Journal of hospital medicine最新文献

{"title":"Time to evolve? Modernizing the hospital ethics committee","authors":"Julie R. Bloom MD, Kunal K. Sindhu MD","doi":"10.1002/jhm.70074","DOIUrl":"10.1002/jhm.70074","url":null,"abstract":"","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 10","pages":"1124-1126"},"PeriodicalIF":2.3,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144083000","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":"Interventions to reduce readmissions after pneumonia hospitalization: A systematic review and meta-analysis","authors":"Sarah A. Phillips BA,&nbsp;Julie D. Sill PhD,&nbsp;Rehan Qayyum MD, MHS","doi":"10.1002/jhm.70073","DOIUrl":"10.1002/jhm.70073","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Preventable hospital readmissions, reflecting suboptimal healthcare quality and increased costs, highlight the need for evidence to shape healthcare delivery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This systematic review assesses interventions to reduce readmissions following pneumonia-related hospitalizations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>PubMed, Cochrane Library, and CINAHL were searched from inception to May 29, 2024. English language peer-reviewed studies examining interventions to reduce readmissions after pneumonia hospitalization were selected. Two authors independently extracted data, assessed risk of bias, and evaluated certainty of evidence using standardized assessment tools. When possible, study results were pooled using random-effects models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 601 articles initially identified, 15 studies met inclusion criteria. Eight interventions were evaluated from eight retrospective cohort studies, five randomized controlled trials, and two pre-post trials. Hospital-based skilled nursing facilities, patient education, early postdischarge follow-up, nutrition supplementation, and a high physician-to-bed ratio were linked to reduced readmissions. Early mobilization also showed a significant reduction in readmissions (pooled odds ratio = 0.84, 95% confidence interval [CI]: 0.75, 0.95; <i>p</i> = .005). Hospital participation in Accountable Care Organizations did not affect readmissions, and pharmacist-involved discharge similarly found no significant impact (pooled odds ratio = 0.66, 95% CI: 0.44, 1.01; <i>p</i> = .06). Risk of bias was high across most studies due to inadequate controlling for confounding variables.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Certainty of evidence was high for early mobilization, low for hospital-based skilled nursing facilities, and very low for pharmacist-involved discharge processes. Small sample size and single-center intervention implementation limited study generalizability. Randomized controlled trials are needed to determine the efficacy of interventions for reducing readmissions after pneumonia hospitalization.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 9","pages":"988-997"},"PeriodicalIF":2.3,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://shmpublications.onlinelibrary.wiley.com/doi/epdf/10.1002/jhm.70073","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082998","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":"Improving promptness and quality of hospitalist-consultant interactions at an academic teaching hospital","authors":"John M. Cunningham MD, FHM, FACP,&nbsp;Robert Leverence MD, FACP,&nbsp;Nico Gotera DO, MPH,&nbsp;Phillip A. Minor MS,&nbsp;Nathan Sevigny BS,&nbsp;Ankur Segon MD, MPH, MEd, FACP, SFHM","doi":"10.1002/jhm.70047","DOIUrl":"10.1002/jhm.70047","url":null,"abstract":"<p>Communication between consulting and consultant services is essential to provide high-value care. We implemented a collaborative project between hospital medicine (HM), emergency medicine (EM), and departmental leadership of the major consulting services to provide feedback regarding consultant communication, promptness, and follow-up planning. We conducted pre- and postintervention surveys of HM and EM clinicians and measured the mean turnaround time (TAT) from consult order to consultant note completion. Perceptions of consultant promptness and follow-up communication improved postintervention. Mean TAT was significantly reduced postintervention (1098 vs. 1011 min, <i>p</i> = .002, confidence interval [CI]: 30.7–143.3). A collaborative approach using interdepartmental feedback improved perceptions of the quality of interactions with consulting services.