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Hospitalist medicine

Hardeep Singh, Laura Zwaan
No abstract text is available yet for this article.
October 18, 2016: Annals of Internal Medicine
Monique Mounce, Candace Essel, Tiffany Kim, Che Matthew Harris
BACKGROUND: Supratherapeutic international normalized ratio (INR) in patients on warfarin is a common side effect. Updated guidelines recommend against using vitamin K to correct INRs 4.5 to 10 in the absence of bleeding. The impact of compliance with updated guidelines during hospitalization has not been fully explored. METHODS: A retrospective, observational study was performed utilizing electronic medical records. The goal was to evaluate management of supratherapeutic INR values for medicine inpatients and identify differences in clinical outcomes among inpatients treated and not treated with vitamin K...
November 2015: Hospital Pharmacy
Jennifer M Oshimura, Benjamin D Bauer, Neha Shah, Eugene Nguyen, Jennifer Maniscalco
OBJECTIVES: Pediatric hospitalists report the need for additional training in clinical and nonclinical domains. Pediatric hospital medicine (PHM) fellowships seek to provide this training and produce leaders in the field. Our objective is to describe current roles and perceived training needs of PHM fellowship graduates. METHODS: In 2014, all PHM fellowship graduates were asked to complete a Web-based survey. Survey questions addressed demographics, past training, current roles, and training needs in clinical care, research, education, and administration...
October 2016: Hospital Pediatrics
Janet G Wood
OBJECTIVE: The aim of this study was to evaluate the economic and quality outcomes associated with a collaborative advanced practice nurse and hospitalist physician model of care on the inpatient stroke unit as compared with usual hospitalist physician-led care. BACKGROUND: High functioning collaborative teams are anticipated to be essential under value-based reimbursement. METHODS: Hospitalist nurse practitioners were assigned to the stroke unit in collaboration with hospitalist physicians to implement daily hospital management for patients with stroke and transient ischemic attack...
October 2016: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
Margaret J Trost, Kira Molas-Torreblanca, Carol Man, Ernesto Casillas, Hoda Sapir, Sheree M Schrager
BACKGROUND: Postpartum depression is common and adversely affects children of afflicted mothers; postpartum depression recognition and treatment may improve outcomes. Hospitalization represents a potential health encounter for expanding screening and intervention. OBJECTIVE: We aimed to assess for postpartum depression at infant hospitalization and examine postpartum depression risk factors in this population. DESIGN, SETTING, AND PARTICIPANTS: We conducted a prospective observational study of 310 English- or Spanish-speaking women with an infant aged 2 weeks to 1 year admitted to a pediatric hospitalist service at a large urban freestanding children's hospital...
August 16, 2016: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
Susrutha Kotwal, Waseem Khaliq, Regina Landis, Scott Wright
BACKGROUND: An exceptional experience in a hospital is largely influenced by the quality and performance of the hospitalist physician. We set out to establish a metric that would comprehensively assess hospitalists' comportment and communication to establish norms and expectations. METHODS: The chiefs of hospital medicine divisions at 5 hospitals were asked to identify their "most clinically excellent" hospitalists. An investigator observed each hospitalist during a routine clinical shift and recorded behaviors believed to be associated with excellent comportment and communication using the hospital medicine comportment and communication tool (HMCCOT)...
August 13, 2016: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
Mina S Sedrak, Mitesh S Patel, Justin B Ziemba, Dana Murray, Esther J Kim, C Jessica Dine, Jennifer S Myers
Resident physicians routinely order unnecessary inpatient laboratory tests. As hospitalists face growing pressures to reduce low-value services, understanding the factors that drive residents' laboratory ordering can help steer resident training in high-value care. We conducted a qualitative analysis of internal medicine (IM) and general surgery (GS) residents at a large academic medical center to describe the frequency of perceived unnecessary ordering of inpatient laboratory tests, factors contributing to that behavior, and potential interventions to change it...
August 13, 2016: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
Carmen Sulton, Courtney McCracken, Harold K Simon, Kiran Hebbar, Jason Reynolds, Joseph Cravero, Michael Mallory, Pradip Kamat
OBJECTIVES: Dexmedetomidine (DEX) is widely used in pediatric procedural sedation (PPS) by a variety of pediatric subspecialists. The objective of our study was to describe the overall rates of adverse events and serious adverse events (SAEs) when DEX is used by various pediatric subspecialists. METHODS: Patients from the Pediatric Sedation Research Consortium (PSRC) database were retrospectively reviewed and children that received DEX as their primary sedation agent for elective PPS were identified...
September 2016: Hospital Pediatrics
Robert M Wachter, Lee Goldman
Twenty years ago, we described the emergence of a new type of specialist that we called a "hospitalist." Since then, the number of hospitalists has grown from a few hundred to more than 50,000 (see graph) — making this new field substantially larger than any subspecialty of internal medicine (the..
September 15, 2016: New England Journal of Medicine
Nilam J Soni, Luis F Reyes, Holly Keyt, Alejandro Arango, Jonathan A Gelfond, Jay I Peters, Stephanie M Levine, Sandra G Adams, Marcos I Restrepo
PURPOSE: The purpose of the study is to evaluate the frequency and barriers to use of ultrasound guidance for central venous catheter (CVC) insertion by physicians specializing in critical care and hospital medicine. MATERIALS AND METHODS: A national cross-sectional electronic survey of intensivists and hospitalists was administered from November 2014 to January 2015. RESULTS: The survey response rate was 5.9% (1013/17 233). Moderate to very frequent use of ultrasound guidance varied by site: internal jugular vein (80%), subclavian vein (31%), and femoral vein (45%)...
