carl van Walraven
Hospitalists responsible for specific inpatients may change during their hospitalization. To measure the association of hospitalist continuity with the adjusted daily discharge probability, 6,405 admissions (38,967 patientdays, 5,208 patients) to a general medicine service at a tertiary care teaching hospital in 2015 were investigated. Continuity was measured as the consecutive number of days-including weekends-a hospitalist treated a particular team of patients. After accounting for important covariables, discharge probability increased significantly with hospitalist continuity; the adjusted daily discharge probabilities for an average patient with a new physician vs...
March 26, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29578550/training-residents-in-hospital-medicine-the-hospitalist-elective-national-survey
#19
Steven Ludwin, James D Harrison, Sumant Ranji, Bradley A Sharpe, Patrick Kneeland
As the field of hospital medicine expands, internal medicine residency programs can play a role in preparing future hospitalists. To date, little is known of the prevalence and characteristics of hospitalist-focused resident rotations. We surveyed the largest 100 Internal Medicine Residency Programs to better understand the prevalence, objectives, and structure of hospitalist-focused rotations in the United States. Residency leaders from 82 programs responded (82%). The prevalence of hospitalist-focused rotations was 50% (41/82) with an additional 9 programs (11%) planning to start one...
March 26, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29578549/patient-perceptions-of-readmission-risk-an-exploratory-survey
#20
Daniel J Brotman, Hasan M Shihab, Amanda Bertram, Alan Tieu, Henry G Cheng, Erik H Hoyer, Nowella Durkin, Amy Deutschendorf
Interventions to prevent readmissions often rely upon patient participation to be successful. We surveyed 895 general medicine patients slated for hospital discharge to (1) assess patient attitudes surrounding readmission, (2) ascertain whether these attitudes were associated with actual readmission, and (3) determine whether patients can estimate their own readmission risk. Actual readmissions and other clinical variables were captured from administrative data and linked to individual survey responses. We found that actual readmissions were not correlated with patients' interest in preventing readmission, sense of control over readmission, or intent to follow discharge instructions...
March 26, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
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