Journal of hospital medicine最新文献

{"title":"A multicomponent unit-based approach for hospital care of older adults with behavioral and psychological symptoms of dementia","authors":"Winnie Chu DO,&nbsp;Debra Recchia RN, BSN, NE-BC,&nbsp;Shahidul Islam DrPH,&nbsp;Cristina Sison PhD,&nbsp;Liron Sinvani MD","doi":"10.1002/jhm.70336","DOIUrl":"10.1002/jhm.70336","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Persons with Alzheimer's disease and related dementias (ADRD) are more frequently hospitalized and often experience behavioral and psychological symptoms of dementia (BPSD). This study describes a dementia-focused medical unit that aims to improve the management of BPSD in hospitalized patients with ADRD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The objective of the present paper is to: (1) describe the dementia-focused medical unit; (2) describe the population admitted to the dementia-focused medical unit; (3) present management strategies of BPSD prior to and post unit transfer; and (4) describe patient (e.g., mobility, goals-of-care, mortality) and hospital metrics (e.g., LOS, 30-day hospital readmission) for the unit. The remainder of the abstract is the same.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A 10-bed dementia-focused medical unit was created in a large academic center in New York. The unit consisted of geographic cohorting, dementia care education for staff (e.g., de-escalation, redirection), and environmental modifications (e.g., common area). An interprofessional team conducted daily rounds that focused on the 4Ms (mobility, mentation, matters most, and medication management), and early discharge planning.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 165 hospitalized patients were admitted to the dementia-focused medical unit between July 1, 2024, and October 28, 2024. The mean age of patients was 84.7 years old (SD = 9.0); 67.9% (<i>n</i> = 112) had a documented history of dementia, of which 96.4% (<i>n</i> = 108) had at least moderate dementia (FAST stage 6A+). A comparison of BPSD management before and after transfer demonstrated a significant reduction in constant observation (30.9% vs. 0.0%, <i>p</i> &lt; .001), benzodiazepines (13.3% vs. 6.7%, <i>p</i> = .035), and “as-needed” antipsychotics (29.7% vs. 20.0%, <i>p</i> = .009). While as-needed antipsychotics decreased, there was an increase in scheduled antipsychotics (18.2% vs. 28.5%, <i>p</i> &lt; .001), indicating a shift from reactive to proactive medication management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>There is an urgent need to improve the management of BPSD in hospitalized older adults with ADRD. Dementia-focused medical units are an innovative strategy that requires further investigation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"21 10","pages":"1142-1148"},"PeriodicalIF":1.8,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793297","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":"Commensality as community rebuilding: A qualitative study of physician shared meals in a hospital setting","authors":"Zarqum Masood BA,&nbsp;Isabella Capelli,&nbsp;John Neri BS,&nbsp;Seran Schug PhD,&nbsp;Lawrence S. Weisberg MD, MACP, FASN","doi":"10.1002/jhm.70341","DOIUrl":"10.1002/jhm.70341","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Modern healthcare environments increasingly limit opportunities for physicians to build collegial relationships, contributing to feelings of isolation and disconnection. Commensality has been proposed as a way to restore relational infrastructure within clinical settings. While prior commensality programs have shown modest quantitative effects on burnout, less is known about how physicians experience these gatherings and the cultural functions they serve.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To explore how physicians participating in a hospital-based commensality program perceived its impact on community, connection, and culture.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a qualitative study of two cohorts of attending physicians participating in a 12-month hospital-based commensality program. Open-ended survey responses were analyzed using inductive thematic coding followed by an interpretive cultural analysis to situate emergent themes within broader frameworks of medical culture.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifty-six physicians participated across two program years. Six themes reflected patterns of connection and constraint: creating community; shared experiences as support; learning new perspectives; bridging professional boundaries; professional growth and mentorship; and structural barriers to connection. Average attendance was 75.5% in 2023–2024 and 59.7% in 2024–2025. Physicians described commensality as restorative and humanizing while noting time pressure and workload as key barriers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Physician commensality facilitated meaningful connection, cross-departmental relationships, and informal mentorship within the clinical workplace. These findings suggest that shared meals can support relational aspects of professional life that traditional institutional structures may erode.