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https://www.readbyqxmd.com/read/29757916/filling-the-gaps-preparing-nurse-practitioners-for-hospitalist-practice
#1
Sharon E Bryant
Over the last 20 years, the emergence of the hospitalist has changed the face of medicine. Hospitalists may serve as either general or specialty-focused providers caring for acutely ill patients in the hospital setting. As the demands and constraints of hospital-specific patient management have continued to grow, an increased need for inclusion of nurse practitioners (NP) into current hospitalist staffing models has occurred. A hospitalist-focused educational model has been developed to better prepare NP students for a variety of hospitalist roles after graduation...
January 2018: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/29713690/improving-medication-reconciliation-at-hospital-admission-discharge-and-ambulatory-care-through-a-transition-of-care-team
#2
John Kreckman, Waiz Wasey, Sharron Wise, Tammy Stevens, Lance Millburg, Cassie Jaeger
Medication reconciliation is an important component to the care of hospitalised patients and their safe transition to the ambulatory setting. In our Family Medicine Hospitalist Service, patient care is frequently transferred between the various physicians, residents, nurses and eventually to a separate group of providers who provide ambulatory management. Due to frequent transitions of care, there was no clear ownership of the medication reconciliation process. To improve the medication reconciliation process, a Transition of Care Team composed of registered nurses was created to oversee the entire reconciliation process...
2018: BMJ Open Quality
https://www.readbyqxmd.com/read/29624189/improving-the-safety-of-opioid-use-for-acute-noncancer-pain-in-hospitalized-adults-a-consensus-statement-from-the-society-of-hospital-medicine
#3
Shoshana J Herzig, Hilary J Mosher, Susan L Calcaterra, Anupam B Jena, Teryl K Nuckols
Hospital-based clinicians frequently treat acute, noncancer pain. Although opioids may be beneficial in this setting, the benefits must be balanced with the risks of adverse events, including inadvertent overdose and prolonged opioid use, physical dependence, or development of opioid use disorder. In an era of epidemic opioid use and related harms, the Society of Hospital Medicine (SHM) convened a working group to develop a consensus statement on opioid use for adults hospitalized with acute, noncancer pain, outside of the palliative, end-of-life, and intensive care settings...
April 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29623157/collaborative-comanagement-between-neurohospitalists-and-internal-medicine-hospitalists-decreases-provider-costs-and-enhances-satisfaction-with-neurology-care-at-an-academic-medical-center
#4
James G Greene
Background and Purpose: The majority of academic medical centers are moving to a neurohospitalist model of care for hospital neurology coverage. Potential benefits over a more traditional academic model of patient care include greater expertise in acute neurologic disease, increased efficiency, and improved availability to patients, providers, and learners. Despite these perceived advantages, switching to a neurohospitalist model can come at substantial financial cost, so finding ways to maximize the positive impact of a limited number of neurohospitalists is very important to the future health of academic neurology departments...
April 2018: Neurohospitalist
https://www.readbyqxmd.com/read/29579132/implementation-of-a-seven-day-hospitalist-program-to-improve-the-outcomes-of-the-weekend-admission-a-retrospective-before-after-study-in-taiwan
#5
Nin-Chieh Hsu, Chun-Che Huang, Chin-Chung Shu, Ming-Chin Yang
OBJECTIVE: Patients admitted during weekends may have worse outcomes than those during weekdays. Adjusting the practice of senior physicians over weekends may reduce the weekend effect. DESIGN: A controlled before-after study, with propensity score matching (PSM) for potential confounding variables, to compare outcomes between weekday and weekend admissions. SETTING: A 2000-bed medical centre in Taiwan. PARTICIPANTS: Hospitalised general medicine patients cared for by traditional internal medicine teams (pre-intervention cohort) and those cared for by hospitalists after introducing a seven-day hospitalist program in the first six-month (post-intervention cohort) and following three-year periods...
2018: PloS One
https://www.readbyqxmd.com/read/29578551/the-influence-of-hospitalist-continuity-on-the-likelihood-of-patient-discharge-in-general-medicine-patients
#6
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
#7
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/29558229/change-implementation-the-association-of-adaptive-reserve-and-burnout-among-inpatient-medicine-physicians-and-nurses
#8
Christine Huynh, Darci Bowles, Miao-Shan Yen, Allison Phillips, Rachel Waller, Lindsey Hall, Shin-Ping Tu
Adaptive Reserve (AR) is positively associated with implementing change in ambulatory settings. Deficits in AR may lead to change fatigue or burnout. We studied the association of self-reported AR and burnout among providers to hospitalized medicine patients in an academic medical center. An electronic survey containing a 23-item Adaptive Reserve scale, burnout inventory, and demographic questions was sent to a convenience sample of nurses, house staff team members, and hospitalists. A total of 119 self-administered, online surveys collected from June 2014 to March 2015 were analyzed...
