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https://www.readbyqxmd.com/read/29341527/-recent-advances-in-internal-medicine
#1
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
https://www.readbyqxmd.com/read/29340567/annals-for-hospitalists-16-january-2018
#2
David H Wesorick, Vineet Chopra
No abstract text is available yet for this article.
January 16, 2018: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29340341/credentialing-of-hospitalists-in-ultrasound-guided-bedside-procedures-a-position-statement-of-the-society-of-hospital-medicine
#3
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
https://www.readbyqxmd.com/read/29336006/the-place-of-frailty-and-vulnerability-in-the-surgical-risk-assessment-should-we-move-from-complexity-to-simplicity
#4
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
https://www.readbyqxmd.com/read/29335822/emergency-department-throughput-an-intervention
#5
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
https://www.readbyqxmd.com/read/29335736/annals-for-hospitalists-inpatient-notes-modernizing-rounds-why-it-s-time-to-redesign-our-hospital-practice
#6
Jason Stein, Susan Shapiro
No abstract text is available yet for this article.
January 16, 2018: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29323810/hospital-medicine-and-fellowship-program-in-rural-north-dakota-a-multifaceted-success-story
#7
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
https://www.readbyqxmd.com/read/29322872/a-collaborative-approach-to-improve-consistent-use-of-procalcitonin-in-lower-respiratory-tract-infections
#8
Alexander R Levine, Robyn Riggott, Kristela Vulaj, Tera R Falcetti, Syed Ali, Gagandeep Singh
BACKGROUND: Procalcitonin (PCT) is a biomarker that can help differentiate bacterial from viral infections and has been extensively studied in patients with sepsis and pneumonia to guide antibiotic therapy. However, there is poor adherence to prescribed algorithms when used to discontinue antibiotics in the real world. A quality improvement project was implemented to increase consistent use of PCT. OBJECTIVE: To evaluate use of PCT and impact on antibiotic length of therapy (LOT) preimplementation and postimplementation of a quality improvement initiative...
January 1, 2018: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/29314105/ambulatory-diagnostic-ecg-monitoring-for-syncope-and-collapse-an-assessment-of-clinical-practice-in-the-united-states
#9
David G Benditt, Wayne O Adkisson, Richard Sutton, Robin K Mears, Scott Sakaguchi
INTRODUCTION: Diagnostic ambulatory ECG (AECG) monitoring is widely used for evaluating syncope and collapse, and practice guidelines provide recommendations regarding optimal AECG device selection. However, whether physicians utilize AECGs in accordance with the pertinent guidelines is unclear. This study assessed utilization of AECG monitoring systems for syncope and collapse diagnosis by physicians in the United States. METHODS AND RESULTS: A quantitative survey was undertaken of physicians comprising multiple specialties (Emergency Room, n = 35; Primary care, n = 35; Hospitalists, n = 30; Neurologists, n = 30; non-implanting, n = 34 and implanting-Cardiologists, n = 35)...
January 4, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29303821/sustained-hospital-performance-on-hospital-consumer-assessment-of-healthcare-providers-and-systems-survey-measures-what-are-the-determinants
#10
Mona Al-Amin, Melody K Schiaffino, Sinyoung Park, Jeffrey Harman
This study examines hospital characteristics associated with sustained superior performance on Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) measures. We classified hospitals as sustainers if they remained in the top 25th percentile of overall patient ratings of inpatient experience from 2009 through 2013. We classified hospital characteristics as modifiable or unmodifiable. Modifiable characteristics are operational measures that hospitals can change to improve performance; these characteristics include registered nurse (RN) staffing levels, presence of hospitalists, and level of physician integration...
January 2018: Journal of Healthcare Management / American College of Healthcare Executives
https://www.readbyqxmd.com/read/29280687/evaluation-of-the-value-of-team-based-psychiatric-consultation-in-a-general-hospital-setting
#11
Catherine Orsak, Abey Thomas, Paul Bush, E Sherwood Brown
Background With the increase use of pay for performance in healthcare, 30-day readmissions after discharges are critically important. Objective A team-based psychiatric consultation approach was tested in an inpatient hospital setting. This is the first study that examines 30-day readmission rate with this approach. Methods In this quality improvement study, 164 patients received a team-based psychiatric consultation that included daily meetings during the weekdays between psychiatrists and hospitalists and 436 received care of treatment-as-usual or traditional consultation-liaison services...