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"21 10","pages":"1149-1154"},"PeriodicalIF":1.8,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhm.70341","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147871006","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 highlights for the hospitalist: Management of elevated blood pressure","authors":"Youssef Saklawi MD,&nbsp;Bhargav Marthambadi MD,&nbsp;Adrian Umpierrez MD","doi":"10.1002/jhm.70393","DOIUrl":"10.1002/jhm.70393","url":null,"abstract":"","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"21 10","pages":"1162-1164"},"PeriodicalIF":1.8,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148371468","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":"Teaching time in short supply: Preferred strategies for allocating traditional teaching duties among academic hospitalists across six institutions","authors":"Catherine Callister MD,&nbsp;Michelle Brooks MD,&nbsp;Julia Caton MD, EdM,&nbsp;Angela Keniston PhD, MSPH,&nbsp;Sarah Mann MA,&nbsp;Shannon K. Martin MD MS,&nbsp;Lauren McBeth BA,&nbsp;Daniel McFarlane MD,&nbsp;Daniel Ricotta MD,&nbsp;Marisha Burden MD, MBA","doi":"10.1002/jhm.70301","DOIUrl":"10.1002/jhm.70301","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Clinical growth is outpacing educational growth at academic medical centers (AMCs) reducing traditional teaching opportunities, especially in rapidly expanding fields like hospital medicine. Despite these pressures, little guidance exists on how leadership should allocate limited teaching time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To explore academic hospitalists' preferences for allocating traditional teaching time (i.e., time on services with interns and residents) amid clinical expansion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional survey of academic adult hospitalists at six large AMCs across the United States with survey responses and free-response questions analyzed qualitatively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 572 hospitalists surveyed, 156 academic hospitalists responded (27%). Respondents averaged 8.9 years' experience and spent 25% of their clinical time on traditional teaching services. Teaching was a strong professional priority: 74% rated it very or extremely important when considering new job positions, and 66% preferred it as their primary service role. Most respondents (81%) preferred a merit-based model that rewards teaching skill development and learner engagement beyond clinical care. An external recognition-based model (i.e., teaching evaluations) was also supported (64%), although respondents raised concerns about bias. Equal distribution, seniority-based, and split-group models were less favored. Only 6% of respondents preferred working exclusively on direct care services (i.e., a service without learners).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In this exploratory sample, academic hospitalists highly value teaching but most spend little time on it. Hospitalists preferred a merit-based model, where faculty demonstrate their interest in and commitment to education by improving their teaching skills.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"21 10","pages":"1124-1133"},"PeriodicalIF":1.8,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446612","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":"Evaluating the impact of a newly established hospitalist medicine procedure service on length of stay and procedural outcomes: A retrospective propensity-matched analysis","authors":"Jeremy Gentile DO, FACP, SFHM,&nbsp;Saria Alazmeh MBBS,&nbsp;Kriti Soni MBBS,&nbsp;Tarek Alsibai MBBS,&nbsp;Felicia Wright MD,&nbsp;Alicia Stowe BS,&nbsp;Fergus Peacock MD","doi":"10.1002/jhm.70311","DOIUrl":"10.1002/jhm.70311","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Reliance on interventional radiology (IR) has been associated with delays in procedure completion and prolonged hospital length of stay (LOS). Hospitalist medicine procedure services (HMPS) have been proposed as a strategy to mitigate these inefficiencies, though outcomes of newly established programs composed of physicians with minimal ultrasound training remain underexplored.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the clinical and operational impact of a newly implemented HMPS composed of hospitalists with minimal prior procedural experience.