March 20, 2018: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/29548676/discharge-processes-and-30-day-readmission-rates-of-patients-hospitalized-for-heart-failure-on-general-medicine-and-cardiology-services
#9
Brian M Salata, Madeline R Sterling, Ashley N Beecy, Ajayram V Ullal, Erica C Jones, Evelyn M Horn, Parag Goyal
Given high rates of heart failure (HF) hospitalizations and widespread adoption of the hospitalist model, patients with HF are often cared for on General Medicine (GM) services. Differences in discharge processes and 30-day readmission rates between patients on GM and those on Cardiology during the contemporary hospitalist era are unknown. The present study compared discharge processes and 30-day readmission rates of patients with HF admitted on GM services and those on Cardiology services. We retrospectively studied 926 patients discharged home after HF hospitalization...
May 1, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29548042/maternal-fetal-medicine-workforce-survey-are-we-ready-for-regionalized-levels-of-maternal-care
#10
Katharine D Wenstrom, Mary E D'Alton, Daniel F O'Keefe
OBJECTIVE:  To conduct a survey of the members of the Society for Maternal-Fetal Medicine (SMFM) to determine the practice patterns of maternal-fetal medicine (MFM) subspecialists in the United States and to estimate the likelihood that our work force is sufficient to support the proposed MFM staffing requirements for level III and IV maternity centers. STUDY DESIGN:  All regular SMFM members in the United States were invited to answer a 26 question survey by email...
March 16, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29513362/a-multisite-intervention-for-pediatric-community-acquired-pneumonia-in-community-settings
#11
Corrie E McDaniel, Wren Haaland, Joshua Parlaman, Chuan Zhou, Arti D Desai
OBJECTIVES: The majority of children with community-acquired pneumonia (CAP) are primarily evaluated in community hospital emergency departments (EDs); however, studies on the management of pediatric CAP have largely targeted care provided in freestanding children's hospital EDs or inpatient settings. The objectives of this study were to examine whether implementation of a CAP pathway within three community hospital EDs and inpatient units improved process measures related to appropriate laboratory testing and antibiotic prescribing and to compare performance on these measures between the community hospitals and a freestanding children's hospital...
March 7, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29489925/the-harm-we-do-the-environmental-impact-of-medicine
#12
Julia Schoen, Vineet Chopra
While often unseen and infrequently discussed, the environmental impact of hospital systems and healthcare providers is substantial. However, some US hospitals and healthcare systems have developed innovative approaches to reduce their environmental impact while reducing costs. In this perspective, we discuss how hospitalists may support ongoing environmental efforts through education and awareness, measurement and amelioration, public reporting, and individual actions. Given the extent of healthcare's impact on the environment, the benefits of interventions, and the link between hospitalists and hospitals, We must minimize the harm we do...
May 1, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29468658/dermatology-hospitalists-a-multicenter-survey-study-characterizing-the-infrastructure-of-consultative-dermatology-in-select-american-hospitals
#13
Lauren N Ko, Daniela Kroshinsky
BACKGROUND: Although considered an outpatient specialty, dermatology plays an important role in inpatient medicine. We characterized the activity and structure of dermatology consultation services in select U.S. hospitals. METHODS: In this cross sectional study, a 31-question survey was distributed in person to 32 board-certified dermatologists at the 2017 Society of Dermatology Hospitalists meeting. RESULTS: Thirty participants completed the survey (yield 93...
May 2018: International Journal of Dermatology
https://www.readbyqxmd.com/read/29441157/oiling-the-gate-a-mobile-application-to-improve-the-admissions-process-from-the-emergency-department-to-an-academic-community-hospital-inpatient-medicine-service
#14
Russell Fung, Jensen Hart Hyde, Mike Davis
The process of admitting patients from the emergency department (ED) to an academic internal medicine (AIM) service in a community teaching hospital is one fraught with variability and disorder. This results in an inconsistent volume of patients admitted to academic versus private hospitalist services and results in frustration of both ED and AIM clinicians. We postulated that implementation of a mobile application (app) would improve provider satisfaction and increase admissions to the academic service. The app was designed and implemented to be easily accessible to ED physicians, regularly updated by academic residents on call, and a real-time source of the number of open AIM admission spots...
