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Hospitalist medicine

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https://www.readbyqxmd.com/read/28502710/graduating-pediatric-residents-entering-the-hospital-medicine-workforce-2006-2015
#1
JoAnna K Leyenaar, Mary Pat Frintner
OBJECTIVE: In October 2016, the American Board of Medical Specialties approved the petition for pediatric hospital medicine (PHM) to become the newest pediatric subspecialty. Knowledge about residents entering the PHM workforce is needed to inform certification and fellowship accreditation. This study describes the characteristics of graduating pediatric residents with PHM positions and identifies factors associated with post-residency position choices. METHODS: We analyzed data from the American Academy of Pediatrics Annual Survey of Graduating Residents, 2006-2015...
May 11, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28459909/inpatient-management-of-opioid-use-disorder-a-review-for-hospitalists
#2
REVIEW
Jesse Theisen-Toupal, Matthew V Ronan, Amber Moore, Elana S Rosenthal
The United States is experiencing an epidemic of nonmedical opioid use and opioid overdose-related deaths. As a result, there have been a number of public health interventions aimed at addressing this epidemic. However, these interventions fail to address care of individuals with opioid use disorder during hospitalizations and, therefore, miss a key opportunity for intervention. The role of hospitalists in managing hospitalized patients with opioid use disorder is not established. In this review, we discuss the inpatient management of individuals with opioid use disorder, including the treatment of withdrawal, benefits of medication-assisted treatment, and application of harm-reduction strategies...
May 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28459902/it-all-just-clicks-development-of-an-inpatient-e-consult-program
#3
Nader Najafi, James D Harrison, Jonathan Duong, Anya Greenberg, Hugo Quinny Cheng
Although the use of electronic consultations (e-consults) in the outpatient setting is commonplace, there is little evidence of their use in the inpatient setting. Often, the only choice hospitalists have is between requesting a time-consuming in-person consultation or requesting an informal, undocumented "curbside" consultation. For a new, remote hospital in our healthcare system, we developed an e-consult protocol that can be used to address simple consultation questions. In the first year of the program, 143 e-consults occurred; the top 5 consultants were infectious disease, hematology, endocrinology, nephrology, and cardiology...
May 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28439362/use-of-a-90-minute-admission-window-and-front-fill-system-to-reduce-work-compression-on-a-general-medicine-inpatient-teaching-service
#4
Youngjee Choi, Daniel Kim, Hyemi Chong, Christopher Mallow, Jason Bill, Anthony T Fojo, Melvin Blanchard
BACKGROUND: Duty hour limits have shortened intern shifts without concurrent reductions in workload, creating work compression. Multiple admissions during shortened shifts can result in poor training experience and patient care. OBJECTIVE: To relieve work compression, improve resident satisfaction, and improve duty hour compliance in an academic internal medicine program. METHODS: In 2014, interns on general ward services were allotted 90 minutes per admission from 3 pm to 7 pm, when the rate of admissions was high...
April 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/28411297/hospitalizations-with-observation-services-and-the-medicare-part-a-complex-appeals-process-at-three-academic-medical-centers
#5
Ann M Sheehy, Jeannine Z Engel, Charles F S Locke, Daniel J Weissburg, Kevin Eldridge, Bartho Caponi, Amy Deutschendorf
Hospitalists and other providers must classify hospitalized patients as inpatient or outpatient, the latter of which includes all observation stays. These orders direct hospital billing and payment, as well as patient out-of-pocket expenses. The Centers for Medicare & Medicaid Services (CMS) audits hospital billing for Medicare beneficiaries, historically through the Recovery Audit program. A recent U.S. Government Accountability Office (GAO) report identified problems in the hospital appeals process of Recovery Audit program audits to which CMS proposed reforms...
April 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28411294/hospital-medicine-and-perioperative-care-a-framework-for-high-quality-high-value-collaborative-care
#6
REVIEW
Rachel E Thompson, Kurt Pfeifer, Paul J Grant, Cornelia Taylor, Barbara Slawski, Christopher Whinney, Laurence Wellikson, Amir K Jaffer
BACKGROUND: Hospitalists have long been involved in optimizing perioperative care for medically complex patients. In 2015, the Society of Hospital Medicine organized the Perioperative Care Work Group to summarize this experience and to develop a framework for providing optimal perioperative care. METHODS: The work group, which consisted of perioperative care experts from institutions throughout the United States, reviewed current hospitalist-based perioperative care programs, compiled key issues in each perioperative phase, and developed a framework to highlight essential elements to be considered...
April 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28375816/confidence-with-and-barriers-to-serious-illness-communication-a-national-survey-of-hospitalists
#7
Leah B Rosenberg, Jeff Greenwald, Bartho Caponi, Ami Doshi, Howard Epstein, Jeff Frank, Elizabeth Lindenberger, Nick Marzano, Lynnea M Mills, Rab Razzak, James Risser, Wendy G Anderson
OBJECTIVE: To describe the concerns, confidence, and barriers of practicing hospitalists around serious illness communication. BACKGROUND: Hospitalist physicians are optimally positioned to provide primary palliative care, yet their experiences in serious illness communication are not well described. METHODS: Web-based survey, conducted in May 2016. The survey link was distributed via email to 4000 members of the Society of Hospital Medicine...
