Journal of hospital medicine最新文献

{"title":"Yes, and: Leveraging peer-led professional development support as a bridge between the status quo and senior faculty-led efforts","authors":"Annie Massart MD,&nbsp;Mary Ann Kirkconnell Hall MPH,&nbsp;Manpreet Malik MD","doi":"10.1002/jhm.70350","DOIUrl":"10.1002/jhm.70350","url":null,"abstract":"<p>Hospital medicine is a young and rapidly growing specialty. As such, most hospital medicine groups have many junior faculty with proportionately few senior faculty to support their career growth through traditional dyadic mentorship. As an alternative that may be more feasible in practice, we propose the development and expansion of peer-led efforts, in tandem with training efforts from organizations such as the Society of Hospital Medicine. In addition to logistical advantages, these approaches bring numerous benefits compared with traditional mentoring: potential for greater psychological safety and reciprocal social support, and opportunities to build career-long relationships. We believe that there are substantial opportunities for innovation and for scholarship to evaluate the impact and outcomes of peer mentorship efforts. We suggest several avenues for advancing peer mentorship within hospital medicine at the national, regional, local, and institutional levels.</p>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"21 9","pages":"1055-1058"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147876976","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 role of acknowledgment in rebuilding trust","authors":"Smrithi Mahadevan MPA,&nbsp;Caroline Shore MPA,&nbsp;Kate B. Hilton JD, MTS,&nbsp;Lindsay Martin MSPH,&nbsp;Lauren A. Taylor PhD, MDiv","doi":"10.1002/jhm.70415","DOIUrl":"10.1002/jhm.70415","url":null,"abstract":"<p>In response to declining public trust in healthcare institutions, the Institute for Healthcare Improvement (IHI) and the American Board of Internal Medicine Foundation (ABIMF) began a collaborative to identify changes that healthcare organizations could make to regain the trust of their care teams and communities. Using IHI and ABIMF's theory of change as a guide, six healthcare organizations tested this framework on-site and shared lessons learned, identifying the critical role of not just acknowledging past breaches but also demonstrating accountability as crucial steps to strengthening trust. The experiences of three healthcare organizations are summarized here.</p>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"21 9","pages":"1067-1070"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhm.70415","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148665343","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: Measles","authors":"Anne Ewing MD,&nbsp;Catherine Hahn MD,&nbsp;Adam J. Ratner MD","doi":"10.1002/jhm.70250","DOIUrl":"10.1002/jhm.70250","url":null,"abstract":"<p>Many medical providers in the United States have never seen a case of measles. This situation will likely change if decreases in childhood vaccination rates and increases in multi-state measles outbreaks continue. Measles can lead to hospitalization and severe disease, especially for high-risk groups including young children and people who are pregnant or immunocompromised. In-hospital transmission of measles can occur prior to diagnosis, as patients are infectious for approximately 4 days prior to the onset of rash. Review of the diagnosis and management of measles is essential for the hospitalist to ensure timely responses to this highly contagious virus.</p>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"21 9","pages":"1031-1034"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145914313","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":"Overnight consult message volume and patterns to pediatric subspecialty fellows","authors":"Lauren Coogle MD,&nbsp;Brooke Luo MD,&nbsp;Amina Khan MS,&nbsp;Alexis Z. Tomlinson PhD,&nbsp;Nathan L'Etoile MD,&nbsp;Chris Bonafide MD, MSCE,&nbsp;Halley Ruppel PhD, RN,&nbsp;Austin DeChalus MD, MSHP","doi":"10.1002/jhm.70384","DOIUrl":"10.1002/jhm.70384","url":null,"abstract":"<p>In children's hospitals, pediatric subspecialists provide crucial diagnostic and therapeutic guidance for hospital-based clinicians around-the-clock. Consultation commonly occurs through secure text message systems (STMS) with potential important impacts on trainee sleep and wellbeing. We sought to quantify STMS metadata to on call subspeciality fellows overnight in a single children's hospital over a 6-month period (March to August 2024). We analyzed STMS metadata for message counts and timing patterns. We found significant differences in call shift message volume across subspecialists (<i>p</i> &lt; .001). Fellows in the hospital received 32 more messages per shift compared to fellows at home (53 to 21; <i>p</i> &lt; .001). We found significant differences in the median longest time between messages across subspecialties (<i>p</i> &lt; .001), ranging from 1.6 to 10.0 h. Guidance on clinical workload duty hours for trainees was developed prior to technological advances in clinical communication and requires further evaluation considering overnight messaging burden and impact on sleep.