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https://www.readbyqxmd.com/read/28091865/improving-the-diagnostic-workup-of-hyponatremia-in-the-setting-of-kidney-disease-a-continuing-medical-education-cme-initiative
#1
Ladan Golestaneh, Joel Neugarten, William Southern, Faraj Kargoli, Amanda Raff
PURPOSE: Hyponatremia is a common electrolyte disorder and is associated with mortality. We examined the frequency of appropriate testing in response to an episode of inpatient hyponatremia in a large urban hospital to better inform our educational intervention. We then evaluated the impact of a live CME activity with a focus on CKD- and ESRD-associated hyponatremia physiology, on diagnostic practices of audience hospitalist attendings. METHODS: We performed a retrospective database analysis of all patients admitted to Montefiore Medical Center in 2014 to examine the performance of hospital staff in response to hyponatremia across all CKD stages...
January 13, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28074588/care-under-the-influence
#2
Joseph J Fins, Samantha F Knowlton
A forty-year-old man is brought to the emergency room by his wife at five in the morning, two hours after he fell down the stairs at home, hitting his head and injuring his arm. He tells the ER physician that he got up to get a drink of water and tripped in the dark. His speech is slurred, and he smells strongly of alcohol. Lab results reveal elevated liver enzymes, and his blood alcohol level is 0.1. His medical history is unremarkable. When asked about his alcohol consumption, he says he usually has one or two drinks a night with dinner but that he drinks more on holidays and special occasions...
January 2017: Hastings Center Report
https://www.readbyqxmd.com/read/28073738/evaluating-youtube-as-a-source-of-patient-education-on-the-role-of-the-hospitalist-a-cross-sectional-study
#3
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/28067679/a-study-of-role-expectations-and-satisfaction-with-the-healthcare-coach-role
#4
Pamela Kohlbry, JoAnn S Daugherty, Joy Gorzeman, Joseph Parker
OBJECTIVE: The research objective was to determine the expectations of and satisfaction with the healthcare coach (HCC) role among hospitalists and staff RNs, as well as expectations of case managers who collaborate with them. BACKGROUND: Care transitions occur when patients move from 1 care setting or provider to another. The Centers for Medicare & Medicaid Services developed the Community-Based Care Transitions Program to address readmission, patient safety, improved quality of care, and cost savings...
January 6, 2017: Journal of Nursing Administration
https://www.readbyqxmd.com/read/28063865/evaluation-of-a-mastery-learning-intervention-on-hospitalists-code-status-discussion-skills
#5
Rashmi K Sharma, Eytan Szmuilowicz, Adeboye Ogunseitan, Sasha F Jones, Jessica A Montalvo, Kevin J O'Leary, Diane B Wayne
CONTEXT: Although code status discussions (CSD) occur frequently in the hospital setting, discussions often lack content necessary for informed decision making. Simulation-based mastery learning (SBML) has been used to improve clinical skills among resident physicians and may provide a novel way to improve hospitalists' CSD skills. OBJECTIVES: The objective of this pilot randomized controlled trial was to develop and evaluate a CSD SBML intervention for hospitalists...
January 4, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28052171/commentary-on-differences-in-routine-laboratory-ordering-between-a-teaching-service-and-a-hospitalist-service-at-a-single-academic-medical-center
#6
Gurprataap S Sandhu
No abstract text is available yet for this article.
January 2017: Southern Medical Journal
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
#7
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/28032896/extension-for-community-healthcare-outcomes-care-transitions-enhancing-geriatric-care-transitions-through-a-multidisciplinary-videoconference
#8
Grace Farris, Mousumi Sircar, Jonathan Bortinger, Amber Moore, J Elyse Krupp, John Marshall, Alan Abrams, Lewis Lipsitz, Melissa Mattison
OBJECTIVES: To examine whether a novel videoconference that connects an interdisciplinary hospital-based team with clinicians at postacute care sites improves interprofessional communication and reduces medication errors. DESIGN: Prospective cohort. SETTING: One tertiary care medical center and eight postacute care sites. PARTICIPANTS: Hospital-based providers (hospitalists, geriatricians, pharmacists, social workers, medical trainees, and subspecialists) and postacute care clinicians...
