Journal of hospital medicine最新文献

{"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":null,"pages":null},"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, Emily Senay, Jodi D. Sherman","doi":"10.1002/jhm.13493","DOIUrl":"https://doi.org/10.1002/jhm.13493","url":null,"abstract":"","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Your service, our gratitude: A thank you to our peer reviewers","authors":"Samir S. Shah, Gregory W. Ruhnke, Sanjay Mahant, Daniel J. Brotman, Farah A. Kaiksow, Charlie M. Wray","doi":"10.1002/jhm.13457","DOIUrl":"https://doi.org/10.1002/jhm.13457","url":null,"abstract":"","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141570742","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: The science of motivating change","authors":"Katarina Leyba MBA, MD,&nbsp;Samuel Porter MD","doi":"10.1002/jhm.13445","DOIUrl":"10.1002/jhm.13445","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":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141474011","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":"Point/counterpoint: Should we stop writing and reading letters of recommendation for residency selection?","authors":"Matthew Kelleher MD, MEd,&nbsp;Benjamin Kinnear MD, MEd,&nbsp;Danielle E. Weber MD, MEd,&nbsp;Michelle I. Knopp MD,&nbsp;Daniel Schumacher MD, MEd, PhD,&nbsp;Eric Warm MD","doi":"10.1002/jhm.13440","DOIUrl":"10.1002/jhm.13440","url":null,"abstract":"&lt;p&gt;As hospitalists involved in internal medicine and pediatrics residency selection, each of us have read letters of recommendation (LORs) like the one in Box 1. As part of the process of selecting candidates for residency training, LORs hold significant implications for both applicants and programs and are tainted by deep-rooted flaws. These defects continue largely because of our collective failure to confront and address the glaring issues within the process. At best, LORs offer marginal benefit in selecting residents; at worst, they become overt channels for bias, inequity, inequality, and arbitrariness, often devolving into exercises of inanity, untruthfulness, obfuscation, and even propaganda. As such, they decrease the integrity and purpose of the residency selection process.&lt;/p&gt;&lt;p&gt;For example, gender bias in residency application LORs has been noted for Radiology, Orthopedic Surgery, Female Pelvic Medicine and Reconstructive Surgery, Cardiovascular Surgery, Emergency Medicine, Pediatrics, Anesthesiology, Radiation Oncology, Ophthalmology, Internal Medicine, and General Surgery, among others.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Women often find themselves described in these letters with communal traits, such as &lt;i&gt;helpful&lt;/i&gt; and &lt;i&gt;caring&lt;/i&gt;.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; In contrast, men are more likely to be portrayed with agentic traits, including &lt;i&gt;leader&lt;/i&gt; and &lt;i&gt;taking initiative&lt;/i&gt;. LORs for women also tend to focus more on personal appearance (such as the misogynistic but real-life example about Ms. J. Smiths' figure in the above letter) and personal life. They also contain more doubt raisers (e.g., “it appears her health and personal life are stable”&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt;), including hesitancy from the recommender, use of faint praise, potentially negative comments, unexplained comments, and irrelevancies.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Ethnic and racial biases are also prominent in residency LORs, where differences in language can subtly influence readers' perceptions of candidates.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; As with gender, agentic and communal terms are used differently based on a candidate's ethnicity or race. Even apart from bias, LORs compound inequity. The process of obtaining LORs favors already advantaged groups who are more likely to have access to the most influential letter writers. Students often spend an inordinate amount of time searching for the “right” letter writer, often choosing those with titles or positions of power over those who know them best. LORs also tend to focus only on positive aspects of applicants, neglecting the comprehensive portrayal of a candidate's journey, struggles, and growth. This one-sided representation undermines the principle of holistic review (a balanced assessment of an applicant's experiences, attributes, and academic metrics&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt;) by not fully acknowledging the resilience and perseverance shown in overcoming challenges, especially among disadvantaged applicants. Even wo","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhm.13440","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141461462","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":"Where and what separates rural from urban hospital closures?","authors":"Sara D. Turbow MD, MPH,&nbsp;Jennifer Lom MD,&nbsp;Mohammed K. Ali MD, MSc, MBA","doi":"10.1002/jhm.13438","DOIUrl":"10.1002/jhm.13438","url":null,"abstract":"<p>Despite the recent closure of several high-profile metropolitan