July 17, 2016: Journal of Critical Care
Christopher T Aquina, Adan Z Becerra, Christian P Probst, Zhaomin Xu, Bradley J Hensley, James C Iannuzzi, Katia Noyes, John R T Monson, Fergal J Fleming
OBJECTIVE: To evaluate the impact of a primary medical versus surgical service on healthcare utilization and outcomes for adhesive small bowel obstruction (SBO) admissions. SUMMARY BACKGROUND DATA: Adhesive-SBO typically requires hospital admission and is associated with high healthcare utilization and costs. Given that most patients are managed nonoperatively, many patients are admitted to medical hospitalists. However, comparisons of outcomes between primary medical and surgical services have been limited to small single-institution studies...
September 2016: Annals of Surgery
Robert M Wachter
No abstract text is available yet for this article.
July 19, 2016: Annals of Internal Medicine
Anthony Montuno, Bijou R Hunt, May M Lee
BACKGROUND: The Society of Hospital Medicine has delineated procedures as one of the core competencies for hospitalists. Little is known about whether exposure to a medical procedure service (MPS) impacts the procedural certification rate in internal medicine trainees in a community hospital training program. OBJECTIVE: To determine whether or not exposure to an MPS would impact both the number of procedures performed and the rate of resultant certifications in a community hospital internal medicine training program...
2016: Journal of Community Hospital Internal Medicine Perspectives
Lluís Blanch, Fayez François Abillama, Pravin Amin, Michael Christian, Gavin M Joynt, John Myburgh, Joseph L Nates, Paolo Pelosi, Charles Sprung, Arzu Topeli, Jean-Louis Vincent, Susan Yeager, Janice Zimmerman
Demand for intensive care unit (ICU) resources often exceeds supply, and shortages of ICU beds and staff are likely to persist. Triage requires careful weighing of the benefits and risks involved in ICU admission while striving to guarantee fair distribution of available resources. We must ensure that the patients who occupy ICU beds are those most likely to benefit from the ICU's specialized technology and professionals. Although prognosticating is not an exact science, preference should be given to patients who are more likely to survive if admitted to the ICU but unlikely to survive or likely to have more significant morbidity if not admitted...
June 22, 2016: Journal of Critical Care
Eric A Coleman
The objective of this Perspective was to provide guidance to hospitalists and hospital clinical leadership on how to implement the Caregiver Advise Record and Enable (CARE) Act, which has been passed into law in 30 US states and territories. Specifically, the objective is 3-fold: (1) increase awareness among hospitalists and encourage them to begin to prepare for implementation, (2) explore the impetus for this legislation, and (3) provide a list of suggested resources geared to both family caregivers and healthcare professionals that may be helpful in preparation for implementing the CARE Act...
July 5, 2016: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
Susan E Merel, Christy M McKinney, Patrick Ufkes, Alan C Kwan, Andrew A White
Sitting at a patient's bedside in the inpatient setting is recommended as a best practice but has not been widely adopted. Previous studies suggest that a physician's seated posture may increase the patient's perception of time spent in the room but have not included hospitalists. We performed a cluster-randomized trial of seated versus standing physician posture during inpatient rounds on a hospitalist service at an academic medical center. Patients whose physician sat were significantly more likely to rate their physician highly on measures of listening carefully and explaining things in a way that was easy to understand...
July 5, 2016: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
Arati A Inamdar, Ajinkya C Inamdar
Despite the advancement in medicine, management of heart failure (HF), which usually presents as a disease syndrome, has been a challenge to healthcare providers. This is reflected by the relatively higher rate of readmissions along with increased mortality and morbidity associated with HF. In this review article, we first provide a general overview of types of HF pathogenesis and diagnostic features of HF including the crucial role of exercise in determining the severity of heart failure, the efficacy of therapeutic strategies and the morbidity/mortality of HF...
2016: Journal of Clinical Medicine
Cynthia Kay, Erica M Wozniak, Aniko Szabo, Jeffrey L Jackson
OBJECTIVES: Explore the performance patterns of invasive bedside procedures at an academic medical center, evaluate whether patient characteristics predict referral, and examine procedure outcomes. METHODS: This was a prospective, observational, and retrospective chart review of adults admitted to a general medicine service who had a paracentesis, thoracentesis, or lumbar puncture between February 22, 2013 and February 21, 2014. RESULTS: Of a total of 399 procedures, 335 (84%) were referred to a service other than the primary team for completion...
July 2016: Southern Medical Journal
Ethan Cumbler, Carrie Herzke, Roger Smalligan, Jeffrey J Glasheen, Cheryl O'Malley, J Rush Pierce
INTRODUCTION: As an emerging and rapidly growing specialty, academic hospitalists face unique challenges in career advancement. Key mentoring needs, especially developing reputation and relationships outside of their institution are often challenging. METHODS: We describe the structure of a novel Visiting Professorship in Hospital Medicine Program. It utilizes reciprocal exchanges of hospitalist faculty at the rank of late assistant to early associate professor...
June 23, 2016: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
Hemali Patel, Margaret C Fang, James D Harrison, Andy Auerbach, Kirsten Neudoerffer Kangelaris
BACKGROUND: Hospitalists frequently work on diverse projects, but often do not have the training and experience necessary to translate projects into peer-reviewed publications and grants. OBJECTIVE: Describe implementation and effect of a works-in-progress (WIP) series on progress and training in scholarly work. DESIGN: Cross-sectional survey. SETTING: Urban academic medical center. INTERVENTION: A weekly WIP session, named Incubator, serving as a forum where researchers, clinicians, and educators meet to review and provide feedback on projects underway across the Division of Hospital Medicine...
June 13, 2016: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
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