April 4, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28362539/whither-the-pulmonary-ward-attending-preserving-subspecialty-exposure-in-united-states-internal-medicine-residency-training
#8
Lekshmi Santhosh, Jennifer Babik, Mark R Looney, Harry Hollander
Twenty years ago, the term "hospitalist" was coined at the University of California-San Francisco (San Francisco, CA), heralding a new specialty focused on the care of inpatients. There are now more than 50,000 hospitalists practicing in the United States. At many academic medical centers, hospitalists are largely replacing subspecialists as attendings on the inpatient medicine wards. At University of California-San Francisco, this has been accompanied by declining percentages of residency graduates who enter subspecialty training in internal medicine...
April 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28272595/perceived-safety-and-value-of-inpatient-very-important-person-services
#9
Joshua Allen-Dicker, Andrew Auerbach, Shoshana J Herzig
Providing care to "very important person" (VIP) patients can pose unique moral and value-based challenges for providers. No studies have examined VIP services in the inpatient setting. Through a multi-institutional survey of hospitalists, we assessed physician viewpoints and behavior surrounding the care of VIP patients. A significant proportion of respondents reported feeling pressured by patients, family members, and hospital representatives to provide unnecessary care to VIP patients. Based on self-reported perceptions, as well as case-based questions, we also found that the VIP status of a patient may impact physician clinical decision-making related to unnecessary medical care...
March 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28272588/the-impact-of-bedside-interdisciplinary-rounds-on-length-of-stay-and-complications
#10
Andrew S Dunn, Maria Reyna, Brian Radbill, Michael Parides, Claudia Colgan, Tobi Osio, Ari Benson, Nicole Brown, Joy Cambe, Margo Zwerling, Natalia Egorova, Harold Kaplan
BACKGROUND: Communication among team members within hospitals is typically fragmented. Bedside interdisciplinary rounds (IDR) have the potential to improve communication and outcomes through enhanced structure and patient engagement. OBJECTIVE: To decrease length of stay (LOS) and complications through the transformation of daily IDR to a bedside model. DESIGN: Controlled trial. SETTING: 2 geographic areas of a medical unit using a clinical microsystem structure...
March 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28252466/defining-clinical-excellence-in-hospital-medicine-a-qualitative-study
#11
Susrutha Kotwal, Ivonne Peña, Eric Howell, Scott Wright
INTRODUCTION: There are now more than 50,000 hospitalists working in the United States. Limited empiric research has been performed to characterize clinical excellence in hospital medicine. We conducted a qualitative study to discover elements judged to be most pertinent to excellence in clinical care delivered by hospitalists. METHODS: The chiefs of hospital medicine at five hospitals were asked to identify their "clinically best" hospitalists. Data collection, in the form of one-on-one interviews, was directed by an interview guide...
January 2017: Journal of Continuing Education in the Health Professions
https://www.readbyqxmd.com/read/28246349/pediatric-hospital-medicine-a-proposed-new-subspecialty
#12
Douglas J Barrett, Gail A McGuinness, Christopher A Cunha, S Jean Emans, William T Gerson, Mary F Hazinski, George Lister, Karen F Murray, Joseph W St Geme, Patricia N Whitley-Williams
Over the past 20 years, hospitalists have emerged as a distinct group of pediatric practitioners. In August of 2014, the American Board of Pediatrics (ABP) received a petition to consider recommending that pediatric hospital medicine (PHM) be recognized as a distinct new subspecialty. PHM as a formal subspecialty raises important considerations related to: (1) quality, cost, and access to pediatric health care; (2) current pediatric residency training; (3) the evolving body of knowledge in pediatrics; and (4) the impact on both primary care generalists and existing subspecialists...
March 2017: Pediatrics
https://www.readbyqxmd.com/read/28242141/patient-centric-medical-notes-identifying-areas-for-improvement-in-the-age-of-open-medical-records
#13
Eric Hweegeun Lee, Jay Pravin Patel, Auguste Hector Fortin
OBJECTIVE: Patients are increasingly provided facilitated access to their medical notes. Physicians have reported concerns that patients will find notes confusing and offensive, and that typographical errors will appear unprofessional. This exploratory study quantifies the prevalence of potentially confusing or offensive medical language and typographic errors within notes. METHODS: The authors performed a retrospective, cross-sectional review of 400 inpatient History and Physical notes from a tertiary care center...
February 22, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/28194689/exploring-physician-perspectives-of-residency-holdover-handoffs-a-qualitative-study-to-understand-an-increasingly-important-type-of-handoff
#14
Jonathan A Duong, Trevor P Jensen, Sasha Morduchowicz, Michelle Mourad, James D Harrison, Sumant R Ranji
BACKGROUND: The term "holdover admissions" refers to patients admitted by an overnight physician and whose care is then transferred to a new primary team the next morning. Descriptions of the holdover process in internal medicine are sparse. OBJECTIVE: To identify important factors affecting the quality of holdover handoffs at an internal medicine (IM) residency program and to compare them to previously identified factors for other handoffs. DESIGN: We undertook a qualitative study using structured focus groups and interviews...