</p>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"21 9","pages":"1017-1021"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148378764","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":"Identification of tailored faculty development for diverse career trajectories in hospital medicine","authors":"Sachita Shrestha MPH,&nbsp;Dave Bozaan MD, SFHM, FACP,&nbsp;Shuo Tian PhD,&nbsp;Stephanie Rennke MD,&nbsp;Lanna Felde MD,&nbsp;Maria Klimenko MD,&nbsp;Ashwini Niranjan-Azadi MD, SFHM,&nbsp;Pinky Jha MD, MPH, FACP,&nbsp;Elizabeth Murphy MD, SFHM,&nbsp;David Paje MD, MPH,&nbsp;Stephanie Parks Taylor MD, MS","doi":"10.1002/jhm.70292","DOIUrl":"10.1002/jhm.70292","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Academic hospital medicine faculty possess diverse interests and pursue a variety of career pathways. Faculty development programs are essential for career advancement; however, a lack of alignment between individual faculty needs and development activities can impede career development efforts. To our knowledge, there are no studies that have examined whether clusters of faculty exist with similar development needs, for which tailored faculty development “packages” can be offered.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To determine whether distinct clusters of faculty with shared development needs can be identified and to explore faculty-level factors associated with these clusters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>We conducted a survey study among hospitalists at seven academic institutions from November 2023 to September 2024. We generated a comprehensive list of 33 potential faculty development topics and asked survey respondents to indicate whether each topic was important to them, choosing as many as applied. We used latent class analysis (LCA) to classify faculty into distinct clusters based on their selection of desired development topics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 136 faculty (median age 38 years) participated in the study. LCA identified five distinct groups as the optimal solution: (1) Master clinician (29%), (2) medical education scholar (11%), (3) clinical investigator (24%), (4) educational leader (22%), and (5) operational leader (14%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In a representative sample of academic hospitalists, we identified five distinct latent classes of faculty based on their preference for faculty development topics. These results can be leveraged to curate specific packages to optimally align faculty development offerings with diverse faculty interests and career trajectories.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"21 9","pages":"995-1001"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhm.70292","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446566","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":"The role of hospitalists in bedside ethics education for medical trainees","authors":"Holland Kaplan MD","doi":"10.1002/jhm.70337","DOIUrl":"10.1002/jhm.70337","url":null,"abstract":"<p>Hospitalists are well-positioned to teach ethics to trainees at the bedside, traversing the chasm between preclinical instruction and real-world patient care. This paper proposes a structured, generalizable approach to ethics education for hospitalists. Rooted in principles from the One-Minute Preceptor approach, the <i>NAME</i> framework—<i>N</i>ame the ethical issue, <i>A</i>nchor the discussion in ethical standards, <i>M</i>ap relevant values and uncertainties, and <i>E</i>ngage trainees in supervised action and reflection—emphasizes practical ethical reasoning as an important part of clinical care. This framework is illustrated across common inpatient scenarios to show how hospitalists can explicitly teach ethics without disrupting established structures of rounds.