December 29, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28018539/promoting-resident-autonomy-during-family-centered-rounds-a-qualitative-study-of-resident-hospitalist-and-subspecialty-physicians
#9
Jimmy Beck, Terry Kind, Rebecca Meyer, Priti Bhansali
BACKGROUND : Family-centered rounds (FCR) have become a leading model for pediatric inpatient rounding. Several studies have examined effective teaching strategies during FCR, but none have focused on promoting resident autonomy. OBJECTIVE : The aim of this study was to identify strategies used by attending physicians to promote resident autonomy during FCR. METHODS : We conducted a qualitative study of attending physicians and residents between December 2012 and February 2013 at an academic children's hospital, where FCR is the standard model for inpatient rounds...
December 2016: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/28006091/cardiometabolic-assessment-diagnosis-and-treatment-of-chronic-medical-illnesses-during-an-inpatient-psychiatric-hospitalization-colocated-medical-care-versus-treatment-as-usual
#10
Jason R Tatreau, Suzanne Harris, Brian Sheitman, Beat D Steiner
Background: Reverse colocation care models reduce lifestyle risk factors, emergency department visits, and readmissions. Persons with serious mental illness have higher than average rates of cardiovascular disease-related morbidity and mortality, with second-generation antipsychotics (SGAs) conferring added related risks. Little is written about reverse colocated medical care (RCL) in inpatient psychiatric settings. The objective of this study was to identify associations between screening, diagnosis, and treatment of chronic medical comorbidities and mode of medical care for patients discharged from 2 inpatient psychiatric units on SGAs...
December 22, 2016: Primary Care Companion to CNS Disorders
https://www.readbyqxmd.com/read/28005124/comprehensive-care-for-joint-replacement-cjr-bundle-expense-in-perioperative-pain-management
#11
Susan D Bear
The implementaion of the Comprehensive Care for Joint Replacement (CJR) model has necessitated value-focused care for a 90-day period. Pain management in joint arthroplasty therefore represents a focused opportunity to achieve lasting change in the delivery of care. To be successful, orthopedic surgeons must integrate approaches that take into account administration route and therapy duration, and various combinations thereof, to achieve improved longer term outcomes for joint arthroplasty patients. In addition, pain management choices must be based on value and not on simple costs, as patient satisfaction scores affect CJR repayments...
November 2016: American Journal of Orthopedics
https://www.readbyqxmd.com/read/27993764/implementation-of-solutions-to-reduce-opioid-induced-oversedation-and-respiratory-depression
#12
Barry Meisenberg, John Ness, Sumati Rao, Jane Rhule, Cathaleen Ley
PURPOSE: The implementation of interventions to mitigate the causes of opioid-induced oversedation and respiratory depression (OSRD) is reported. SUMMARY: A single-site retrospective review of eligible rescue naloxone cases was conducted to identify the causes of opioid-induced OSRD in a hospital as well as to identify risk factors. A survey was used to assess potential opioid knowledge deficits among hospitalist prescribers. Based on the findings of the case reviews and results of the opioid knowledge assessments, a series of interventions to address noted deficiencies was implemented over the ensuing months, including enhanced monitoring for sedation, improved clinical decision support in the electronic medical record (EMR), and various adjustments to dosing for high-risk patients...
December 19, 2016: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/27992928/annals-for-hospitalists-20-december-2016
#13
David H Wesorick, Vineet Chopra
No abstract text is available yet for this article.
December 20, 2016: Annals of Internal Medicine
https://www.readbyqxmd.com/read/27992915/annals-for-hospitalists-inpatient-notes-mistakes-in-the-hospital-communicating-apologizing-and-beyond
#14
Allen Kachalia
No abstract text is available yet for this article.
