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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/30379146/less-lumens-less-risk-a-pilot-intervention-to-increase-the-use-of-single-lumen-peripherally-inserted-central-catheters
#1
David Bozaan, Deanna Skicki, Adamo Brancaccio, Ashley Snyder, Sue Friebe, Matthew Tupps, David Paje, Vineet Chopra
To reduce risk of complications, existing guidelines recommend use of peripherally inserted central catheters (PICCs) with the minimal number of lumens. This recommendation, however, is difficult to implement in practice. We conducted a pilot study to increase the use of single-lumen PICCs in hospitalized patients. The intervention included (1) education for physicians, pharmacists, and nurses; (2) changes to the electronic PICC order-set that set single lumen PICCs as default; and (3) criteria defining when use of multilumen PICCs is appropriate...
October 31, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/30379145/ethical-considerations-in-the-care-of-hospitalized-patients-with-opioid-use-and-injection-drug-use-disorders
#2
David Alfandre, Cynthia Geppert
No abstract text is available yet for this article.
October 31, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/30379144/interventions-for-frequently-hospitalized-patients-and-their-effect-on-outcomes-a-systematic-review
#3
Alexandra Goodwin, Bruce L Henschen, Linda C O'Dwyer, Natash Nichols, Kevin J O'Leary
BACKGROUND: A small subset of patients account for a substantial proportion of hospital readmissions. Programs to reduce utilization among this subset of frequently hospitalized patients have the potential to improve health and reduce unnecessary spending. PURPOSE: To conduct a systematic review of interventions targeting frequently hospitalized patients. DATA SOURCES: PubMed MEDLINE; Embase (embase.com); and Cochrane Central Register of Controlled Trials, January 1, 1980 to January 1, 2018. STUDY SELECTION: Four physicians screened 4762 titles and abstracts for inclusion...
October 31, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/30379143/on-decreasing-utilization-models-of-care-for-frequently-hospitalized-patients-and-their-effect-on-outcomes
#4
Paul D Hain, Bharath Thankavel, Leanne Metcalfe
No abstract text is available yet for this article.
October 31, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/30379142/random-drug-testing-of-physicians-a-complex-issue-framed-in-7-questions
#5
Ethan Cumbler, Jean S Kutner
No abstract text is available yet for this article.
October 31, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/30379141/prevalence-of-staphylococcus-aureus-and-use-of-antistaphylococcal-therapy-in-children-hospitalized-with-pneumonia
#6
Jennifer M Frush, Yuwei Zhu, Kathryn M Edwards, Carlos G Grijalva, Isaac P Thomsen, Wesley H Self, Seema Jain, Evan J Anderson, Krow Ampofo, Andrew T Pavia, Sandra R Arnold, Jonathan A McCullers, Derek J Williams
Within a cohort of >2,000 children hospitalized with community-acquired pneumonia, staphylococcal pneumonia was rare (1%) but associated with adverse in-hospital outcomes. Despite this low prevalence, use of antistaphylococcal antibiotics was common (24%). Efforts are needed to minimize overuse of antistaphylococcal antibiotics while also ensuring adequate treatment for pathogen-specific diseases.
October 31, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/30379140/things-we-do-for-no-reason-prealbumin-testing-to-diagnose-malnutrition-in-the-hospitalized-patient
#7
Mary Lacy, Justin Roesch, Jens Langsjoen
No abstract text is available yet for this article.
October 31, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/30379139/acute-treatment-of-hypertensive-urgency
#8
Anthony C Breu, R Neal Axon
No abstract text is available yet for this article.
October 31, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/30379138/association-of-weekend-admission-and-weekend-discharge-with-length-of-stay-and-30-day-readmission-in-children-s-hospitals
#9
Jessica L Markham, Troy Richardson, Matthew Hall, Christopher P Bonafide, Derek J Williams, Katherine A Auger, Karen M Wilson, Samir S Shah
BACKGROUND: Worse outcomes among adults presenting for/receiving care on weekends (ie, "the weekend effect") have been observed for many diseases. However, little is known about the overall impact of the weekend effect in hospitalized children. OBJECTIVE: o determine the association between weekend admission and length of stay (LOS) and between weekend discharge and 30-day all-cause readmission. METHODS: We conducted a retrospective, cross-sectional study of children hospitalized between October 1, 2014 and September 30, 2015 using the Pediatric Health Information System...
October 31, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/30379137/the-interplay-between-financial-incentives-institutional-culture-and-physician-behavior-an-incompletely-understood-relationship-worth-elucidating
#10
Kristin E Bergethon, Daniel M Blumenthal
No abstract text is available yet for this article.
October 31, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/30379136/association-between-hospitalist-productivity-payments-and-high-value-care-culture
#11
Reshma Gupta, Neil Steers, Christopher Moriates, Michael Ong
BACKGROUND: Given the national emphasis on affordability, healthcare systems expect that their clinicians are motivated to provide high-value care. However, some hospitalists are reimbursed with productivity bonuses, and little is known about the effects of these reimbursements on the local culture of high-value care delivery. OBJECTIVE: To evaluate if hospitalist reimbursement models are associated with high-value culture in university, community, and safety-net hospitals...
