Journal of hospital medicine最新文献

{"title":"On healing and humanity","authors":"Samir S. Shah MD, MSCE, MHM","doi":"10.1002/jhm.13549","DOIUrl":"10.1002/jhm.13549","url":null,"abstract":"","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"19 12","pages":"1103"},"PeriodicalIF":2.4,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leadership & professional development: From setback to setup","authors":"Jennifer Lom MD, Eva Rimler MD","doi":"10.1002/jhm.13520","DOIUrl":"10.1002/jhm.13520","url":null,"abstract":"","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"19 12","pages":"1160-1161"},"PeriodicalIF":2.4,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Career development committees: A guide for early- and mid-career faculty.","authors":"Samir S Shah","doi":"10.1002/jhm.13509","DOIUrl":"https://doi.org/10.1002/jhm.13509","url":null,"abstract":"","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"13 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142247565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lessons from patient safety to accelerate healthcare decarbonization","authors":"Hardeep Singh MD, MPH, Emily Senay MD, Jodi D. Sherman MD","doi":"10.1002/jhm.13493","DOIUrl":"10.1002/jhm.13493","url":null,"abstract":"<p>Climate change and environmental degradation are increasingly impacting human health, with more frequent heatwaves, wildfires, extreme weather events, emerging infectious diseases, increased respiratory, cardiovascular, and mental health conditions, and food and water insecurity.<span><sup>1</sup></span> Current projections of global greenhouse gas (GHG) emissions suggest it will be harder to limit warming below the critical threshold of 2°C to avoid the worst predicted harms unless deep and immediate reductions in GHGs occur in all sectors of society. The healthcare sector contributes approximately 4.6% of total global GHGs and 4 million disability-adjusted life years lost from air pollution annually.<span><sup>1</sup></span> Health care must do its part to mitigate environmental degradation and pollution and avoid excessive resource consumption.<span><sup>2, 3</sup></span></p><p>One-fifth of global healthcare GHG contributions come from the US healthcare sector despite the United States comprising only 4% of the global population. A number of motivated US healthcare delivery organizations (HCOs) have begun to implement decarbonization initiatives, and these efforts should be applauded.<span><sup>4, 5</sup></span> However, many of these initiatives are not grounded in rigorous measurement and data transparency, making it difficult to judge the veracity of claims or progress consistent with science-based targets.<span><sup>6</sup></span> The nascent state of healthcare sustainability is reminiscent of the early days of the patient safety movement and is experiencing similar growing pains. In 1999, the report “To Err is Human” raised the alarm about patient safety, but demonstrable improvement was slow going and hampered by, among other things, a lack of data and transparency required for guiding and tracking evidence-based performance improvement.<span><sup>7</sup></span> Progress has been made since then primarily through regulatory and payment reforms, and in 2025, the US Centers for Medicare & Medicaid Services (CMS) is expected to implement a Patient Safety Structural Measure that further embeds measurement, accountability, and transparency in assessing how hospitals ensure patient safety.<span><sup>8</sup></span> However, the urgency of the climate crisis and healthcare's significant contribution to it leaves no room for decades-long delays. To ensure progress in the absence of regulation and payment levers, HCOs should apply the principles guiding the patient safety movement to ensure that data transparency and verification are the centerpiece of the transformation to evidenced-based, environmentally sustainable health care.</p><p>Previous research has quantified the harmful effects of US healthcare pollution at nearly 400,000 disability-adjusted life years (DALYs) lost in 2018.<span><sup>9</sup></span> Creating effective systems to protect patients, the public, and the planet from harm requires adherence to basic principles of trans","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"19 11","pages":"1071-1076"},"PeriodicalIF":2.4,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhm.13493","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142247611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical guideline highlight for the hospitalist: Diagnosis and management of acute bacterial arthritis in children","authors":"Brandon Palmer MD, MACM,&nbsp;Austin Cummings MD,&nbsp;Danita Hahn MD","doi":"10.1002/jhm.13499","DOIUrl":"10.1002/jhm.13499","url":null,"abstract":"<p><b>GUIDELINE TITLE</b>: Clinical Practice Guideline by the Pediatric Infectious Diseases Society (PIDS) and the Infectious Diseases Society of America (IDSA): 2023 Guideline on Diagnosis and Management of Acute Bacterial Arthritis</p><p><b>RELEASE DATE</b>: January 1, 2024</p><p><b>PRIOR VERSION(S):</b> n/a</p><p><b>DEVELOPER</b>: Pediatric Infectious Diseases Society (PIDS), Infectious Diseases Society of America (IDSA)</p><p><b>FUNDING SOURCE</b>: PIDS and IDSA</p><p><b>TARGET POPULATION</b>: Children with suspected or confirmed acute bacterial arthritis</p>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"19 12","pages":"1162-1164"},"PeriodicalIF":2.