Journal of hospital medicine最新文献

{"title":"Designing better research posters: A primer and recommendations","authors":"Michelle Kiger MD, PhD,&nbsp;Audrea Burns PhD,&nbsp;Jon McGreevy MD, MSPH,&nbsp;Elizabeth E. Halvorson MD, MS,&nbsp;Su-Ting T. Li MD, MPH,&nbsp;Rebecca Hart MD,&nbsp;Adin Nelson MD, MHPE","doi":"10.1002/jhm.70354","DOIUrl":"10.1002/jhm.70354","url":null,"abstract":"<p>Poster presentations play a vital role in the dissemination of scholarly work and provide key opportunities for networking and professional growth. However, suboptimal poster design often hinders this transfer of knowledge and opportunity for meaningful engagement with peers. Drawing from principles of visual design and the increasing prominence of the “Better Poster” format, this Perspectives article presents practical suggestions for designing posters that hone messaging and promote interaction with viewers. We recommend a shift away from thinking of posters as a medium to present every detail of one's scientific work and toward reimagining posters as a tool to promote scholarly dialogue.</p>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"21 10","pages":"1173-1178"},"PeriodicalIF":1.8,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148019651","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":"Patients might distrust honest doctors","authors":"Byron Hyde FRAS, FRSA, FRAI, MRi","doi":"10.1002/jhm.70416","DOIUrl":"10.1002/jhm.70416","url":null,"abstract":"<p>Evidence-based medicine revolutionized clinical practice, bringing expectations that physician–patient communication should be similarly transparent about scientific evidence and uncertainty. However, the replication crisis has revealed significant weaknesses in biomedical research. This creates something of a paradox: honest disclosure of uncertainty is ethically obligatory but often breeds patient distrust rather than confidence. This commentary argues that trust in medicine requires systemic educational reform to improve public scientific literacy, and offers some practical communicative strategies physicians can employ immediately, including deliberate language hedging and setting realistic expectations. Critically, such approaches only succeed when grounded in compassionate physician–patient relationships. In an era of increasing commercialization and artificial intelligence in medicine, preserving this fundamental relationship is essential for maintaining public trust in healthcare.</p>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"21 10","pages":"1191-1193"},"PeriodicalIF":1.8,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhm.70416","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148611433","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 progress note: De-labeling penicillin allergies","authors":"Carter Groch PharmD,&nbsp;Stephy George PharmD, BCCCP,&nbsp;Daniel Giddings PharmD, BCEMP,&nbsp;Andrew C. Faust PharmD, BCCCP,&nbsp;Matthew Feldman MD","doi":"10.1002/jhm.70254","DOIUrl":"10.1002/jhm.70254","url":null,"abstract":"<p>About 15% of hospitalized adults report a penicillin allergy. Of these patients, approximately 90% tolerate penicillin when re-challenged, potentially due to misattribution of nonallergic rash as hypersensitivity or outgrowing the index reaction. Patients with penicillin allergy labels are more likely to receive less effective therapy, develop antibiotic resistance, incur higher healthcare costs, and have poorer outcomes. Although cephalosporins are recommended for most patients with a reported or confirmed penicillin allergy, de-labeling and removing penicillin allergies represent an impactful antimicrobial stewardship activity. A recently developed scoring tool (PEN-FAST) identifies those at low risk for a recurrent reaction and is less cumbersome than traditional testing methods.</p>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"21 10","pages":"1165-1168"},"PeriodicalIF":1.8,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145919297","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":"Game film","authors":"Samir S. Shah MD, MSCE","doi":"10.1002/jhm.70377","DOIUrl":"10.1002/jhm.70377","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":"1105-1106"},"PeriodicalIF":1.8,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhm.70377","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148311141","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":"Applying the model for improvement to enhance recruitment and retention in a discharge intervention randomized controlled trial","authors":"Calise Curry BA,&nbsp;Skyler Patterson BA,&nbsp;Allison M. Wiedeman BS, CCRP,&nbsp;Jasmine Parker BS, CCRP,&nbsp;Elisabeth Peskin MS,&nbsp;Kerry Tepe MHI,&nbsp;Dianna Bosse BA,&nbsp;Ramya Sri Lakshmi Adapa MPH,&nbsp;Patrick W. Brady MD, MSc,&nbsp;Katherine Auger MD, MSc,&nbsp;Hadley Sauers-Ford MPH, CCRP,&nbsp;the Garnering Effective Telehealth 2 Help Optimize Multidisciplinary Team Engagement (GET2HOME) Study Team","doi":"10.1002/jhm.70296","DOIUrl":"10.1002/jhm.70296","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>High recruitment, intervention fidelity, and retention rates in clinical trials are necessary to ensure generalizable conclusions; quality improvement (QI) methods can be used to track and improve these rates. The Garnering Effective Telehealth to Help Optimize Multidisciplinary Team Engagement (GET2HOME) study is a randomized controlled trial comparing a discharge intervention bundle to standard care for patients with medical complexity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>We sought to achieve a mean enrollment rate of 55% and intervention fidelity rate of 90% for each intervention. Additionally, we aimed to achieve survey completion rates (retention) of 90% for the 7- and 30-day surveys, and 75% for the 60- and 90-day surveys.