October 31, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/30255862/predictors-of-clinically-significant-echocardiography-findings-in-older-adults-with-syncope-a-secondary-analysis
#12
Marc A Probst, Thomas A Gibson, Robert E Weiss, Annick N Yagapen, Susan E Malveau, David H Adler, Aveh Bastani, Christopher W Baugh, Jeffrey M Caterino, Carol L Clark, Deborah B Diercks, Judd E Hollander, Bret A Nicks, Daniel K Nishijima, Manish N Shah, Kirk A Stiffler, Alan B Storrow, Scott T Wilber, Benjamin C Sun
BACKGROUND: Syncope is a common reason for visiting the emergency department (ED) and is associated with significant healthcare resource utilization. OBJECTIVE: To develop a risk-stratification tool for clinically significant findings on echocardiography among older adults presenting to the ED with syncope or nearsyncope. DESIGN: Prospective, observational cohort study from April 2013 to September 2016. SETTING: Eleven EDs in the United States...
September 26, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/30255858/so-much-more-than-bald-and-bloated
#13
Briana Ketterer, Anthony Montanaro, Alan J Hunter
No abstract text is available yet for this article.
September 26, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/30156583/beyond-reporting-early-warning-score-sensitivity-the-temporal-relationship-and-clinical-relevance-of-true-positive-alerts-that-precede-critical-deterioration
#14
Meredith C Winter, Sherri Kubis, Christopher P Bonafide
BACKGROUND: Clinical deterioration is difficult to detect in hospitalized children. The pediatric Rothman Index (pRI) is an early warning score that incorporates vital signs, laboratory studies, and nursing assessments to generate deterioration alerts. OBJECTIVE: (1) Evaluate the timing of pRI alerts and clinicians recognizing deterioration or escalating care prior to critical deterioration events (CDEs) and (2) determine whether the parameters triggering alerts were clinically related to deterioration...
August 29, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/30156582/who-consults-us-and-why-an-evaluation-of-medicine-consult-comanagement-services-at-academic-medical-centers
#15
Emily S Wang, Christopher Moreland, Michael Shoffeitt, Luci K Leykum
Although general medicine consultation is an integral component of inpatient medical care and a requirement of internal medicine training, little is known about current consultative practice. We used a cross-sectional, prospective survey design to examine current practices at 11 academic medical centers over four two-week periods from July 2014 through July 2015. Out of 11 consult services, four had comanagement agreements with surgical services, primarily with orthopedic surgery. We collected data regarding 1,264 consultation requests...
August 29, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/30156581/a-model-to-improve-hospital-based-palliative-care-the-palliative-care-redistribution-integrated-system-model-prism
#16
Nauzley C Abedini, Vineet Chopra
Many hospitalized patients have unmet palliative care needs that are exacerbated by gaps in the palliative care subspecialty workforce. Training frontline physicians, including hospitalists, to provide primary palliative care has been proposed as one solution to this problem. However, improving palliative care access requires more than development of the physician workforce. Systemlevel change and interdisciplinary approaches are also needed. Using task shifting as a guiding principle, we propose a new workforce framework (the Palliative care Redistribution Integrated System Model, or PRISM), which utilizes physician and nonphysician providers and resources to their maximum potential...
August 29, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/30156579/identifying-observation-stays-in-medicare-data-policy-implications-of-a-definition
#17
Ann M Sheehy, Fangfang Shi, Amy J H Kind
Observation stays are increasingly common, yet no standard method to identify observation stays in Medicare claims is available, including events with status change. To determine the claims patterns of Medicare observation stays, define comprehensive claims-based methodology for future Medicare observation research and data reporting, and identify policy implications of such definition, we identified potential observation events in a 2014 20% random sample of Medicare beneficiaries with both Part A and B claims and at least 1 acute care stay (1,667,660 events)...
August 29, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/30156577/electronic-order-volume-as-a-meaningful-component-in-estimating-patient-complexity-and-resident-physician-workload
#18
Nicole Van Groningen, Priya A Prasad, Nader Najafi, Alvin Rajkomar, Raman R Khanna, Margaret C Fang
BACKGROUND: Though patient census has been used to describe resident physician workload, this fails to account for variations in patient complexity. Changes in clinical orders captured through electronic health records may provide a complementary window into workload. We aimed to determine whether electronic order volume correlated with measures of patient complexity and whether higher order volume was associated with quality metrics. METHODS: In this retrospective study of admissions to the internal medicine teaching service of an academic medical center in a 13-month period, we tested the relationship between electronic order volume and patient level of care and severity of illness category...
August 29, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/30255861/the-virtual-hospitalist-the-future-is-now
#19
Michael K Ong, Daniel J Brotman
No abstract text is available yet for this article.
November 1, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/30255860/a-dark-horse-diagnosis
#20
Sara Koenig McLaughlin, Adrienne Carey, Nathan Houchens, Jennifer Meddings, Ajit P Limaye
No abstract text is available yet for this article.
November 1, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
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