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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/29073318/bedside-assessment-of-the-necessity-of-daily-lab-testing-for-patients-nearing-discharge
#1
Surafel Tsega, Michelle O'Connor, Jashvant Poeran, Colin Iberti, Hyung J Cho
As part of the Choosing Wisely® campaign, the Society of Hospital Medicine recommends against performing "repetitive complete blood count chemistry testing in the face of clinical and lab stability." With this recommendation as a framework, we targeted 2 hospitalist-run inpatient medicine units that employed bedside, scripted, interdisciplinary rounds. Our multifaceted intervention included prompting the hospitalist to identify clinically stable patients for next-day discharge and to discontinue labs when appropriate...
October 18, 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29073317/the-diagnostic-yield-of-noninvasive-microbiologic-sputum-sampling-in-a-cohort-of-patients-with-clinically-diagnosed-hospital-acquired-pneumonia
#2
Elliot L Naidus, Mary T Lasalvia, Edward R Marcantonio, Shoshana J Herzig
The clinical predictors of positive sputum culture have not been previously reported in hospital-acquired pneumonia (HAP), and data on yield of sputum culture in this setting are scant. Current Infectious Disease Society of America guidelines for HAP recommend noninvasive sputum sampling, though the data for this practice are limited. We assessed the yield of sputum culture in HAP cases at an academic medical center from January 2007 to July 2013. HAP cases were identifi ed by International Classifi cation of Diseases, Ninth Revision-Clinical Modifi cation codes for bacterial pneumonia and all cases were validated by chart review...
October 18, 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29073316/observational-study-of-peripheral-intravenous-catheter-outcomes-in-adult-hospitalized-patients-a-multivariable-analysis-of-peripheral-intravenous-catheter-failure
#3
Nicole Marsh, Joan Webster, Emily Larson, Marle Cooke, Gabor Mihala, Claire M Rickard
BACKGROUND: Almost 70% of hospitalized patients require a peripheral intravenous catheter (PIV), yet up to 69% of PIVs fail prior to completion of therapy. OBJECTIVE: To identify risk factors associated with PIV failure. DESIGN: A single center, prospective, cohort study. SETTING: Medical and surgical wards of a tertiary hospital located in Queensland, Australia. PARTICIPANTS: Adult patients requiring a PIV...
October 18, 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29073315/derivation-of-a-clinical-model-to-predict-unchanged-inpatient-echocardiograms
#4
Craig G Gunderson, Elizabeth S Gromisch, John J Chang, Brian J Malm
BACKGROUND: Transthoracic echocardiography (TTE) is one of the most commonly ordered tests in healthcare. Repeat TTE, defined as a TTE done within 1 year of a prior TTE, represents 24% to 42% of all studies. The purpose of this study was to derive a clinical prediction model to predict unchanged repeat TTE, with the goal of defining a subset of studies that are unnecessary. METHODS: Single-center retrospective cohort study of all hospitalized patients who had a repeat TTE between October 1, 2013, and September 30, 2014...
October 18, 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29073314/the-sdm-3-circle-model-a-literature-synthesis-and-adaptation-for-shared-decision-making-in-the-hospital
#5
Stephanie Rennke, Patrick Yuan, Brad Monash, Rebecca Blankenburg, Ian Chua, Stephanie Harman, Debbie S Sakai, Adeena Khan, Joan F Hilton, Lisa Shieh, Jason Satterfield
Patient engagement through shared decision-making (SDM) is increasingly seen as a key component for patient safety, patient satisfaction, and quality of care. Current SDM models do not adequately account for medical and environmental contexts, which may influence medical decisions in the hospital. We identified leading SDM models and reviews to inductively construct a novel SDM model appropriate for the inpatient setting. A team of medicine and pediatric hospitalists reviewed the literature to integrate core SDM concepts and processes and iteratively constructed a synthesized draft model...
October 18, 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29073313/things-we-do-for-no-reason-echocardiogram-in-unselected-patients-with-syncope
#6
Charles L Madeira, Michael J Craig, Andrew Donohoe, John R Stephens
Syncope is a common cause of emergency department visits and hospitalizations. Echocardiogram is frequently used as a diagnostic tool in the evaluation of syncope, performed in 39% to 91% of patients. The diagnostic yield of echocardiogram for detecting clinically important abnormalities in patients with a normal history, physical examination, and electrocardiogram (ECG), however, is extremely low. In contrast, echocardiograms performed on patients with syncope with a positive cardiac history, abnormal examination, and/or ECG identify an abnormality in up to 29% of cases, though these abnormalities are not always defi nitively the cause of symptoms...