</p>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"21 9","pages":"1051-1054"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhm.70337","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793299","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":"Twelve hours of gratitude","authors":"Samir S. Shah MD, MSCE","doi":"10.1002/jhm.70426","DOIUrl":"10.1002/jhm.70426","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 9","pages":"969-970"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhm.70426","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148698666","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":"Informal peer diagnostic second opinion: Hospitalist practices and perspectives","authors":"Taiju Miyagami MD, PhD,&nbsp;Andrew Auerbach MD,&nbsp;Jeffrey L. Schnipper MD, MPH,&nbsp;Sumant Ranji MD,&nbsp;Peter Barish MD,&nbsp;Molly A. Kantor MD,&nbsp;Anuj Dalal MD,&nbsp;Tiffany Lee,&nbsp;Katie E. Raffel MD,&nbsp;for the ADEPT Research Group","doi":"10.1002/jhm.70380","DOIUrl":"10.1002/jhm.70380","url":null,"abstract":"<p>Team-based care enhances accurate diagnosis in hospitalized patients. In addition to formal inter-professional collaboration, such as specialty consultation, many hospitalists use informal strategies, such as peer diagnostic second opinions. Little is known about this practice. We conducted a cross-sectional survey among hospital medicine physicians and Advanced Practice Providers at 13 hospitals. We assessed the frequency of requesting and providing peer second opinions, comfort discussing diagnostic uncertainty, and perceived barriers to second opinions. 338 hospitalists responded. Half (51.5%) reported routinely seeking a second opinion when facing diagnostic uncertainty. 98.2% felt psychologically safe discussing uncertainty, and 97.3% believed second opinions improved diagnostic accuracy. The most common barriers to seeking a peer-second opinion were time constraints (64.3%) and fear of bothering colleagues (56.6%). Less experienced hospitalists were more likely to report vulnerability as a barrier (39.2% vs. 26.8%, <i>p</i> = .03). Strengthening systems that facilitate peer consultation and support junior clinicians could improve diagnostic collaboration and accuracy.</p>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"21 9","pages":"1022-1025"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148392766","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 highlights for the hospitalist: Complicated urinary tract infection","authors":"Lesley B. Gordon MD, MS,&nbsp;Kristina E. Rokas PharmD, BCPS,&nbsp;Elizabeth L. Herrle MD,&nbsp;Christina Yen MD","doi":"10.1002/jhm.70367","DOIUrl":"10.1002/jhm.70367","url":null,"abstract":"","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"21 8","pages":"920-923"},"PeriodicalIF":1.8,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148335237","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":"Estimated impact of model-guided venous thromboembolism prophylaxis versus real-world practice","authors":"Benjamin G Mittman PhD,&nbsp;Michael B. Rothberg MD, MPH","doi":"10.1002/jhm.70267","DOIUrl":"10.1002/jhm.70267","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The American Society of Hematology (ASH) recommends assessing venous thromboembolism (VTE) and major bleeding risk to optimize pharmacological VTE prophylaxis for medical inpatients. However, the clinical utility of model-guided approaches remains unknown.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Our objective was to estimate differences in VTE and major bleeding rates and efficiency with prophylaxis guided by risk models versus clinician judgment. Patients were adults admitted to one of 10 Cleveland Clinic hospitals between December 2017 and January 2020. We compared real-world practice with hypothetical prophylaxis recommended by model-based strategies, including widely used risk scores (Padua &amp; IMPROVE) and locally derived Cleveland Clinic risk prediction models. For each strategy, we quantified the prophylaxis rate, VTE and major bleeding rates, and the incremental number-needed-to-treat (NNT) to prevent one event (VTE or bleeding).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Clinicians prescribed prophylaxis to 62% of patients whereas model-based strategies recommended prophylaxis for 17%–87%. Model-guided prophylaxis produced more VTEs and fewer major bleeds than real-world practice, but total events varied among strategies. Overall, per 1000 patients, model-based strategies produced 14.0–16.1 events compared with 14.3 for real-world practice. The Padua &amp; IMPROVE strategy minimized prophylaxis but caused the most total events. The most efficient model-based strategy recommended prophylaxis to 28% of patients with an incremental NNT (relative to no prophylaxis) of 80. Compared to real-world practice, it reduced prophylaxis by 55% and total events by 0.14%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Clinicians often prescribed inappropriate prophylaxis, highlighting the need for decision support. Model-guided prophylaxis maximized efficiency by reducing prophylaxis relative to real-world practice without increasing event rates.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"21 8","pages":"845-853"},"PeriodicalIF":1.8,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhm.70267","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146128006","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}