December 20, 2016: Annals of Internal Medicine
https://www.readbyqxmd.com/read/27992617/comparison-of-hospital-mortality-and-readmission-rates-for-medicare-patients-treated-by-male-vs-female-physicians
#15
Yusuke Tsugawa, Anupam B Jena, Jose F Figueroa, E John Orav, Daniel M Blumenthal, Ashish K Jha
Importance: Studies have found differences in practice patterns between male and female physicians, with female physicians more likely to adhere to clinical guidelines and evidence-based practice. However, whether patient outcomes differ between male and female physicians is largely unknown. Objective: To determine whether mortality and readmission rates differ between patients treated by male or female physicians. Design, Setting, and Participants: We analyzed a 20% random sample of Medicare fee-for-service beneficiaries 65 years or older hospitalized with a medical condition and treated by general internists from January 1, 2011, to December 31, 2014...
December 19, 2016: JAMA Internal Medicine
https://www.readbyqxmd.com/read/27988160/vascular-surgeon-hospitalist-comanagement-improves-in-hospital-mortality-at-the-expense-of-increased-in-hospital-cost
#16
Rami O Tadros, Melissa L Tardiff, Peter L Faries, Michael Stoner, Chien Yi M Png, David Kaplan, Ageliki G Vouyouka, Michael L Marin
OBJECTIVE: We have shown that vascular surgeon- hospitalist co management resulted in improved in-hospital mortality rates. We now aim to assess the impact of the hospitalist co management service (HCS) on healthcare cost. METHODS: A total of 1558 patients were divided into three cohorts and compared: 516 in 2012, 525 in 2013, and 517 in 2014. The HCS began in January 2013. Data were standardized for six vascular surgeons that were present 2012-2014. New attendings were excluded...
December 14, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27987287/actual-use-of-pocket-sized-ultrasound-devices-for-cardiovascular-examination-by-trained-physicians-during-a-hospitalist-rotation
#17
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/27940792/establishing-a-standard-protocol-for-the-voiding-cystourethrography
#18
Dominic Frimberger, Maria-Gisela Mercado-Deane
The voiding cystourethrogram (VCUG) is a frequently performed test to diagnose a variety of urologic conditions, such as vesicoureteral reflux. The test results determine whether continued observation or an interventional procedure is indicated. VCUGs are ordered by many specialists and primary care providers, including pediatricians, family practitioners, nephrologists, hospitalists, emergency department physicians, and urologists. Current protocols for performing and interpreting a VCUG are based on the International Reflux Study in 1985...
November 2016: Pediatrics
https://www.readbyqxmd.com/read/27939178/establishing-a-standard-protocol-for-the-voiding-cystourethrography
#19
Dominic Frimberger, Stuart B Bauer, Mark P Cain, Saul P Greenfield, Andrew J Kirsch, Faridali Ramji, Maria-Gisela Mercado-Deane, Christoper S Cooper
The voiding cystourethrogram (VCUG) is a frequently performed test to diagnose a variety of urologic conditions, such as vesicoureteral reflux (VUR). The test results determine whether continued observation or an interventional procedure is indicated. VCUGs are ordered by many specialists and primary care providers, including pediatricians, family practitioners, nephrologists, hospitalists, emergency room physicians, and urologists. Current protocols for performing and interpreting a VCUG are based on the International Reflux Study in 1985...
December 2016: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/27919427/-lose-the-tube-a-choosing-wisely-initiative-to-reduce-catheter-associated-urinary-tract-infections-in-hospitalist-led-inpatient-units
#20
Hyung J Cho, Steve Khalil, Jashvant Poeran, Madhu Mazumdar, Nathaniel Bravo, Fran Wallach, Brian Markoff, Nathan Lee, Andrew S Dunn
We developed a multidisciplinary initiative, "Lose the Tube," focused on a Choosing Wisely recommendation to decrease catheter-associated urinary tract infection (CAUTI) rates and catheter days. Through an electronic health record catheter identification tool, daily interdisciplinary query, and clinician education, our multifaceted intervention reduced mean per-person catheter days from 3.3 to 2.9, decreased CAUTI rates from 2.85 to 0.32 per 1,000 catheter days, and reduced cost by $32,245.
December 2, 2016: American Journal of Infection Control
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