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142116577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leadership & professional development: #LeadTheVote: Practical steps to encourage physicians to vote","authors":"Michelle N. Brooks MD, SFHM, FACP,&nbsp;Jennifer Readlynn MD, FHM","doi":"10.1002/jhm.13494","DOIUrl":"10.1002/jhm.13494","url":null,"abstract":"<p>\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"19 10","pages":"929-930"},"PeriodicalIF":2.4,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142010140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association of hospitalist medical procedure service with operational efficiency at an academic medical center","authors":"Brett R. Curtis MD, MS,&nbsp;Shuo Tian PhD,&nbsp;Sachita Shrestha MPH,&nbsp;Trevor Denton DPT,&nbsp;Blake Haller MD,&nbsp;Jonathan Sebolt MD,&nbsp;Michael Adams MD,&nbsp;Stephanie P. Taylor MD, MSc,&nbsp;David Paje MD, MPH","doi":"10.1002/jhm.13484","DOIUrl":"10.1002/jhm.13484","url":null,"abstract":"<p>We examined the impact of a hospital medicine medical procedure service (MPS) on hospital length of stay (LOS), postprocedure LOS, and completion of procedures on weekends. We included 4952 patients admitted to our large academic hospital between July 1, 2021 and July 31, 2023 who underwent thoracentesis, paracentesis, or lumbar puncture (LP). MPS performed 30% (1499) of these procedures. After adjusting for age, sex, body mass index, Charlson comorbidity score, and procedure type, procedure performance by MPS was associated with a shorter total hospital LOS (incidence rate ratio [IRR]: 0.93; 95% confidence interval [CI]: 0.87–0.99) and postprocedure LOS (IRR: 0.82; 95% CI: 0.76–0.88). Also, MPS-performed procedures were twice as likely to occur on weekends compared to non-MPS-performed procedures (odds ratio [OR]: 2.05; 95% CI: 1.75–2.41). These findings support the beneficial impact of MPS on operational efficiency, an important outcome for both patients and hospitals.</p>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"19 12","pages":"1155-1159"},"PeriodicalIF":2.4,"publicationDate":"2024-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhm.13484","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141997133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interventions to support medical trainee well-being after patient death: A scoping review","authors":"Halah Ibrahim MD, MEHP,&nbsp;Leen Oyoun Alsoud MSc,&nbsp;Kelsey West MD,&nbsp;Jude O. Maraka BS,&nbsp;Sara Sorrell MD, PhD,&nbsp;Thana Harhara MD,&nbsp;Satish C. Nair MBBCh, PhD, MBA,&nbsp;Cecelia J. Vetter MLIS,&nbsp;Lalit Krishna MD, PhD","doi":"10.1002/jhm.13489","DOIUrl":"10.1002/jhm.13489","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Medical trainees are at the forefront of end-of-life care provision in the hospital setting but often feel unprepared to manage the complex emotions after patient death.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To systematically identify and synthesize the published literature on interventions to support medical trainees dealing with patient death.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Searches were conducted in MEDLINE, Scopus, Embase, Psych Info, Cochrane Database of Systematic Reviews, CINAHL, and ERIC from inception to June 30, 2023. English language peer-reviewed publications of interventions to support medical students and residents/fellows dealing with patient death. Studies of practicing clinicians and nonphysician healthcare trainees were excluded. Two reviewers independently determined study eligibility. Discrepancies were resolved through consensus and a third reviewer served as a tiebreaker if needed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 9107 articles retrieved, 973 underwent full-text review, and 50 studies met inclusion criteria. Most interventions targeted residents (<i>n</i> = 32; 64%) and were conducted in North America (<i>n </i>= 45, 90%). Types of interventions included preventive measures involving educational lectures and workshops (<i>n</i> = 19; 38%), clinical placements (<i>n</i> = 10; 20%), and postventions (<i>n</i> = 16; 32%), including debriefing and memorial services. Several interventions incorporated the arts (<i>n </i>= 5; 10%), including movies, drama, and artwork, and most incorporated reflective narratives (<i>n</i> = 16; 32%). Most interventions were limited in frequency and duration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This review identified several interventions to support trainees through the experience of patient death but also highlighted areas for improvement. Strengthening support for medical trainees will foster emotionally resilient physicians who are better equipped to deliver high-quality, empathetic care to dying patients and their families.