Journal of hospital medicine最新文献

{"title":"Implementation of a same‐day, round‐trip interventional endoscopy service for rural and critical access hospital patients","authors":"Mithun R. Suresh, Najib Nassani, Luis A. Servin‐Abad, Deanne B. Walz, Paul R. Davis, Christopher W. Boelter, Tyler G. Goettl, Greg J. Beilman, Martin L. Freeman, Andrew P. J. Olson, Fateh Bazerbachi","doi":"10.1002/jhm.13333","DOIUrl":"https://doi.org/10.1002/jhm.13333","url":null,"abstract":"","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140826650","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":"Development of antibiotic metrics for hospitalists via multi-institutional modified Delphi survey","authors":"Allison Bond MD,&nbsp;Sandra Oreper MPH,&nbsp;Priya Prasad PhD,&nbsp;Emily Abdoler MD,&nbsp;Sarah Doernberg MD, MAS","doi":"10.1002/jhm.13377","DOIUrl":"10.1002/jhm.13377","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Closing the gap between evidence-supported antibiotic use and real-world prescribing among clinicians is vital for curbing excessive antibiotic use, which fosters antimicrobial resistance and exposes patients to antimicrobial side effects. Providing prescribing information via scorecard improves clinician adherence to quality metrics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>We aimed to delineate actionable, relevant antimicrobial prescribing metrics extractable from the electronic health record in an automated way.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>We used a modified Delphi consensus-building approach.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Settings and Participants</h3>\u0000 \u0000 <p>Our study entailed two iterations of an electronic survey disseminated to hospital medicine physicians at 10 academic medical centers nationwide.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcomes and Measures</h3>\u0000 \u0000 <p>Main outcomes comprised consensus metrics describing the quality of antibiotic prescribing to hospital medicine physicians.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-eight participants from 10 United States institutions completed the first survey version containing 38 measures. Sixteen respondents completed the second survey, which contained 37 metrics. Sixteen metrics, which were modified based on qualitative survey feedback, met criteria for inclusion in the final scorecard. Metrics considered most relevant by hospitalists focused on the appropriate de-escalation of antimicrobial therapy, selection of guideline-concordant antibiotics, and appropriate duration of treatment for common infectious syndromes. Next steps involve prioritization and implementation of these metrics based on quality gaps at our institution, focus groups exploring impressions of clinicians who receive a scorecard, and analysis of antibiotic prescribing patterns before and after metric implementation. Other institutions may be able to implement metrics from this scorecard based on their own quality gaps to provide hospitalists with automated feedback related to antibiotic prescribing.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhm.13377","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140826548","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":"Don't hold the metformin: Enhancing inpatient diabetes education to encourage best practices in a public hospital","authors":"Samantha F. Sanders MD, MBA,&nbsp;Michael S. Shen MD,&nbsp;Daniel Alaiev BBA,&nbsp;Brianna Knoll MD, MBA,&nbsp;Hyung J. Cho MD,&nbsp;Surafel Tsega MD,&nbsp;Mona Krouss MD,&nbsp;Ian Fagan MD,&nbsp;Amanda Klinger MD","doi":"10.1002/jhm.13269","DOIUrl":"10.1002/jhm.13269","url":null,"abstract":"","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140826827","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":"OslerCare: Modifying timing and delivery of feedback to impact resident lab ordering practices","authors":"Amit Pahwa MD,&nbsp;Aardra Rajendran MD,&nbsp;Stephan Castellanos MD,&nbsp;Linxuan Wu MS,&nbsp;Laura Prichett PhD, MHS,&nbsp;Shanshan Huang MBA,&nbsp;Sara Keller MD, MPH, MSHP,&nbsp;Michael Daniel MD,&nbsp;Leonard Feldman MD","doi":"10.1002/jhm.13330","DOIUrl":"10.1002/jhm.13330","url":null,"abstract":"","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140826549","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":"Improving culturally and linguistically appropriate care in hospital medicine","authors":"Adaugo