</p>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 8","pages":"903-907"},"PeriodicalIF":2.3,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhm.70047","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000993","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":"Point-counterpoint: What is the best strategy for developing generative AI for hospital medicine?","authors":"Hannah Kerman MD,&nbsp;Andre Kumar MD, MAEd,&nbsp;Byron Crowe MD,&nbsp;William Collins MD","doi":"10.1002/jhm.70070","DOIUrl":"10.1002/jhm.70070","url":null,"abstract":"<p>Generative Artificial Intelligence (Gen AI) shows significant promise as a technology that could improve healthcare delivery, but its implementation will be influenced by the spheres in which it is studied and the limited resources of hospitals. The Point authors argue that we should focus on is the cognitive abilities of GenAI or we risk being left out of a technological leap that will change the way doctors practice. The Counterpoint argues that we should focus on using GenAI to ease system burdens and address workflow issues, focusing our efforts on fixing the problems that would improve doctors’ quality of life and increase time spent with patients.</p>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 8","pages":"893-898"},"PeriodicalIF":2.3,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016040","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":"Intervention for hospitalized people with chronic pain and elevated risk for opioid-related harm: A pilot randomized controlled trial","authors":"Melissa B. Weimer DO, MCR,&nbsp;Michele J. Buonora MD, MS, MHS,&nbsp;Alexandra M. Hajduk PhD, MPH,&nbsp;Adam L. Ackerman MD,&nbsp;Krishna R. Daggula MS,&nbsp;William C. Becker MD,&nbsp;Sarwat I. Chaudhry MD,&nbsp;David A. Fiellin MD","doi":"10.1002/jhm.70066","DOIUrl":"10.1002/jhm.70066","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The management of analgesia in people hospitalized with chronic pain and elevated risk for opioid-related harm is challenging. While opioid stewardship programs could provide guidance, their feasibility in this population has not been examined.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To develop a case identification tool and evaluate the feasibility of an electronic medical record (EMR)-delivered opioid stewardship and pain intervention among hospitalized people with chronic pain and elevated risk for opioid-related harm.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>After developing and evaluating the operating characteristics of a case identification tool to identify people with chronic pain and elevated risk for opioid-related harm, hospitalized adults with chronic pain and elevated risk for opioid-related harm were randomized to an EMR-delivered opioid stewardship and pain intervention versus usual care. Primary outcomes were feasibility-based. Exploratory outcomes were pain-related clinical outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The case identification tool had a sensitivity of 88.9% and a specificity of 95.7%. The trial recruited 52/97 (54%) of potential participants who completed 52/52 (100%) potential assessments and of whom 45/52 (87%) were retained in the study at 4 weeks, demonstrating feasibility. On average, both treatment arms received 56% of the recommended guideline-concordant care and there was no significant difference in opioid and pain-related care in the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>It is both feasible to develop an EMR-based tool to prospectively identify hospitalized people with chronic pain and elevated risk for opioid-related harm as well as recruit these individuals to an EMR-delivered opioid stewardship and pain intervention. Additional strategies to support the provision of guideline-concordant care may be warranted.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 10","pages":"1079-1086"},"PeriodicalIF":2.3,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002002","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":"SHM Converge 2025 Abstracts","authors":"","doi":"10.1002/jhm.70025","DOIUrl":"10.1002/jhm.70025","url":null,"abstract":"","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 S1","pages":"S1-S1051"},"PeriodicalIF":2.3,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143861603","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™: Avoiding intravenous iodinated contrast material in patients with acute kidney injury or chronic kidney disease","authors":"Caroline Coleman MD,&nbsp;Meredith Trubitt MD, MPH,&nbsp;Joel Topf MD, FACP,&nbsp;Monee Amin MD","doi":"10.1002/jhm.70063","DOIUrl":"10.1002/jhm.70063","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":"20 10","pages":"1108-1111"},"PeriodicalIF":2.3,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061338","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":"Hospitalization