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Hospitalist, hospital medicine, patient satisfaction

Noemi Doohan, Jennifer DeVoe
The year 2016 marked the 20th anniversary of the hospitalist profession, with more than 50,000 physicians identifying as hospitalists. The Achilles heel of hospitalist medicine, however, is discontinuity. Despite many current payment and delivery systems rewarding this discontinuity and severing long-term relationships between patient and primary care teams at the hospital door, primary care does not stop being important when a person is admitted to the hospital. The notion of a broken primary care continuum is not an academic construct, it causes real harm to patients...
July 2017: Annals of Family Medicine
Vicente J Velez, Roop Kaw, Bo Hu, Richard M Frankel, Amy K Windover, Dan Bokar, Julie M Rish, Michael B Rothberg
BACKGROUND: Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores measure patient satisfaction with hospital care. It is not known if these reflect the communication skills of the attending physician on record. The Four Habits Coding Scheme (4HCS) is a validated instrument that measures bedside physician communication skills according to 4 habits, namely: investing in the beginning, eliciting the patient's perspective, demonstrating empathy, and investing in the end...
June 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
Charlie M Wray, Jeanne M Farnan, Vineet M Arora, David O Meltzer
BACKGROUND: Inpatient service handoffs occur when physicians who care for hospitalized patients end a period of clinical service and handover a panel of patients to an oncoming physician. Despite the large amount of research on handoffs, none has described the patient perspective when cared for by a hospitalist physician during a service handoff. OBJECTIVE: To describe hospitalized patients' experiences regarding inpatient service changes, and develop a conceptual framework to inform future efforts to improve service-level handoffs...
October 2016: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
Susan L Calcaterra, Anne D Drabkin, Sarah E Leslie, Reina Doyle, Stephen Koester, Joseph W Frank, Jennifer A Reich, Ingrid A Binswanger
BACKGROUND: Pain is a frequent symptom among patients in the hospital. Pain management is a key quality indicator for hospitals, and hospitalists are encouraged to frequently assess and treat pain. Optimal opioid prescribing, described as safe, patient-centered, and informed opioid prescribing, may be at odds with the priorities of current hospital care, which focuses on patient-reported pain control rather than the potential long-term consequences of opioid use. OBJECTIVE: We aimed to understand physicians' attitudes, beliefs, and practices toward opioid prescribing during hospitalization and discharge...
August 2016: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
Kimberly Indovina, Angela Keniston, Mark Reid, Katherine Sachs, Chi Zheng, Angie Tong, Danny Hernandez, Kathy Bui, Zeinab Ali, Thao Nguyen, Helpees Guirguis, Richard K Albert, Marisha Burden
BACKGROUND: Real-time feedback about patients' perceptions of the quality of the care they are receiving could provide physicians the opportunity to address concerns and improve these perceptions as they occur, but physicians rarely if ever receive feedback from patients in real time. OBJECTIVE: To evaluate if real-time patient feedback to physicians improves patient experience. DESIGN: Prospective, randomized, quality-improvement initiative...
April 2016: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
Charlie M Wray, Andrea Flores, William V Padula, Micah T Prochaska, David O Meltzer, Vineet M Arora
BACKGROUND: Data comparing patient experiences between general medicine teaching and nonteaching hospitalist services are lacking. OBJECTIVE: Evaluate hospitalized patients' experience on general medicine teaching and nonteaching hospitalist services by assessing patients' confidence in their ability to identify their physician(s), understand their roles, and their rating of the coordination and overall care. METHODS: Retrospective cohort analysis of general medicine teaching and nonteaching hospitalist services from 2007 to 2013 at an academic medical center...
February 2016: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
Jed D Gonzalo, Ethan F Kuperman, Cynthia H Chuang, Erik Lehman, Frendy Glasser, Thomas Abendroth
BACKGROUND: Many academic hospitals have implemented overnight hospitalists to supervise house staff and improve outcomes, but few studies have described the impact of this role. OBJECTIVE: To investigate the effect of an overnight academic hospitalist program on patient-level outcomes. Secondary objectives were to describe the program's revenue generation and work tasks. DESIGN: Retrospective interrupted time-series analysis of patients admitted to the medicine service before and after implementation of the program...
