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":"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":"Bedside rounds: Not where but why","authors":"Shannon K. Martin MD, MS, H. Barrett Fromme MD, MHPE, Claire Hailey MD","doi":"10.1002/jhm.13504","DOIUrl":"10.1002/jhm.13504","url":null,"abstract":"","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 2","pages":"205-206"},"PeriodicalIF":2.4,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142142198","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":"Age has an independent association with total cost of care in adults admitted to pediatric hospitals","authors":"Sean Robert Dornbush DO, MBA,&nbsp;Michael Scott Kleinman MD,&nbsp;Elisha McCoy MD,&nbsp;Jeffrey Craig Winer MD, MA, MSHS,&nbsp;Anna Quantrille Allen MD","doi":"10.1002/jhm.13501","DOIUrl":"10.1002/jhm.13501","url":null,"abstract":"<p>Previous studies in adults admitted to pediatric hospitals primarily investigated associations between complex chronic condition characteristics and patient outcomes. Our study explored the association of age with length of stay (LOS) and total cost in these adults, accounting for other patient factors. Using the Pediatric Health Information System, we included 1,215,736 patient encounters from 2021 to 2022. Unadjusted and adjusted analyses were performed using bivariable and multivariable log-linear regression. There was a significant positive association between age and total cost, with adults 18–20 years having 13% higher total cost (95% confidence interval [CI]: 12%–15%), 21–25 years with 25% higher total cost (95% CI: 22%–29%), and 25–99 years having 72% higher total cost (95% CI: 66%–79%) than 1–17 years. Our findings suggest expanding upon the existing status quo to identify the most appropriate environment to care for this unique and growing population, especially given the anticipated reduction in pediatric beds and subspecialty expertise.</p>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 2","pages":"167-171"},"PeriodicalIF":2.4,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142121358","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":"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":"Using patient preferences to shift healthcare culture: Patient-centered clinical decision support as a tool to aid in hospital at home participation","authors":"Courtney Sump MD, MSc,&nbsp;Matthew J. Molloy MD, MPH,&nbsp;Shivani K. Jindal MD, MPH","doi":"10.1002/jhm.13497","DOIUrl":"10.1002/jhm.13497","url":null,"abstract":"","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 1","pages":"96-97"},"PeriodicalIF":2.4,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142116579","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":"Elevated care at home: An alternative to traditional levels of care","authors":"Emily R. Downing MD,&nbsp;Sandra R. Castro-Pearson MS, PhD,&nbsp;Abbey C. Sidebottom MPH, PhD,&nbsp;Timothy D. Sielaff MD, PhD","doi":"10.1002/jhm.13496","DOIUrl":"10.1002/jhm.13496","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Elevated care at home (ECH) is a novel in-home care model supporting early hospital discharge and providing an alternative to institutional postacute care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study compares patient characteristics, mortality, and readmission outcomes of hospitalized patients who transitioned to ECH to patients who transitioned to skilled nursing facilities (SNF) and skilled home health services (SHH).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective study of patients between May 2020 and January 2022 transitioned from the hospital to ECH, SNF, or SHH. The analysis compared patient characteristics, 30-day mortality, and readmission stratified by COVID-19 infection status. Outcomes were assessed using logistic regression after propensity score matching.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 32,132 eligible patients, 6.3% were transitioned to ECH, 39.7% to SNF, and 54.0% to SHH. After matching, all baseline characteristics except for age were balanced between groups. Postmatch and adjusting for age differences, ECH patients experienced lower risk of death compared to SNF (adjusted odds ratio [AOR] 0.61, 95% confidence interval [CI] 0.40, 0.92) and similar risk of hospital readmission compared to SNF patients (AOR 1.08, 95% CI 0.89, 1.31) and SHH patients (AOR 0.96, 95% CI 0.80, 1.16). COVID-19-negative ECH patients compared to matched SNF patients were more likely to readmit (AOR 1.30, 95% CI 1.02, 1.65) with no significant difference in risk of mortality (AOR 0.72, 95% CI 0.44, 1.18).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>ECH had similar or improved outcomes relative to SNF and SHH. COVID-19-negative ECH patients experienced higher readmissions relative to SNF. ECH supported patients to return home from the hospital and provided an alternative to an institutional postacute setting.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 2","pages":"135-145"},"PeriodicalIF":2.4,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142116578","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":"Inpatients' understanding of the hospitalist role and common medical terminology","authors":"Nicole Curatola MD,&nbsp;Nathan Juergens MD, MPH,&nbsp;Mariam K. Atkinson PhD,&nbsp;Jeffrey L. Schnipper MD, MPH,&nbsp;Rachel Weiss MD,&nbsp;Erin Y. Cohen MD,&nbsp;Jenica Cimino BA,&nbsp;Clara To MSPH,&nbsp;Elizabeth A. Bambury BS,&nbsp;Ebrahim Barkoudah MD, MPH,&nbsp;Sampathkumar Mani MD,&nbsp;Hassan Khalil MD,&nbsp;Rosa Mora BS,&nbsp;Johsias Maru BA,&nbsp;James D. Harrison MPH, PhD","doi":"10.1002/jhm.13492","DOIUrl":"10.1002/jhm.13492","url":null,"abstract":"<p>Many patients are unable to identify members of their hospital care team and experience confusion regarding some medical terminology used during hospitalization, including descriptions of the structure of their inpatient care team. This cross-sectional study sought to (1) examine inpatients' understanding of the role of a hospitalist and (2) assess inpatients' familiarity with other medical terminology commonly used in the hospital. We surveyed 172 patients admitted to the hospital medicine service at two academic medical centers. We found that almost half (47%) of respondents were unfamiliar with the term and/or role of a hospitalist, while the remaining patients had varied understanding of the role. Several other medical terms were frequently misunderstood (such as “NPO,” “PA,” and “Attending”). Ongoing efforts are needed to improve communication to ensure that hospitalized patients understand the hospitalist's role and the medical terms shared with them.</p>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 1","pages":"51-55"},"PeriodicalIF":2.4,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142094340","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: Pro-motility agents: Mobilizing mentors to make progress","authors":"V. Ram Krishnamoorthi MD, MPH,&nbsp;Shannon K. Martin MD, MS","doi":"10.1002/jhm.13495","DOIUrl":"10.1002/jhm.13495","url":null,"abstract":"","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 1","pages":"56-57"},"PeriodicalIF":2.4,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142038068","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}