hospitals, investigations into risk factors for metropolitan hospital closures have been limited. The goal of this study was to describe metropolitan hospitals that closed and compare them to metropolitan hospitals that remain open and micropolitan and rural hospitals that closed using American Hospital Association Annual Survey Data from 2010 to 2021. We independently verified hospitals reported as closed in the Annual Survey and examined the hospital characteristics associated with closure using bivariate statistics and logistic regression. We found that metropolitan hospitals that closed (<i>n</i> = 142) were more likely to be for-profit (66.9% vs. 29.7%, <i>p</i> &lt; .0001; adjusted odds ratio [AOR]: 3.05, 95% confidence interval [CI]: 1.93, 4.81) and to come from a state that did not expand Medicaid (45.1% vs. 29.4%, <i>p</i> &lt; .0001; AOR: 1.66, 95% CI: 1.16, 2.38). Policies tailored to metropolitan hospitals should be developed to identify at-risk hospitals and mitigate the effect of closures on patients, clinicians, and other stakeholders.</p>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhm.13438","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141422219","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":"Beyond “Who is your mentor?”","authors":"Samir S. Shah MD, MSCE, MHM","doi":"10.1002/jhm.13435","DOIUrl":"10.1002/jhm.13435","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":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhm.13435","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141319379","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":"Leadership & professional development: Prevent poster paresis: Pushing through to publish","authors":"Shannon K. Martin MD, MS,&nbsp;Venkatesan R. Krishnamoorthi MD, MPH","doi":"10.1002/jhm.13430","DOIUrl":"10.1002/jhm.13430","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":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141302317","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":"Don't forget your Skittles","authors":"Samir S. Shah MD, MSCE, MHM","doi":"10.1002/jhm.13419","DOIUrl":"10.1002/jhm.13419","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":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhm.13419","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141159344","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":"Prognostic clinical decision support for pneumonia in the emergency department: A randomized trial","authors":"Derek J. Williams MD, MPH,&nbsp;Hui Nian PhD,&nbsp;Srinivasan Suresh MD, MBA,&nbsp;Jason Slagle PhD,&nbsp;Stephen Gradwohl MD, MSACI,&nbsp;Jakobi Johnson BS,&nbsp;Justine Stassun MS,&nbsp;Carrie Reale RN, MSN,&nbsp;Shari L. Just RN, MSN,&nbsp;Nancy S. Rixe MD,&nbsp;Russ Beebe BA,&nbsp;Donald H. Arnold MD, MPH,&nbsp;Robert W. Turer MD,&nbsp;James W. Antoon MD, PhD,&nbsp;Laura F. Sartori MD, MPH,&nbsp;Robert E. Freundlich MD, MSCI,&nbsp;Carlos G. Grijalva MD, MPH,&nbsp;Joshua C. Smith PhD,&nbsp;Asli O. Weitkamp PhD, MSACI,&nbsp;Matthew B. Weinger MD, MS,&nbsp;Yuwei Zhu MD, MS,&nbsp;Judith M. Martin MD","doi":"10.1002/jhm.13391","DOIUrl":"10.1002/jhm.13391","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Hospitalization rates for childhood pneumonia vary widely. Risk-based clinical decision support (CDS) interventions may reduce unwarranted variation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a pragmatic randomized trial in two US pediatric emergency departments (EDs) comparing electronic health record (EHR)-integrated prognostic CDS versus usual care for promoting appropriate ED disposition in children (&lt;18 years) with pneumonia. Encounters were randomized 1:1 to usual care versus custom CDS featuring a validated pneumonia severity score predicting risk for severe in-hospital outcomes. Clinicians retained full decision-making authority. The primary outcome was inappropriate ED disposition, defined as early transition to lower- or higher-level care. Safety and implementation outcomes were also evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study enrolled 536 encounters (269 usual care and 267 CDS). Baseline characteristics were similar across arms. Inappropriate disposition occurred in 3% of usual care encounters and 2% of CDS encounters (adjusted odds ratio: 0.99, 95% confidence interval: [0.32, 2.95]). Length of stay was also similar and adverse safety outcomes were uncommon in both arms. The tool's custom user interface and content were viewed as strengths by surveyed clinicians (&gt;70% satisfied). Implementation barriers include intrinsic (e.g., reaching the right person at the right time) and extrinsic factors (i.e., global pandemic).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>EHR-based prognostic CDS did not improve ED disposition decisions for children with pneumonia. Although the intervention's content was favorably received, low subject accrual and workflow integration problems likely limited effectiveness. Clinical Trials Registration: NCT06033079.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141155466","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}