February 13, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28152940/code-status-documentation-in-the-electronic-medical-record-for-patients-with-stage-iv-pancreatic-cancer
#15
Janet M Armstrong, Joseph D Ma, Carolyn Revta, Eric Roeland
125 Background: Improving incidence of code status documentation in the electronic medical record (EMR) has been suggested a better guidance for clinical care compared with a traditional advance directive. We have previously reported that in the absence of a template in the EMR, code status documentation was 36% and inconsistent in patients with advanced cancer. Utilizing a different cohort of patients with metastatic pancreatic cancer, we examined the prevalence of EMR code status documentation. METHODS: A retrospective analysis in patients with analytic metastatic pancreatic cancer (2008-2014) was conducted at a single, academic medical center...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28073738/evaluating-youtube-as-a-source-of-patient-education-on-the-role-of-the-hospitalist-a-cross-sectional-study
#16
Tamer Hudali, Muralidhar Papireddy, Mukul Bhattarai, Alan Deckard, Susan Hingle
BACKGROUND: Hospital medicine is a relatively new specialty field, dedicated to the delivery of comprehensive medical care to hospitalized patients. YouTube is one of the most frequently used websites, offering access to a gamut of videos from self-produced to professionally made. OBJECTIVE: The aim of our study was to determine the adequacy of YouTube as an effective means to define and depict the role of hospitalists. METHODS: YouTube was searched on November 17, 2014, using the following search words: "hospitalist," "hospitalist definition," "what is the role of a hospitalist," "define hospitalist," and "who is a hospitalist...
January 10, 2017: Interactive Journal of Medical Research
https://www.readbyqxmd.com/read/28052170/differences-in-routine-laboratory-ordering-between-a-teaching-service-and-a-hospitalist-service-at-a-single-academic-medical-center
#17
Michael I Ellenbogen, Madeleine Ma, Nicholas P Christensen, Jungwha Lee, Kevin J O'Leary
OBJECTIVES: Studies have shown that the overutilization of laboratory tests ("labs") for hospitalized patients is common and can cause adverse health outcomes. Our objective was to compare the ordering tendencies for routine complete blood counts (CBC) and chemistry panels by internal medicine residents and hospitalists. METHODS: This observational study included a survey of medicine residents and hospitalists and a retrospective analysis of labs ordering data. The retrospective data analysis comprised patients admitted to either the teaching service or nonteaching hospitalist service at a single hospital during 2014...
January 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/27987287/actual-use-of-pocket-sized-ultrasound-devices-for-cardiovascular-examination-by-trained-physicians-during-a-hospitalist-rotation
#18
Benjamin T Tsai, Eric B Dahms, Jill Waalen, Bruce J Kimura
BACKGROUND: In actual clinical practice as opposed to published studies, the application of bedside ultrasound requires a perception of need, confidence in one's skills, and convenience. OBJECTIVE: As the frequency of ultrasound usage is evidence to its perceived value in patient care, we observed the pattern of autonomous use of a pocket-sized device (PSD) by ultrasound-trained residents during a night hospitalist rotation. METHODS: Consecutive internal medicine residents (n=24), trained in a cardiac limited ultrasound examination (CLUE) as a mandatory part of their curriculum, were sampled on their PSD use after their admitting nights, regarding perceived necessity, deterring factors, detected abnormalities, and imaging difficulties...
2016: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/27898253/establishing-equipoise-national-survey-of-the-treatment-of-pediatric-para-pneumonic-effusion-and-empyema
#19
Morgan K Richards, Jarod P Mcateer, Todd C Edwards, Lucas R Hoffman, Matthew P Kronman, Dennis W Shaw, Adam B Goldin
BACKGROUND: Despite six randomized trials of various treatments for pediatric para-pneumonic effusion (PPE), management approaches differ. The purpose of this study was to gain insight into opinions on PPE treatment with the goal of designing a definitive trial to generate consensus intervention guidelines. METHODS: To evaluate physician opinions regarding PPE management, we developed a survey based on input from a nationwide, multi-disciplinary advisory group that established content validity...
February 2017: Surgical Infections
https://www.readbyqxmd.com/read/27811162/pediatric-medication-safety-in-adult-community-hospital-settings-a-glimpse-into-nationwide-practice
#20
Francisco Alvarez, Lana Ismail, Allison Markowsky
BACKGROUND AND OBJECTIVES: Most children in the United States are treated in adult settings. Studies show that the pediatric population is vulnerable to medication errors. It can be extrapolated that children cared for in adult settings are at equal or higher risk for errors. The goal of this study was to assess the existing pediatric medication safety infrastructure within adult hospitals. METHODS: Questionnaire developed through Research Electronic Data Capture (REDCap) and distributed to pediatric hospitalist programs listed on the American Academy of Pediatrics, Section on Hospital Medicine web site and members of the American Academy of Pediatrics Quality Improvement Innovation Networks listserv...
December 2016: Hospital Pediatrics
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