Amobi","doi":"10.1002/jhm.13379","DOIUrl":"https://doi.org/10.1002/jhm.13379","url":null,"abstract":"","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140826751","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":"Design with purpose: User-centered processes for effective digital research tools","authors":"Conrad Gleber MD, MBA,&nbsp;Meghan Plate MA,&nbsp;Catherine Glatz MD","doi":"10.1002/jhm.13384","DOIUrl":"10.1002/jhm.13384","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":"2024-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140811470","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":"Antibiotic route and outcomes for children hospitalized with pneumonia","authors":"Jillian M. Cotter MD, MSCS,&nbsp;Mathew Hall PhD,&nbsp;Mark I. Neuman MD, MPH,&nbsp;Anne J. Blaschke MD, PhD,&nbsp;Thomas V. Brogan MD,&nbsp;Jonathan D. Cogen MD, MPH,&nbsp;Jeffrey S. Gerber MD, PhD,&nbsp;Adam L. Hersh MD, PhD,&nbsp;Susan C. Lipsett MD,&nbsp;Daniel J. Shapiro MD, MPH,&nbsp;Lilliam Ambroggio PhD, MPH","doi":"10.1002/jhm.13382","DOIUrl":"10.1002/jhm.13382","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Emerging evidence suggests that initial oral and intravenous (IV) antibiotics have similar efficacy in pediatric community-acquired pneumonia (CAP), but further data are needed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>We determined the association between hospital-level initial oral antibiotic rates and outcomes in pediatric CAP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Designs, Settings, and Participants</h3>\u0000 \u0000 <p>This retrospective cohort study included children hospitalized with CAP at 43 hospitals in the Pediatric Health Information System (2016–2022). Hospitals were grouped by whether initial antibiotics were given orally in a high, moderate, or low proportion of patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome and Measures</h3>\u0000 \u0000 <p>Regression models examined associations between high versus low oral-utilizing hospitals and length of stay (LOS, primary outcome), intensive care unit (ICU) transfers, escalated respiratory care, complicated CAP, cost, readmissions, and emergency department (ED) revisits.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Initial oral antibiotics were used in 16% (interquartile range: 10%–20%) of 30,207 encounters, ranging from 1% to 68% across hospitals. Comparing high versus low oral-utilizing hospitals (oral rate: 32% [27%–47%] and 10% [9%–11%], respectively), there were no differences in LOS, intensive care unit, complicated CAP, cost, or ED revisits. Escalated respiratory care occurred in 1.3% and 0.5% of high and low oral-utilizing hospitals, respectively (relative ratio [RR]: 2.96 [1.12, 7.81]), and readmissions occurred in 1.5% and 0.8% (RR: 1.68 [1.31, 2.17]). Initial oral antibiotics varied across hospitals without a difference in LOS. While high oral-utilizing hospitals had higher escalated respiratory care and readmission rates, these were rare, the clinical significance of these small differences is uncertain, and there were no differences in other clinically relevant outcomes. This suggests some children may benefit from initial IV antibiotics, but most would probably do well with oral antibiotics.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140811473","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":"Conversations on reasoning: Large language models in diagnosis","authors":"Daniel Restrepo MD,&nbsp;Adam Rodman MD, MPH,&nbsp;Raja-Elie Abdulnour MD","doi":"10.1002/jhm.13378","DOIUrl":"10.1002/jhm.13378","url":null,"abstract":"","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140811981","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":"A critical juncture in antiracism education: From classroom to bedside","authors":"Gerald H. Stein MD, FACP,&nbsp;Priya S. Garg MD","doi":"10.1002/jhm.13381","DOIUrl":"10.1002/jhm.13381","url":null,"abstract":"","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140811484","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":"Remaining diagnostic and treatment uncertainties for urinary tract infections in children with genitourinary anomalies","authors":"Catherine S. Forster MD, MS,&nbsp;Sowdhamini S. Wallace DO, MS","doi":"10.1002/jhm.13383","DOIUrl":"10.1002/jhm.13383","url":null,"abstract":"<p>\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure>\u0000 </p>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140811471","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}