as a “reachable moment”: Adding osteoporosis management to acute care processes","authors":"Ali Yazdanyar DO, PhD, MMM,&nbsp;Farah Acher Kaiksow MD, MPP, FHM","doi":"10.1002/jhm.70065","DOIUrl":"10.1002/jhm.70065","url":null,"abstract":"","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 9","pages":"1028-1029"},"PeriodicalIF":2.3,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015407","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":"Climbable mountain","authors":"Nike Izmaylov MD,&nbsp;Michelle Izmaylov MD","doi":"10.1002/jhm.70064","DOIUrl":"10.1002/jhm.70064","url":null,"abstract":"&lt;p&gt;There is a traveler on the road. The traveler has been through a long and difficult journey, and now the traveler arrives at a mountain stretching high up. Theoretically, the traveler could go around the mountain, but this would set the traveler back a few days. The traveler has companions, and the efficiency of the journey is of utmost significance to them.&lt;/p&gt;&lt;p&gt;The traveler decides to scale the mountain.&lt;/p&gt;&lt;p&gt;Climbing the mountain is treacherous and perilous. The traveler confronts many dangers, the crumble of rock beneath feet, and the peril of a narrow path along a cliff.&lt;/p&gt;&lt;p&gt;But the traveler gets to the summit.&lt;/p&gt;&lt;p&gt;The traveler considers the difficult journey that led here. They drop their backpack to the ground, the pain from the straps felt in their shoulders, the pain in their muscles was a reminder of the difficulty of the climb.&lt;/p&gt;&lt;p&gt;But the mountain &lt;i&gt;was&lt;/i&gt; climbable. This challenge, though difficult, &lt;i&gt;was&lt;/i&gt; surmountable.&lt;/p&gt;&lt;p&gt;Then, the traveler looks toward the road ahead. What they find: many more mountains.&lt;/p&gt;&lt;p&gt;The traveler hesitates. The road is much more challenging than anticipated.&lt;/p&gt;&lt;p&gt;But the traveler's companions are shocked by this hesitation. The traveler just demonstrated the capability to climb a challenging mountain. Why hesitate at the prospect of climbing all the other mountains?&lt;/p&gt;&lt;p&gt;The traveler considers how many supplies this climb demanded, how much effort, the exhaustion felt now at the summit.&lt;/p&gt;&lt;p&gt;The companions respond: but you &lt;i&gt;did&lt;/i&gt; climb this mountain. This mountain &lt;i&gt;was&lt;/i&gt; surmountable. Each of these other mountains is &lt;i&gt;also&lt;/i&gt; surmountable. There is truth to this. &lt;i&gt;Each&lt;/i&gt; mountain is surmountable. But are &lt;i&gt;all&lt;/i&gt; mountains, consecutively, surmountable?&lt;/p&gt;&lt;p&gt;The traveler recognizes there is an alternative: to go around the other mountains, to have a journey with less challenge and more enjoyment. But the companions are expecting the traveler to pursue the most efficient route.&lt;/p&gt;&lt;p&gt;The traveler continues to climb the mountains instead of going around.&lt;/p&gt;&lt;p&gt;Each mountain seems more difficult. There is perhaps no difference from the perspective of objective terms, but the traveler feels the mounting challenge of each step. There's a fall, then a strain, each injury increasing the possibility of another error during the climb.&lt;/p&gt;&lt;p&gt;Then, the traveler reaches their limit. The injuries they have accumulated have rendered them not capable of climbing any more mountains, at least not without a significant opportunity to recover.&lt;/p&gt;&lt;p&gt;But there is a mountain ahead. The traveler recognizes that this is the mountain they must go around. They are too exhausted to climb. There is no alternative.&lt;/p&gt;&lt;p&gt;When the traveler approaches, they recognize there is no manner in which to go around this mountain. There are even more difficult mountains flanking this mountain, no other path but to climb. There is no alternative.&lt;/p&gt;&lt;p&gt;The traveler recognizes that, perhaps if they had not","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 10","pages":"1122-1123"},"PeriodicalIF":2.3,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://shmpublications.onlinelibrary.wiley.com/doi/epdf/10.1002/jhm.70064","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012267","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: A TEAM sport: Dual-physician couples","authors":"Christopher Wynkoop MD, MS, FACP,&nbsp;Ann E. Perrin MD, MPH, FACP, FHM","doi":"10.1002/jhm.70057","DOIUrl":"10.1002/jhm.70057","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":"20 8","pages":"858-859"},"PeriodicalIF":2.3,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061022","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}