October 18, 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29073312/vascular-ultrasonography-a-novel-method-to-reduce-paracentesis-related-major-bleeding
#7
Jeffrey H Barsuk, Bradley T Rosen, Elaine R Cohen, Joe Feinglass, Mark J Ault
Paracentesis is a core competency for hospitalists. Using ultrasound for fluid localization is standard practice and involves a low-frequency probe. Experts recommend a "2-probe technique, " which incorporates a high-frequency ultrasound probe in addition to the low-frequency probe to identify blood vessels within the intended needle path. Evidence is currently lacking to support this 2-probe technique, so we performed a pre- to postintervention study to evaluate its effect on paracentesis-related bleeding complications...
October 18, 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29073311/expanding-treatment-opportunities-for-hospitalized-patients-with-opioid-use-disorders
#8
Daniel Winetsky, Robert M Weinrieb, Jeanmarie Perrone
The prevalence of opioid use disorders (OUDs) is rising across the United States. Patients with OUDs are often hospitalized for medical conditions other than addiction, such as infection, injury, or pregnancy. These hospital admissions provide an opportunity for healthcare providers to initiate opioid agonist therapy with methadone or buprenorphine. Randomized trials have demonstrated the superior effectiveness of this treatment strategy, but its adoption by hospital providers has been slow. A number of barriers have impeded its implementation, including misperceptions about the regulation of opioid prescribing, limited resources for the transition to community- based treatment, and a lack of familiarity among clinicians about the appropriate initiation and dose adjustment of these opioid agonists for maintenance therapy...
October 18, 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29073310/opportunities-and-challenges-for-improving-the-patient-experience-in-the-acute-and-postacute-care-setting-using-patient-portals-the-patient-s-perspective
#9
Anuj K Dalal, David W Bates, Sarah Collins
Efforts to improve the patient experience are increasingly focusing on engaging patients and their "care partners" by using patient portals. The Acute Care Patient Portal Task Force was supported by the Gordon and Betty Moore Foundation to convene a national meeting of an interdisciplinary group of stakeholders, including patient advocates, to consider how the acute and postacute care patient experience can be improved by using patient-facing technologies. We identified key opportunities and challenges for enhancing cognitive support, promoting respect while maintaining boundaries, and facilitating patient and family empowerment through the lens of the patient...
October 18, 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29073309/thinking-outside-the-checkbox
#10
Maki Kanamori, Gurpreet Dhaliwal, Masami Matsumura, Bradley Monash
A 34-year-old, previously healthy Japanese man developed a dry cough. He did not have dyspnea, nasal discharge, sore throat, facial pain, nasal congestion, or postnasal drip. His symptoms persisted despite several courses of antibiotics (from different physicians), including clarithromycin, minocycline, and levofl oxacin. A chest x-ray after 2 months of symptoms and a noncontrast chest computed tomography (CT) after 4 months of symptoms were normal, and bacterial and mycobacterial sputum cultures were sterile...
October 18, 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29069119/do-combined-pharmacist-and-prescriber-efforts-on-medication-reconciliation-reduce-postdischarge-patient-emergency-department-visits-and-hospital-readmissions
#11
Michelle Baker, Chaim M Bell, Wei Xiong, Edward Etchells, Peter G Rossos, Kaveh G Shojania, Kelly Lane, Tim Tripp, Mary Lam, Kimindra Tiwana, Derek Leong, Gary Wong, Jin-Hyeun Huh Huh, Emily Musing, Olavo Fernandes
BACKGROUND: Although medication reconciliation (Med Rec) has demonstrated a reduction in potential adverse drug events, its effect on hospital readmissions remains inconclusive. OBJECTIVE: To evaluate the impact of an interprofessional Med Rec bundle from admission to discharge on patient emergency department visits and hospital readmissions (hospital visits). METHODS: The design was a retrospective, cohort study. Patients discharged from general internal medicine over a 57-month interval were identified through administrative databases...
October 4, 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29069118/a-howling-cause-of-pancytopenia
#12
Allison Casciato, Carrie Lind, Andrew P J Olson, Bryce A Binstadt, Alaina M Davis
BACKGROUND: HASH(0x3e0c8c8) OBJECTIVE: HASH(0x397c7c0) DESIGN, SETTING, PATIENTS: HASH(0x399b978) INTERVENTION: HASH(0x39d5900) MEASUREMENTS: HASH(0x39d0cf8) CONCLUSIONS: HASH(0x4727400)
October 4, 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29069117/supporting-faculty-development-in-hospital-medicine-design-and-implementation-of-a-personalized-structured-mentoring-program
#13
Amulya Nagarur, Regina M O'Neill, Donna Lawton, Jeffrey L Greenwald
The guidance of a mentor can have a tremendous influence on the careers of academic physicians. The lack of mentorship in the relatively young field of hospital medicine has been documented, but the efficacy of formalized mentorship programs has not been well studied. We implemented and evaluated a structured mentorship program for junior faculty at a large academic medical center. Of the 16 mentees who participated in the mentorship program, 14 (88%) completed preintervention surveys and 10 (63%) completed postintervention surveys...