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"19 11","pages":"1044-1052"},"PeriodicalIF":2.4,"publicationDate":"2024-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhm.13489","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141997132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simultaneously implementing pathways for improving asthma, pneumonia, and bronchiolitis care for hospitalized children: Protocol for a hybrid effectiveness-implementation, cluster-randomized trial","authors":"Yeelen Edwards MSc,&nbsp;Nancy Yang MPH,&nbsp;Andrew D. Auerbach MD, MPH,&nbsp;Ralph Gonzales MD, MSPH,&nbsp;Charles E. McCulloch PhD,&nbsp;Eric E. Howell MD,&nbsp;Jenna Goldstein MA,&nbsp;Sara Thompson BA,&nbsp;Sunitha V. Kaiser MD, MSc","doi":"10.1002/jhm.13482","DOIUrl":"10.1002/jhm.13482","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Asthma, pneumonia, and bronchiolitis are the top causes of childhood hospitalization in the United States, leading to over 350,000 hospitalizations and ≈$2 billion in costs annually. The majority of these hospitalizations occur in general/community hospitals. Poor guideline adoption by clinicians contributes to poor health outcomes for children hospitalized with these illnesses, including longer recovery time/hospital stay, higher rates of intensive care unit transfer, and increased risk of hospital readmission. A prior single-center study at a children's hospital tested a multicondition clinical pathway intervention (simultaneous implementation of multiple pathways for multiple pediatric conditions) and demonstrated improved clinician guideline adherence and patient health outcomes. This intervention has not yet been studied in community hospitals, which face unique implementation barriers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To study the implementation and effectiveness of a multicondition pathway intervention for children hospitalized with asthma, pneumonia, or bronchiolitis in community hospitals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We will conduct a pragmatic, hybrid effectiveness-implementation, cluster-randomized trial in community hospitals around the United States (1:1 randomization to intervention vs. wait-list control). Our primary outcome will be the adoption of two to three evidence-based practices for each condition over a sustained period of 2 years. Secondary outcomes include hospital length of stay, ICU transfer, and readmission.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>This hybrid trial will lead to a comprehensive understanding of how to pragmatically and sustainably implement a multicondition pathway intervention in community hospitals and an assessment of its effects. Enrollment began in July 2022 and is projected to be completed in September 2024. Primary analysis completion is anticipated in March 2025, with reporting of results following.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"19 12","pages":"1203-1210"},"PeriodicalIF":2.4,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141977523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continuous pulse oximetry monitoring in children hospitalized with bronchiolitis: A qualitative analysis of clinicians' justifications","authors":"Halley Ruppel PhD, RN,&nbsp;Christopher P. Bonafide MD, MSCE,&nbsp;Rinad S. Beidas PhD,&nbsp;Kimberly Albanowski MHS-MA,&nbsp;Raymond Parlar-Chun MD, MS,&nbsp;Prabi Rajbhandari MD,&nbsp;Andrew S. Kern-Goldberger MD, MSCE,&nbsp;Patricia A. Stoeck MD,&nbsp;Kathleen Snow MD,&nbsp;Samantha A. House DO, MPH,&nbsp;Kate E. Lucey MD, MS,&nbsp;Patrick W. Brady MD, MSc,&nbsp;Amanda C. Schondelmeyer MD, MSc,&nbsp;For the Pediatric Research in Inpatient Settings (PRIS) Network","doi":"10.1002/jhm.13442","DOIUrl":"10.1002/jhm.13442","url":null,"abstract":"<p>Continuous pulse oximetry (cSpO₂) monitoring use outside established guidelines is common in children hospitalized with bronchiolitis. We analyzed clinicians' real-time rationale for continuous monitoring in stable children with bronchiolitis not requiring supplemental oxygen. Data for this study were collected as part a multicenter deimplementation trial for cSpO₂ in children hospitalized with bronchiolitis. We analyzed 371 clinician responses across 36 hospitals; 258 (70%) responses did not include a clinical reason for monitoring (“nonclinical”; e.g., respondent forgot to discontinue monitoring, did not know why the patient was monitored, or was following an order). The remaining 113 (30%) responses contained a clinical reason for monitoring (“clinical”; e.g., recently requiring oxygen, physical exam concerns, or concerns relating to patient condition or history). Strategies to reduce unnecessary monitoring should include changes in workflow to facilitate shared understanding of monitoring goals and timely discontinuation of monitoring.</p>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"19 11","pages":"1028-1034"},"PeriodicalIF":2.4,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhm.13442","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141908652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}