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective propensity-matched cohort study at two urban hospitals in Grand Rapids, Michigan, including 920 admitted patients undergoing paracentesis or thoracentesis between April 2021 and May 2023. Patients were matched 1:1 between those treated by IR before HMPS implementation and those treated by HMPS postimplementation. Primary outcomes were LOS and time from procedure order to completion. Secondary outcomes included serious complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Following matching (<i>N</i> = 460 per group), HMPS was associated with a 14.8% reduction in LOS (<i>p</i> = 0.001) and a significant reduction in median time from order to completion compared with IR (794.5 vs. 2049.5 min, <i>p</i> &lt; 0.001). Complication rates were low and not significantly different between groups. Multivariable modeling identified order-to-completion time and antithrombotic use as independent predictors of LOS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>A newly created hospitalist procedure service, staffed by clinicians with limited procedural experience, significantly reduced LOS and procedural delays without compromising safety. Findings suggest that expanding procedural capacity and reducing time-to-procedure is an effective strategy to improve efficiency and throughput in hospitals where IR-based workflows create bottlenecks.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"21 10","pages":"1134-1141"},"PeriodicalIF":1.8,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhm.70311","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147577337","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":"My sister's ordeal: Even a “best hospital” may fail seniors with comorbidities","authors":"Stephen R. Weissman PhD","doi":"10.1002/jhm.70243","DOIUrl":"10.1002/jhm.70243","url":null,"abstract":"","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"21 10","pages":"1194-1196"},"PeriodicalIF":1.8,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145746359","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":"Letter to the Editor regarding “A randomized trial of I-SLEEP: A patient education and empowerment intervention on inpatient sleep duration and medical sleep disruptions”","authors":"Salman Khan MBBS,&nbsp;Sakeena Qamar MBBS","doi":"10.1002/jhm.70405","DOIUrl":"10.1002/jhm.70405","url":null,"abstract":"","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"21 10","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148611459","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":"Things We Do for No Reason™: Reporting every child who ingests tetrahydrocannabinol to child protective services","authors":"Mical Raz MD, PhD, MSc,&nbsp;Josh Gupta-Kagan JD,&nbsp;Andrea G. Asnes MD, MSW","doi":"10.1002/jhm.70334","DOIUrl":"10.1002/jhm.70334","url":null,"abstract":"<p>Legalization of recreational tetrahydrocannabinol (THC) containing products has led to increased hospital visits for accidental ingestions. In response, some hospitals require that care teams report all such ingestions to child protective services (CPS). Yet, ingestions of other household products, like cleaners with more capacity to harm children than THC, do not automatically trigger reporting. CPS investigations can cause harm. Instead of automatic reporting, hospitalists should consider whether the child's caregiver took reasonable steps to prevent unintentional ingestion and recognizes the dangers of child-friendly THC packaging. Hospital providers must explore the circumstances of each ingestion to determine which should trigger mandatory reporting.</p>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"21 10","pages":"1169-1172"},"PeriodicalIF":1.8,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793343","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":"Cost of pediatric gastroenteritis hospitalizations in the United States","authors":"Kenneth A. Michelson MD, MPH,&nbsp;Sriram Ramgopal MD","doi":"10.1002/jhm.70371","DOIUrl":"10.1002/jhm.70371","url":null,"abstract":"<p>Gastroenteritis is a common cause of pediatric hospitalization. We sought to determine the national costs of pediatric gastroenteritis hospitalizations. We conducted a cross-sectional study of children under 18 years old hospitalized for gastroenteritis using the Kids Inpatient Database of 2016, 2019, and 2022. The outcome was inflation-adjusted cost using cost-to-charge ratios. We determined hospitalization counts, summarized costs, and constructed a linear regression model evaluating demographic features associated with cost. There were 127,630 hospitalizations in the 3 years, of which 69,379 (54.4%) hospitalizations occurred among children under 3 years old. National costs were $285 million in 2016, $276 million in 2019, and $305 million in 2022. Median (interquartile range) per-hospitalization costs were $4029 (2452–6997). Compared with no complex chronic conditions, having 1, 2, or ≥3 was associated with 48.2% (95% CI 45.2, 51.3), 111% (95% CI 104, 119), and 194% (95% CI 179, 209) higher adjusted costs. Gastroenteritis generates substantial hospitalization costs.</p>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"21 10","pages":"1155-1159"},"PeriodicalIF":1.8,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148298143","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: Networking best practices for trainees and early career physicians","authors":"Caleb J. Murphy MD, MBA,&nbsp;Rachel M. Cyrus MD","doi":"10.1002/jhm.70383","DOIUrl":"10.1002/jhm.70383","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":"21 10","pages":"1160-1161"},"PeriodicalIF":1.8,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148354887","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}