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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/29073314/the-sdm-3-circle-model-a-literature-synthesis-and-adaptation-for-shared-decision-making-in-the-hospital
#2
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/29069117/supporting-faculty-development-in-hospital-medicine-design-and-implementation-of-a-personalized-structured-mentoring-program
#3
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/29068439/perception-of-resources-spent-on-defensive-medicine-and-history-of-being-sued-among-hospitalists-results-from-a-national-survey
#4
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/29065023/-you-have-to-know-the-end-of-the-story-motivations-to-follow-up-after-transitions-of-clinical-responsibility
#5
Judith L Bowen, Jonathan S Ilgen, David M Irby, Olle Ten Cate, Bridget C O'Brien
PURPOSE: Physicians routinely transition responsibility for patient care to other physicians. When transitions of responsibility occur before the clinical outcome is known, physicians may lose opportunities to learn from the consequences of their decision making. Sometimes curiosity about patients does not end with the transition and physicians continue to follow them. This study explores physicians' motivations to follow up after transitioning responsibilities. METHOD: Using a constructivist grounded theory approach, the authors conducted 18 semistructured interviews in 2016 with internal medicine hospitalist and resident physicians at a single tertiary care academic medical center...
November 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29056177/use-of-unit-based-interventions-to-improve-the-quality-of-care-for-hospitalized-medical-patients-a-national-survey
#6
Kevin J O'Leary, Julie K Johnson, Milisa Manojlovich, Gopi J Astik, Mark V Williams
BACKGROUND: Recent publications have drawn attention to interventions to redesign aspects of care delivery for hospitalized medical patients, including localization of physicians to specific units, nurse-physician co-leadership, interdisciplinary rounds (IDR), and access to quality performance data. Use of these interventions across hospitals has not been previously described. METHODS: A cross-sectional survey of internal medicine (IM) residency program directors and hospital medicine group (HMG) leaders in the United States was conducted to characterize use of unit-based interventions on inpatient medical services...
November 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/29018043/educational-added-value-unit-development-and-testing-of-a-measure-for-educational-activities
#7
Amy B Guiot, Eric S Kirkendall, Craig H Gosdin, Samir S Shah, Dominick J DeBlasio, Katie A Meier, Jennifer K O'Toole
OBJECTIVES: University-based hospitalists educate health care professionals as an expectation, often lacking time and support for these activities. The purpose of this study was to (1) develop a tracking tool to record educational activities, (2) demonstrate its applicability and ease of completion for faculty members in different divisions, and (3) compare educational efforts of individuals from different professional pathways and divisions by using the educational added value unit (EAVU)...
October 10, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28991950/hospital-privileging-practices-for-bedside-procedures-a-survey-of-hospitalist-experts
#8
Trevor P Jensen, Nilam J Soni, David M Tierney, Brian P Lucas
Many hospitalists are routinely granted hospital privileges to perform invasive bedside procedures, but criteria for privileging are not well described. We conducted a survey of 21 hospitalist procedure experts from the Society of Hospital Medicine Point-of-Care Ultrasound Task Force to better understand current privileging practices for bedside procedures and how those practices are perceived. Only half of all experts reported their hospitals require a minimum number of procedures performed to grant initial (48%) and ongoing (52%) privileges for bedside procedures...
October 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28975333/annals-for-hospitalists-inpatient-notes-gender-equality-in-hospital-medicine-are-we-there-yet
#9
Jeanne M Farnan, Vineet M Arora
No abstract text is available yet for this article.
September 19, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28959780/restructuring-hospitalist-work-schedules-to-improve-care-timeliness-and-efficiency
#10
Monika Wells, Evan Coates, Barbara Williams, Craig Blackmore
Background In 2014, we recognised that the pace of admissions frequently exceeded our ability to assign a hospitalist. Long patient wait times occurred at admission, especially for patients arriving in the late afternoon when hospitalist day shifts were ending. Our purpose was to redesign hospitalist schedules, duties and method of distributing admissions to match demand. Design We used administrative data to tabulate Hospital Medicine admission requests by time of day and identified mismatch between volume and capacity with the current staffing model...
2017: BMJ Open Qual
https://www.readbyqxmd.com/read/28914285/hospital-medicine-point-of-care-ultrasound-credentialing-an-example-protocol
#11
Benji K Mathews, Michael Zwank
Though the use of point-of-care ultrasound (POCUS) has increased over the last decade, formal hospital credentialing for POCUS may still be a challenge for hospitalists. This document details the Hospital Medicine Department Ultrasound Credentialing Policy from Regions Hospital, which is part of the HealthPartners organization in Saint Paul, Minnesota. National organizations from internal medicine and hospital medicine (HM) have not published recommended guidelines for POCUS credentialing. Revised guidelines for POCUS have been published by the American College of Emergency Physicians, though these are not likely intended to guide hospitalists when working with credentialing committees and medical boards...