October 4, 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29069116/the-pipeline-from-abstract-presentation-to-publication-in-pediatric-hospital-medicine
#14
Lisa E Herrmann, Matthew Hall, Kathryn Kyler, Joseph Cochran, Annie L Andrews, Derek J Williams, Karen M Wilson, Samir S Shah
BACKGROUND: The annual Pediatric Hospital Medicine (PHM) conference serves as a venue for the dissemination of research in this rapidly growing discipline. A measure of research validity is subsequent publication in peer-reviewed journals. OBJECTIVE: To identify the publication rate of abstracts submitted to the 2014 PHM conference and determine whether presentation format was associated with subsequent journal publication or time to publication. METHODS: We identified abstracts submitted to the 2014 PHM conference...
October 4, 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29069115/the-enhanced-care-program-impact-of-a-care-transition-program-on-30-day-hospital-readmissions-for-patients-discharged-from-an-acute-care-facility-to-skilled-nursing-facilities
#15
Bradley T Rosen, Ronald J Halbert, Kelley Hart, Marcio A Diniz, Sharon Isonaka, Jeanne T Black
BACKGROUND: Increased acuity of skilled nursing facility (SNF) patients challenges the current system of care for these patients. OBJECTIVE: Evaluate the impact on 30-day readmissions of a program designed to enhance the care of patients discharged from an acute care facility to SNFs. DESIGN: An observational, retrospective cohort analysis of 30-day hospital readmissions for patients discharged to 8 SNFs between January 1, 2014, and June 30, 2015...
October 4, 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29068440/the-tend-tomorrow-s-expected-number-of-discharges-model-accurately-predicted-the-number-of-patients-who-were-discharged-from-the-hospital-the-next-day
#16
Carl van Walraven, Alan J Forster
BACKGROUND: Knowing the number of discharges that will occur is important for administrators when hospital occupancy is close to or exceeds 100%. This information will facilitate decision making such as whether to bring in extra staff, cancel planned surgery, or implement measures to increase the number of discharges. We derived and internally validated the TEND (Tomorrow's Expected Number of Discharges) model to predict the number of discharges from hospital in the next day. METHODS: We identified all patients greater than 1 year of age admitted to a multisite academic hospital between 2013 and 2015...
August 23, 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29068439/perception-of-resources-spent-on-defensive-medicine-and-history-of-being-sued-among-hospitalists-results-from-a-national-survey
#17
Sanjay Saint, Valerie M Vaughn, Vineet Chopra, Karen E Fowler, Allen Kachalia
The United States spends substantially more per capita for healthcare than any other nation. Defensive medicine is 1 source of such spending, but its extent is unclear. Using a national survey of approximately 1500 US hospitalists, we report the estimates the US hospitalists provided of the percent of resources spent on defensive medicine and correlates of their estimates. We also ascertained how many reported being sued. Sixty-eight percent of eligible recipients responded. Overall, respondents estimated that 37...
August 23, 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29068438/clinical-decision-making-observing-the-smartphone-user-an-observational-study-in-predicting-acute-surgical-patients-suitability-for-discharge
#18
Richard Hoffman, Simon Harley, Samuel Ellison, Peter G Devitt
INTRODUCTION: An accurate and rapid assessment of an acutely unwell patient's clinical status is paramount for the physician. There is an increasing trend to rely on investigations and results to inform a clinician of a patient's clinical status, with the subtleties of clinical observation often ignored. The aim of this study was to determine if a patient's use of a smartphone during the initial clinical assessment by a surgical consultant could be used as a surrogate marker for patient well-being, represented as their suitability for sameday discharge...
August 23, 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29091986/erratum
#19
(no author information available yet)
The authors would like to correct the error in the publication of the original article with the inclusion of an additional author (Dr. Henrik Nielsen). The corrected detail is published with this erratum for your reading. Helene Moller Nielsen, MD1, Shakil Shakar, MD1, Ulla Weinreich, MD1, Mary Hansen, MD2, Rune Fisker, MD3, Henrik Nielsen, MD4, Thomas E. Baudendistel, MD5, Paul Aronowitz, MD6. 1Department of Pulmonary Medicine, Aalborg University Hospital, Denmark, 2Department of Pathology, Aalborg University Hospital, Denmark, 3Department of Nuclear Medicine, Aalborg University Hospital, Denmark, 4Department of Infectious Diseases, Aalborg University Hospital, Denmark, 5Department of Medicine, Kaiser Permanente, Oakland, CA, 6Department of Medicine, University of California, Davis, CA...
November 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29091985/low-health-literacy-and-transitional-care-needs-beyond-screening
#20
Leah Karliner
No abstract text is available yet for this article.
November 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
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