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Hospitalist medicine

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
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...
February 7, 2018: American Journal of Cardiology
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
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 free-standing 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 free-standing children's hospital...
March 7, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
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...
February 28, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
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...
February 22, 2018: International Journal of Dermatology
Paul J Grant, Kim A Eagle
No abstract text is available yet for this article.
February 20, 2018: Annals of Internal Medicine
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
Alice E Barsoumian, Joshua D Hartzell, Erin M Bonura, Roseanne A Ressner, Timothy J Whitman, Heather C Yun
Introduction: Nationally, the number of internal medicine physicians practicing in primary care has decreased amidst increasing interest in hospitalist medicine. Current priorities in the Military Health System include access to primary care and retention of trained personnel. Recently, we have conducted a study of military internal medicine residents' decision to enter infectious disease. As part of our larger effort, we saw an opportunity to characterize factors impacting decision making of internal medicine residents' desire to apply for subspecialty training and to extend active duty service obligations...
February 6, 2018: Military Medicine
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
D Wade Clapp, Teresa Quattrin, Richard F Jacobs, Valerie Castle Opipari
No abstract text is available yet for this article.
February 2018: Journal of Pediatrics
Judith L Bowen, Bridget C O'Brien, Jonathan S Ilgen, David M Irby, Olle Ten Cate
CONTEXT: Transitions of patient care responsibility occur frequently between physicians. Resultant discontinuities make it difficult for physicians to observe clinical outcomes. Little is known about what physicians do to overcome the practical challenges to learning these discontinuities create. This study explored physicians' activities in practice as they sought follow-up information about patients. METHODS: Using a constructivist grounded theory approach, semi-structured interviews with 18 internal medicine hospitalist and resident physicians at a single tertiary care academic medical center explored participants' strategies when deliberately conducting follow-up after they transitioned responsibility for patients to other physicians...
January 30, 2018: Medical Education
Traci N Adams, Joanna Bonsall, Daniel Hunt, Alberto Puig, Jeremy B Richards, Liyang Yu, Jakob I McSparron, Nainesh Shah, Jonathan Weissler, Eli M Miloslavsky
BACKGROUND: Medicine subspecialty consultation is becoming increasingly important in inpatient medicine. OBJECTIVE: We conducted a survey study in which we examined hospitalist practices and attitudes regarding medicine subspecialty consultation. DESIGN AND SETTING: The survey instrument was developed by the authors based on prior literature and administered online anonymously to hospitalists at 4 academic medical centers in the United States...
November 22, 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
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
Jeremy Kern, Priti Bhansali
OBJECTIVES: Physicians often use computer technologies to assist in work activities, including family-centered rounds (FCR), but little is known about the attitudes of families on the use of these technologies. We aimed to describe these perceptions on the presence and use of computer technologies during FCR. METHODS: We conducted observations of FCR from a parent's visual perspective to "see what they see." This was followed by in-depth interviews with the families of patients admitted to the hospitalist service at our institution to describe their experience with the use of computer technology by the medical team during FCR...
January 18, 2018: Hospital Pediatrics
Stephan Von Düring, Thomas Mavrakanas, Halima Muller, Steve Primmaz, Olivier Grosgurin, Martine Louis Simonet, Christophe Marti, Mathieu Nendaz, Jacques Serratrice, Jérome Stirnemann, Sebastian Carballo, Pauline Darbellay Farhoumand
In medicine, there are progresses which radically transform practices, change recommendations and win unanimous support in the medical community. There are some which divide, questioning principles that seemed established. There are also small advances, which can answer the questions that internists ask themselves in the daily care of their patients. Here are several articles published in 2017, read and commented for you by hospitalists, selected according to their impact on the medical world.
January 17, 2018: Revue Médicale Suisse
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...
January 18, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
Mario Barbagallo, Ligia J Dominguez, Domenico Cucinotta
Due to aging of the world population, older patients accessing health services are becoming continuously more frequent. This has increased the interest in assessing frailty and vulnerability in all specialties and general medicine. Although the term frailty has been recognized for over 30 years, there is not yet a universally recognized definition, and different care providers assess frailty and vulnerability with dissimilar tools, from very complex to very simple validated scales. Being treated with respect and dignity at the right time and place is the key message, as well as after undergoing a global evaluation both in urgency/emergency and in programmed surgery for all older surgical patients...
January 15, 2018: Aging Clinical and Experimental Research
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
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
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