September 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28882849/pediatric-hospitalist-comanagement-survey-of-clinical-and-billing-practices
#12
Katherine M O'Connor, David G Zipes, Joshua K Schaffzin, Rebecca Rosenberg
Surgical comanagement is an increasingly common practice in pediatric hospital medicine. Information about the structure and financing of such care is limited. The aim of the researchers for this study was to investigate pediatric hospitalist surgical comanagement models and to assess pediatric hospitalist familiarity with and patterns of billing for surgical patients. We conducted a cross-sectional cohort web-based survey of pediatric hospitalists using the American Academy of Pediatrics' Section on Hospital Medicine listserv...
September 7, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28759312/wanted-and-unwanted-care-the-double-edged-sword-of-partial-do-not-resuscitate-orders
#13
Nobuhiro Ariyoshi, Masayuki Nogi, Damon Sakai, Eiji Hiraoka, Daniel Fischberg
BACKGROUND: The interpretation of do-not-resuscitate orders (DNRs) may vary in nonarrest situations. To reduce ambiguity, many hospitals allow patients to elect partial DNRs. OBJECTIVE: To investigate the effect of partial DNRs on physicians' willingness to perform cardiopulmonary resuscitation (CPR) and nonarrest procedures. DESIGN: Cross-sectional study using scenario-based questionnaires between October 2015 and March 2016. A partial DNR was identified as a DNR with Adult Emergency Protocols (AEP) order...
July 31, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28744705/the-growth-of-hospitalists-and-the-future-of-the-society-of-general-internal-medicine-results-from-the-2014-membership-survey
#14
Chad S Miller, Robert L Fogerty, Jillian Gann, Christopher P Bruti, Robin Klein
According to the most recent annual membership surveys, hospitalists are a rapidly growing component of the Society of General Internal Medicine (SGIM). Should this trend continue, hospitalists could increase from 22% of SGIM membership in 2014 to nearly 33% by 2020. Only 34% of hospitalists who responded to the survey, however, consider SGIM their academic home, compared to 54% of non-hospitalist respondents. Based on these survey findings, it is clear that the landscape of general internal medicine is changing with the growth of hospitalists, and SGIM will need to strategize to keep these hospitalist members actively engaged in the organization...
November 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28716613/a-novel-use-of-peer-coaching-to-teach-primary-palliative-care-skills-coaching-consultation
#15
Juliet Jacobsen, Corrine Alexander-Cole, Bethany-Rose Daubman, Dejani Banerji, Joe Greer, Karen o'Brien, Kathleen Doyle, Vicki Jackson
BACKGROUND: We aim to address palliative care workforce shortages by teaching clinicians how to provide primary palliative care through peer coaching. INTERVENTION: We offered peer coaching to internal medicine residents and hospitalists (attendings, nurse practioners, and physician assistants). MEASUREMENTS: An audit of peer coaching encounters and coachee feedback to better understand the applicability of peer coaching in the inpatient setting to teach primary palliative care...
July 14, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28694275/the-chief-primary-care-medical-officer-restoring-continuity
#16
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
https://www.readbyqxmd.com/read/28678872/physician-communication-coaching-effects-on-patient-experience
#17
Adrianne Seiler, Alexander Knee, Reham Shaaban, Christine Bryson, Jasmine Paadam, Rohini Harvey, Satoko Igarashi, Christopher LaChance, Evan Benjamin, Tara Lagu
BACKGROUND: Excellent communication is a necessary component of high-quality health care. We aimed to determine whether a training module could improve patients' perceptions of physician communication behaviors, as measured by change over time in domains of patient experience scores related to physician communication. STUDY DESIGN: We designed a comprehensive physician-training module focused on improving specific "etiquette-based" physician communication skills through standardized simulations and physician coaching with structured feedback...
2017: PloS One
https://www.readbyqxmd.com/read/28644781/teaching-clinical-ethics-at-the-bedside-william-osler-and-the-essential-role-of-the-hospitalist
#18
Matthew William McCarthy, Joseph J Fins
As the field of hospital medicine celebrates its twenty-first anniversary, we believe it is time to expand its mission to play an even greater role in medical education. Given hospitalists' proximity to students and clinical material, members of this growing cohort of physicians are uniquely positioned to teach normative reasoning, professionalism, communication, and medical ethics in real time to trainees on the wards. But, to do so, we must reimagine the role of the hospitalist in graduate and postgraduate medical education...
June 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28640142/the-derivation-and-validation-of-a-simple-model-for-predicting-in-hospital-mortality-of-acutely-admitted-patients-to-internal-medicine-wards
#19
Ali Sakhnini, Walid Saliba, Naama Schwartz, Naiel Bisharat
Limited information is available about clinical predictors of in-hospital mortality in acute unselected medical admissions. Such information could assist medical decision-making.To develop a clinical model for predicting in-hospital mortality in unselected acute medical admissions and to test the impact of secondary conditions on hospital mortality.This is an analysis of the medical records of patients admitted to internal medicine wards at one university-affiliated hospital. Data obtained from the years 2013 to 2014 were used as a derivation dataset for creating a prediction model, while data from 2015 was used as a validation dataset to test the performance of the model...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28630997/annals-for-hospitalists-inpatient-notes-research-highlights-from-hospital-medicine-2017
#20
Robert Burke, Andrew Auerbach
No abstract text is available yet for this article.
June 20, 2017: Annals of Internal Medicine
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