January 1, 2017: International Journal of Psychiatry in Medicine
https://www.readbyqxmd.com/read/29279886/association-of-hospitalist-years-of-experience-with-mortality-in-the-hospitalized-medicare-population
#12
James S Goodwin, Habeeb Salameh, Jie Zhou, Siddhartha Singh, Yong-Fang Kuo, Ann B Nattinger
Importance: Substantial numbers of hospitalists are fresh graduates of residency training programs. Current data about the effect of hospitalist years of experience on patient outcomes are lacking. Objective: To describe the association of hospitalist years of experience with 30-day mortality and hospital mortality of their patients. Design, Setting, and Participants: We used a 5% sample of national Medicare data of patient and hospital characteristics to build a multilevel logistic regression model to predict mortality as a function of years of experience of the hospitalists...
December 26, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/29263711/the-hospitalist-huddle-a-1-year-experience-of-teaching-hospital-medicine-utilizing-the-concept-of-peer-teaching-in-medical-education
#13
Mohammed Elhassan
Background: The relatively new specialty of Hospital Medicine in the USA is one of the fastest growing fields in internal medicine. Academic hospitalists are largely involved in the medical education of postgraduate residents and medical students. Little is known about the effectiveness of peer-to-peer teaching in internal medicine residency training programs and how the medical residents perceive its educational value in learning Hospital Medicine. Materials and methods: The Hospitalist Huddle is a weekly educational activity newly established by our Hospitalist Division to facilitate the concept of peer-to-peer teaching...
2017: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/29263123/neonatal-abstinence-syndrome-and-the-pediatric-hospitalist-5-years-later
#14
Kathryn Dee L MacMillan, Alison Volpe Holmes
No abstract text is available yet for this article.
December 20, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/29262933/the-african-hospitalist-fellowship
#15
A D Daniels, H Buys, R Dunkley, J M Wilmshurst
The African Paediatric Fellowship Programme is rolling out a training course for newly qualified paediatricians to equip them with the leadership skills to function in complex general paediatric settings. The care of children in Africa carries its own unique demands, from the layering effects of multiple conditions through to establishing and sustaining services under severe resource constraints. This novel training concept aims to strengthen confidence and knowledge in areas that are not priorities during standard general paediatric training...
October 31, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/29261820/a-method-for-attributing-patient-level-metrics-to-rotating-providers-in-an-inpatient-setting
#16
Carrie A Herzke, Henry J Michtalik, Nowella Durkin, Joseph Finkelstein, Amy Deutschendorf, Jason Miller, Curtis Leung, Daniel J Brotman
BACKGROUND: Individual provider performance drives group metrics, and increasingly, individual providers are held accountable for these metrics. However, appropriate attribution can be challenging, particularly when multiple providers care for a single patient. OBJECTIVE: We sought to develop and operationalize individual provider scorecards that fairly attribute patient-level metrics, such as length of stay and patient satisfaction, to individual hospitalists involved in each patient's care...
December 20, 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29261816/improving-quality-of-care-for-seriously-ill-patients-opportunities-for-hospitalists
#17
Robin E Fail, Diane E Meier
As the shift to value-based payment accelerates, hospitals are under increasing pressure to deliver high-quality, efficient services. Palliative care approaches improve quality of life and family well-being, and in doing so, reduce resource utilization and costs. Hospitalists frequently provide palliative care interventions to their patients, including pain and symptom management and engaging in conversations with patients and families about the realities of their illness and treatment plans that align with their priorities...
December 20, 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29257769/the-rise-of-hospitalists-an-opportunity-for-clinical-ethics
#18
Matthew W McCarthy, Diego Real de Asua, Joseph J Fins
Translating ethical theories into clinical practice presents a perennial challenge to educators. While many suggestions have been put forth to bridge the theory-practice gap, none have sufficiently remedied the problem. We believe the ascendance of hospital medicine, as a dominant new force in medical education and patient care, presents a unique opportunity that could redefine the way clinical ethics is taught. The field of hospital medicine in the United States is comprised of more than 50,000 hospitalists-specialists in inpatient medicine-representing the fastest growing subspecialty in the history of medicine, and its members have emerged as a dominant new force around which medical education and patient care pivot...
2017: Journal of Clinical Ethics
https://www.readbyqxmd.com/read/29255883/annals-for-hospitalists-19-december-2017
#19
David H Wesorick, Vineet Chopra
No abstract text is available yet for this article.
December 19, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29255873/annals-for-hospitalists-inpatient-notes-trends-in-rates-of-catheter-associated-bloodstream-infection-zeroing-in-on-zero-or-just-fake-news
#20
Naomi P O'Grady
No abstract text is available yet for this article.
December 19, 2017: Annals of Internal Medicine
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