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Interventions</h3>\u0000 \u0000 <p>Using the Model for Improvement, we frequently reviewed data with the multidisciplinary study team and implemented tests of change. Tests of change sought to improve the research team's roles and responsibilities, enhance study visibility, and ensure consistent communication among clinical care teams and research staff.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During the study period, we improved the mean enrollment rate (53%–72%). Fidelity rates also improved across the three interventions: predischarge huddle (69%–85%), postdischarge huddle (65%–90%), and discharge task tracker completion (64%–100%). Survey retention at the end of the study was 90% at 7- and 60-days, 88% at 30-days, and 92% at 90-days.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We increased enrollment and intervention fidelity rates while maintaining high retention rates in a randomized trial by improving enrollment processes and survey completion methods. QI methods can facilitate optimized trial enrollment and intervention fidelity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"21 10","pages":"1107-1114"},"PeriodicalIF":1.8,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhm.70296","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147391983","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":"A conundrum in clinical practice: Clinical documentation queries, more money, or more problems? A qualitative survey of hospitalists and surgeons in a safety-net academic medical center","authors":"Sansrita Nepal MD, MBA, FACP,&nbsp;Rebecca Allyn MD,&nbsp;Angela Keniston PhD, MSPH,&nbsp;Read Pierce MD","doi":"10.1002/jhm.70398","DOIUrl":"10.1002/jhm.70398","url":null,"abstract":"<p>As health systems increasingly rely on Clinical Documentation Integrity (CDI) programs to sustain revenue and quality performance, the physician experience of CDI remains insufficiently understood. In this qualitative survey of hospitalists and surgeons at a safety-net academic medical center, physicians acknowledged the importance of CDI for accurate billing and risk adjustment but frequently described queries as disruptive to workflow, emotionally taxing, and poorly aligned with clinical practice. Many respondents identified physician advisors as trusted system leaders who were perceived to improve communication and engagement. These findings highlight the importance of designing CDI processes that are timely, clinically relevant, and better integrated into physician workflows to support both documentation quality and physician well-being.</p>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"21 10","pages":"1186-1190"},"PeriodicalIF":1.8,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148414473","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":"End-of-life ethics for individuals with intellectual and developmental disabilities: Procedural safeguards, state oversight, and respect for persons","authors":"Catherine Glatz MD,&nbsp;Nicholas R. Mercado DrPH, MS","doi":"10.1002/jhm.70409","DOIUrl":"10.1002/jhm.70409","url":null,"abstract":"<p>New York State law establishes oversight during end-of-life care for individuals with Intellectual and Developmental Disabilities to avoid any additional mistreatment of people with disabilities. Unfortunately, these safeguards can lead to increases in suffering and loss of autonomy. The lessons learned in caring for these patients are generalizable, and following the steps outlined in this article can help ensure ethical end-of-life care for all of our patients.</p>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"21 10","pages":"1183-1185"},"PeriodicalIF":1.8,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148611473","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 5R's of large language model-assisted diagnosis: A practical framework for hospitalists","authors":"Peter Barish MD,&nbsp;Andrew D. Auerbach MD, MPH,&nbsp;Sumant R. Ranji MD","doi":"10.1002/jhm.70390","DOIUrl":"10.1002/jhm.70390","url":null,"abstract":"<p>Diagnostic error remains a major patient safety challenge in hospital medicine. Large language models (LLMs) are increasingly used by clinicians to aid in diagnosis, yet most lack a structured approach for doing so safely and effectively. In this piece, we propose a practical, clinician-centered framework for LLM-assisted diagnosis. The 5R's Framework promotes a human-in-the-loop approach that harnesses LLMs to reduce diagnostic error while preserving critical reasoning skills.