2018: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29401211/shared-decision-making-during-inpatient-rounds-opportunities-for-improvement-in-patient-engagement-and-communication
#15
Rebecca Blankenburg, Joan F Hilton, Patrick Yuan, Stephanie Rennke, Brad Monash, Stephanie M Harman, Debbie S Sakai, Poonam Hosamani, Adeena Khan, Ian Chua, Eric Huynh, Lisa Shieh, Lijia Xie
BACKGROUND: Shared decision-making (SDM) improves patient engagement and may improve outpatient health outcomes. Little is known about inpatient SDM. OBJECTIVE: To assess overall quality, provider behaviors, and contextual predictors of SDM during inpatient rounds on medicine and pediatrics hospitalist services. DESIGN: A 12-week, cross-sectional, single-blinded observational study of team SDM behaviors during rounds, followed by semistructured patient interviews...
February 5, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29350223/what-is-career-success-for-academic-hospitalists-a-qualitative-analysis-of-early-career-faculty-perspectives
#16
Ethan Cumbler, Essey Yirdaw, Patrick Kneeland, Read Pierce, Patrick Rendon, Carrie Herzke, Christine D Jones
BACKGROUND: Understanding the concept of career success is critical for hospital medicine groups seeking to create sustainably rewarding faculty positions. Conceptual models of career success describe both extrinsic (compensation and advancement) and intrinsic (career satisfaction and job satisfaction) domains. How hospitalists define career success for themselves is not well understood. In this study, we qualitatively explore perspectives on how early-career clinician-educators define career success...
January 19, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29340341/credentialing-of-hospitalists-in-ultrasound-guided-bedside-procedures-a-position-statement-of-the-society-of-hospital-medicine
#17
Brian P Lucas, David M Tierney, Trevor P Jensen, Ria Dancel, Joel Cho, Mahmoud El-Barbary, Ricardo Franco-Sadud, Nilam J Soni
Ultrasound guidance is used increasingly to perform the following 6 bedside procedures that are core competencies of hospitalists: abdominal paracentesis, arterial catheter placement, arthrocentesis, central venous catheter placement, lumbar puncture, and thoracentesis. Yet most hospitalists have not been certified to perform these procedures, whether using ultrasound guidance or not, by specialty boards or other institutions extramural to their own hospitals. Instead, hospital privileging committees often ask hospitalist group leaders to make ad hoc intramural certification assessments as part of credentialing...
February 1, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29335822/emergency-department-throughput-an-intervention
#18
Nowreen Haq, Rona Stewart-Corral, Eric Hamrock, Jamie Perin, Waseem Khaliq
Shortening emergency department (ED) boarding time and managing hospital bed capacity by expediting the inpatient discharge process have been challenging for hospitals nationwide. The objective of this study is was to explore the effect of an innovative prospective intervention on hospital workflow, specifically on early inpatient discharges and the ED boarding time. The intervention consisted of a structured nursing "admission discharge transfer" (ADT) protocol receiving new admissions from the ED and helping out floor nursing with early discharges...
January 15, 2018: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/29323810/hospital-medicine-and-fellowship-program-in-rural-north-dakota-a-multifaceted-success-story
#19
S S Hyder, Mary Amundson
INTRODUCTION: Recruitment of hospitalists and primary care physicians for Critical Access Hospitals and tertiary care hospitals in North Dakota is difficult. To address this challenge, 2 programs were implemented in Bismarck, North Dakota. METHODS: St. Alexius Medical Center created a hospitalist fellowship training program in collaboration with the University of North Dakota School of Medicine and Health Sciences and physicians willing to work in Critical Access Hospitals were offered a joint appointment to teach hospitalist fellows and obtain a clinical academic appointment at the university...
November 2017: WMJ: Official Publication of the State Medical Society of Wisconsin
https://www.readbyqxmd.com/read/29279886/association-of-hospitalist-years-of-experience-with-mortality-in-the-hospitalized-medicare-population
#20
James S Goodwin, Habeeb Salameh, Jie Zhou, Siddhartha Singh, Yong-Fang Kuo, Ann B Nattinger
Importance: Substantial numbers of hospitalists are fresh graduates of residency training programs. Current data about the effect of hospitalist years of experience on patient outcomes are lacking. Objective: To describe the association of hospitalist years of experience with 30-day mortality and hospital mortality of their patients. Design, Setting, and Participants: We used a 5% sample of national Medicare data of patient and hospital characteristics to build a multilevel logistic regression model to predict mortality as a function of years of experience of the hospitalists...
February 1, 2018: JAMA Internal Medicine
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