December 2015: Journal of General Internal Medicine
Leslie Sheu, Kelly Fung, Michelle Mourad, Sumant Ranji, Ethel Wu
BACKGROUND: Poor communication between hospitalists and outpatient physicians can contribute to adverse events after discharge. Electronic medical records (EMRs) shared by inpatient and outpatient clinicians offer primary care providers (PCPs) better access to information surrounding a patient's hospitalization. However, the PCP experience and subsequent expectations for discharge communication within a shared EMR are unknown. METHODS: We surveyed PCPs 1 year after a shared EMR was implemented at our institution to assess PCP satisfaction with current discharge communication practices and identify areas for improvement...
May 2015: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
Haruka Torok, Sharon R Ghazarian, Susrutha Kotwal, Regina Landis, Scott Wright, Eric Howell
OBJECTIVES: To develop and validate a new inpatient satisfaction metric to assess patients' perceptions of hospitalist performance. PATIENTS AND METHODS: We developed the Tool to Assess Inpatient Satisfaction with Care from Hospitalists (TAISCH) by building upon the theoretical underpinnings of the quality of care measures that the Society of Hospital Medicine endorses. TAISCH was completed by inpatients at an academic institution between September 2012 and December 2012 after they had been cared for by the same hospitalist provider for at least 2 consecutive days...
September 2014: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
Umesh Sharma, David Klocke
Historically, medicine and nursing has had a hierarchical and patriarchal relationship, with physicians holding monopoly over knowledge-based practice of medical care, thus impeding interprofessional collaboration. Power gradient prevents nurses from demanding cooperative patient rounding. We surveyed attitudes of nursing staff at our tertiary care community hospital, before and after implementation of a patient-centered interprofessional (hospitalist-nurse) rounding process for patients. There was a substantial improvement in nursing staff satisfaction related to the improved communication (7%-54%, p < 0...
September 2014: Journal of Interprofessional Care
E Berry Seelbach, Megan Yunghans, Padmaja Pavuluri
The primary purpose of family-centered rounds (FCR) is to improve communication and family satisfaction with care. However, hospital satisfaction surveys continue to identify parental concerns about communication with the medical team. The goal of this study was to evaluate the impact of a new "Division of Hospital Medicine" brochure on parent (ie, caregiver) identification of physician names, understanding of FCR, and overall satisfaction with the hospitalist team. METHODS A prospective cohort study with historical controls compared parent responses on anonymous, self-administered predischarge surveys, before and after brochure implementation...
April 1, 2012: Hospital Pediatrics
Noemi Adame, Mary E M Rocha, Chris Louden, Rishi Agrawal
OBJECTIVE: The aims of this study were to identify pediatric hospitalists' perceived views of (1) barriers to delivering care to children with medical complexity (CMC) and (2) their preferred model of inpatient health care delivery for CMC. SUBJECTS: American Academy of Pediatrics Section on Hospital Medicine (AAP-SOHM) Listserv subscribers. METHODS: We conducted a cross-sectional survey of subscribers of the AAP-SOHM Listserv using the survey instrument SurveyMonkey®...
July 1, 2011: Hospital Pediatrics
Laurie A Pane, Aisha B Davis, Mary C Ottolini
BACKGROUND AND OBJECTIVE: Attending physicians' career satisfaction is associated with higher patient satisfaction, better patient care, and even medical student career choice. Previous studies indicate that adequate mentorship improves job satisfaction, but finding mentors may be challenging for some hospitalists. Little is known about pediatric hospitalist career satisfaction or the role of mentorship. The goal of this study was to assess career satisfaction among pediatric hospitalists, determine which interventions may improve satisfaction, and investigate the role of mentorship in satisfaction...