</p>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"21 10","pages":"1179-1182"},"PeriodicalIF":1.8,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhm.70390","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148378795","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":"Patient and hospitalization differences in incarcerated versus nonincarcerated men: Insights from a 10-year cohort study","authors":"Farah Acher Kaiksow MD, MPP,&nbsp;Amir Forati PhD,&nbsp;Kristin Merss PhD, RN,&nbsp;Karen Reece PhD,&nbsp;Marguerite Burns PhD,&nbsp;Eduard Eric Vasilevskis MD, MPH","doi":"10.1002/jhm.70297","DOIUrl":"10.1002/jhm.70297","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The incarcerated population in the United States is underserved and aging rapidly; there is a dearth of information regarding their health, including hospital care. Epidemiological information is crucial to guide policymakers’ planning. This analysis provides comparison data on the admissions of incarcerated and nonincarcerated patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Identify differences in inpatient care between incarcerated and nonincarcerated patients by comparing 10 years of data at an academic medical center that serves as the largest single provider of hospital care for the state's Department of Corrections.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Ten-year cohort study comparing all admissions of incarcerated males (<i>n</i> = 4525) to a matched cohort of nonincarcerated (<i>n</i> = 13,575) at an academic medical center serving as the largest provider of hospital care for the state's Department of Corrections. We included patients ≥18 years old and admitted to the hospital while in custody of the Department of Corrections between January 1, 2010, and December 31, 2019. Primary outcomes were patient characteristics, including demographics and comorbidities, and hospitalization characteristics, including length of stay and diagnosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Compared with the nonincarcerated cohort, the incarcerated patients were more likely to be Black (33.4% vs. 6.6%, <i>p</i> &lt; 0.05), Hispanic/Latine (6.1% vs. 2.1%, <i>p</i> &lt; 0.001), admitted to a general medicine service (33.4% vs. 22.6%, <i>p</i> &lt; 0.01), and less likely to be admitted to neurological/psychiatric services (5.2% vs. 9.1%, <i>p</i> &lt; 0.01). The incarcerated cohort had a higher mean Charlson Comorbidity Index (3.83 vs. 3.65, <i>p</i> &lt; 0.001), with statistically significant differences observed among patients aged 40–59.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In this cohort study, there were differences in patient and hospitalization characteristics between incarcerated and nonincarcerated patients that may have clinical implications. Policymakers and researchers must work toward improving both the health and health care of this marginalized population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"21 10","pages":"1115-1123"},"PeriodicalIF":1.8,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13051773/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147313637","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":"A mixed methods assessment of an electronic health record-embedded intervention with supportive education and outreach to increase in-hospital opioid use disorder treatment initiation","authors":"Susan L. Calcaterra MD, MPH, MS,&nbsp;Steven Lockhart MPH,&nbsp;Eric Grimm MS,&nbsp;Jodi Summers Holtrop PhD,&nbsp;Angela Keniston PhD, MSPH,&nbsp;Jason A. Hoppe DO,&nbsp;Jacob A. Lebin MD,&nbsp;Ingrid A. Binswanger MD, MPH","doi":"10.1002/jhm.70289","DOIUrl":"10.1002/jhm.70289","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In-hospital opioid use disorder medication (MOUD) initiation remains low despite its effectiveness to reduce mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Assess whether a non-interruptive electronic health record (EHR)-embedded intervention with supportive education and outreach increased in-hospital MOUD initiation without disrupting clinical workflow.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this mixed-methods study across 12 hospitals, we conducted an interrupted time series analysis of hospitalizations involving OUD and/or opioid poisoning. We condcuted a directed content analysis of interviews from 60 hospital-based clinicians, social workers, nurses, and pharmacists. The intervention involved MOUD initiation orders, discharge naloxone orders, and access to local OUD treatment resources. Strategies for adoption included clinican and nurse OUD education and required nurse trainings for Clinical Opiate Withdrawal Scale (COWS) assessments. Outcome measures included monthly changes of inpatient methadone administration ≥30 mg, discharge buprenorphine and naloxone prescriptions, and COWS assessments. Emergent themes from qualitative data provided context and possible explanations for quantitative results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>From January 2021 to September 2024, there were 450,790 hospitalizations; 3.1% (<i>n</i> = 13,902) involved OUD/opioid poisoning; and, of these, 19.8% (<i>n</i> = 2750) involved MOUD. Between the pre- and post-intervention periods, there was no significant change in monthly methadone administrations or discharge naloxone prescriptions. Monthly buprenorphine discharge prescriptions decreased from 10.5% to 8.2% (slope decrease: −0.35, <i>p</i> &lt; .001) in the post-implementation period. In the immediate post-intervention period, monthly COWS documentation increased from 7.3% to 14.5% (level change: 6.87; <i>p</i> &lt; .001). Qualitative findings reflected a lack of intervention awareness due to limited leadership communication across hospitals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A non-interruptive EHR-embedded intervention with supportive education and outreach was insufficient to increase MOUD initiation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"21 9","pages":"982-994"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146230259","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}