July 2012: Hospital Pediatrics
Christine M Hrach, Carolyn A Smith, Purvi P Shah, Rebecca M Guth, Dana Lashly, Douglas W Carlson
OBJECTIVE: St Louis Children's Hospital (SLCH) developed Service for Hospital Admissions by Referring Physicians (SHARP) in January 2008 as an inpatient referral service for pediatricians who previously admitted their own patients. We hypothesized that use of SHARP would make hospitalization more efficient and cost-effective compared with the general pediatric medicine (GM) service. METHODS: Admission volumes, diagnoses, length of stay (LOS), costs, and physician billing data were abstracted from SLCH information systems and the Pediatric Health Information System database...
January 2013: Hospital Pediatrics
Laurie A Pane, Aisha B Davis, Mary C Ottolini
BACKGROUND: Pediatric hospital medicine has become a viable long-term career choice. To retain qualified physicians, both academic and community hospital leaders seek to improve their job satisfaction. OBJECTIVE: The goal of this study was to determine whether practice in a community versus academic setting is associated with pediatric hospitalists' career satisfaction. METHODS: The study was based on data from an anonymous electronic cross-sectional survey sent to the American Academy of Pediatrics Section on Hospital Medicine Listserv between November 2009 and January 2010...
July 2013: Hospital Pediatrics
Sean Tackett, Darlene Tad-y, Rebeca Rios, Flora Kisuule, Scott Wright
BACKGROUND: The physician-patient relationship is at the heart of patient care. Dr. Michael Kahn proposed a checklist of six behaviors, defining "etiquette-based medicine", as a strategy to start each encounter respectfully and improve patient-physician rapport. OBJECTIVE: To assess performance of "etiquette-based medicine" in the inpatient setting. DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional observational study using time-motion techniques between May and July, 2009...
July 2013: Journal of General Internal Medicine
R Tamler, A S Dunn, D E Green, M Skamagas, T L Breen, H C Looker, D LeRoith
AIM: An online diabetes course for medical residents led to lower patient blood glucose, but also increased hypoglycaemia despite improved trainee confidence and knowledge. Based on these findings, we determined whether an optimized educational intervention delivered to hospitalists (corresponding to an Acute Physician or Specialist in Acute Hospital Medicine in the UK) improved inpatient glycaemia without concomitant hypoglycaemia. METHODS: All 22 hospitalists at an academic medical centre were asked to participate in an online curriculum on the management of inpatient dysglycaemia in autumn 2009 and a refresher course in spring 2010...
August 2013: Diabetic Medicine: a Journal of the British Diabetic Association
Lena M Chen, John D Birkmeyer, Sanjay Saint, Ashish K Jha
BACKGROUND: Payers are increasingly holding hospitals accountable for patients' experiences with their care. This may conflict with another trend among US hospitals-greater hospitalist care-as hospitalists may have less familiarity with the history and preferences of their patients compared with primary-care physicians. OBJECTIVE: Our objective was to better understand the relationship between hospitalist care and patients' experiences with their care. DESIGN: This was a retrospective cohort study...
March 2013: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
Keiki Hinami, Chad T Whelan, Joseph A Miller, Robert J Wolosin, Tosha B Wetterneck
BACKGROUND: Person-job fit is an organizational construct shown to impact the entry, performance, and retention of workers. Even as a growing number of physicians work under employed situations, little is known about how physicians select, develop, and perform in organizational settings. OBJECTIVE: Our objective was to validate in the hospitalist physician workforce features of person-job fit observed in workers of other industries. DESIGN: The design was a secondary survey data analysis from a national stratified sample of practicing US hospitalists...
February 2013: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
Smitha R Chadaga, Lee Shockley, Angela Keniston, Nancy E Klock, Susan Van Dyke, Quin Davis, Eugene S Chu
BACKGROUND: Admitted patients boarding in the emergency department (ED) leads to hospital diversion. Active bed management and care for boarded patients can improve throughput. We developed a hospital medicine ED (HMED) team to participate in active bed management, and to care for boarded patients, to decrease diversion and improve throughput. METHODS: An HMED team was created to participate in active bed management and to care for boarded patients. The HMED team worked with the ED, nursing supervisors, and medical floors to manage inpatient beds...
September 2012: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
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