Journal of hospital medicine最新文献

{"title":"Quality of hospital medicine care in Veterans Affairs hospitals versus non-Veterans Affairs hospitals: A systematic review of comparative studies","authors":"Paul G. Shekelle MD, PhD,&nbsp;Robert E. Burke MD, MS,&nbsp;Eric A. Apaydin PhD, MPP, MS,&nbsp;Meron M. Begashaw MPH,&nbsp;Charlie M. Wray DO, MS","doi":"10.1002/jhm.70351","DOIUrl":"10.1002/jhm.70351","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The Veterans Health Administration (VA) cares for more than one million hospitalized Veterans each year. There is limited knowledge on how hospital medicine care in VA facilities compares with non-VA hospitals in terms of the Institute of Medicine domains of healthcare access, patient experience, quality, clinical outcomes, and cost.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To perform a systematic review that compares hospital-based care in VA and non-VA settings with a focus on general medicine conditions typically cared for by hospitalists.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We identified relevant articles across four databases from January 2015 to April 2025. Eligible studies were required to assess outcomes in any Institute of Medicine healthcare domain among Veterans receiving care in the VA for acute medical conditions. Relevant comparisons included outcomes of (1) Veterans receiving care in the community, or (2) members of the general population receiving care in the community.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified 13 studies. VA care generally exhibited equal or better outcomes compared with non-VA care, especially in risk-adjusted mortality rates. Most process-of-care studies showed VA care to be as good as or better than non-VA care. Findings on readmissions and patient experience were mixed, with some early findings showing VA care lagging behind but improving significantly by 2021. However, few studies were completed after the passage of the 2018 MISSION Act, which significantly shifted hospitalizations to non-VA care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Most published studies of comparisons of quality-of-care show that Veterans receiving hospital medicine care from VA receive the same or better quality care than Veterans getting community care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"21 7","pages":"792-800"},"PeriodicalIF":1.8,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhm.70351","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147966146","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":"Learning to be mentored","authors":"Samir S. Shah MD, MSCE","doi":"10.1002/jhm.70357","DOIUrl":"10.1002/jhm.70357","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 7","pages":"713-714"},"PeriodicalIF":1.8,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhm.70357","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148152572","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":"Continuous infectious diseases coverage by merging with a hospitalist practice in a small community hospital system","authors":"Michael S. Wang MD,&nbsp;Kristina Aleksoniene MD,&nbsp;Jason C. Tompkins MD,&nbsp;Richard W. Douce MD,&nbsp;John W. Froggatt 3rd MD,&nbsp;Mark S. Harrison MD","doi":"10.1002/jhm.70214","DOIUrl":"10.1002/jhm.70214","url":null,"abstract":"<p>Access to infectious diseases physicians has been increasingly difficult, as many infectious diseases fellowship programs have unfilled positions. This has coincided with increasing numbers of internal medicine residents pursuing hospitalist medicine. A small community hospital system merged its infectious diseases practice into a hospitalist group. The group has been able to maintain continuous coverage. Although the majority of physicians enjoyed the work-life balance of being an ID-hospitalist, the majority preferred to do ID without hospital medicine.</p>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"21 7","pages":"819-823"},"PeriodicalIF":1.8,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhm.70214","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145373542","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":"Things We Do for No Reason™: Standing at the bedside","authors":"Adam Gray MD,&nbsp;Alan M. Hall MD,&nbsp;Leonard S. Feldman MD","doi":"10.1002/jhm.70293","DOIUrl":"10.1002/jhm.70293","url":null,"abstract":"<p>Hospitalists rarely sit when communicating with patients at the bedside. As an important component of etiquette-based medicine, hospitalists should strive to get to eye level when communicating with patients. Sitting, when compared to standing at the bedside, improves physician-patient communication and does not lead to any additional time spent in the patient's room.</p>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"21 7","pages":"801-803"},"PeriodicalIF":1.8,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147273722","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":"GOComm: A team-based communication intervention to improve clinicians’ skills and distress tolerance in family meetings","authors":"Kimberly Bloom-Feshbach MD,&nbsp;Evgenia Litrivis MD,&nbsp;Elizabeth Brondolo PhD,&nbsp;Alexandra Spinelli PhD,&nbsp;Thomas Bozzo,&nbsp;Melissa Patterson MD, MBA,&nbsp;Robert Crupi MD,&nbsp;Cynthia X. Pan MD","doi":"10.1002/jhm.70241","DOIUrl":"10.1002/jhm.70241","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Medical training often omits systematic approaches to prognostication and goals of care (GOC) communication, leading to end-of-life (EOL) hospital care misaligned with patients’ values, lower clinician self-efficacy, and greater clinician distress.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This communication training intervention aimed to improve clinician knowledge and self-efficacy and to reduce distress in conducting GOC discussions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We developed and implemented GOComm, a 4-h serious illness communication training program across eight campuses of a large health system. Utilizing a train-the-trainer model, facilitators taught GOComm to inpatient clinicians, primarily hospitalists, intensivists, physician assistants (PAs), and trainees. Topics included prognosticating, conveying serious news, managing emotions, creating values-informed medical recommendations, and discussing hospice. Simulations included a clinician and simulated patient (SP) role play and a family meeting, in which a clinical dyad encountered an SP dyad. Mixed methods evaluation included pre- and postsurveys.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Three hundred and ninety-three clinicians participated: 322 provided demographics, with a mean of 5.57 years in practice; 71.7% were women, 50% were White, and 29.5% were Asian. Of 315 listing roles: 41% were physicians, 41% were PAs. Two hundred and forty-two completed both pre- and postsurveys. Clinicians had statistically significant gains in GOC knowledge, self-efficacy, and distress tolerance. GOComm had high clinician acceptability: 96.2% indicated they would recommend GOComm to a colleague, and 83.2% credited it with changing how they will manage patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>GOComm is an effective train-the-trainer curriculum for hospital-based clinicians to gain knowledge and confidence in empathic communication skills. Clinician distress tolerance can be mitigated by enhancing skills training and social support through team simulations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"21 7","pages":"732-740"},"PeriodicalIF":1.8,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145971736","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":"Not just watching: Defining core competencies for international medical observers","authors":"Amy Yu MD,&nbsp;Flora Kisuule MD, MPH, SFHM,&nbsp;Alhareth Al-Sagban MD,&nbsp;Amteshwar Singh MD, M.Ed., FACP, FHM","doi":"10.1002/jhm.70324","DOIUrl":"10.1002/jhm.70324","url":null,"abstract":"<p>International Medical Graduates (IMGs) play a vital role in addressing the US physician shortage, yet many begin their American Clinical Journey through observership that often lack formal structure or defined learning goals. This perspective proposes a competency-based framework to transform observerships from passive shadowing into purposeful educational experiences. Drawing from the Accreditation Council for Graduate Medical Education (ACGME) model, the authors outline seven adapted competencies: Medical Knowledge, Communication Skills, Reflective Learning, Systems Awareness, Cultural Competence, Ethical and Professional Principles, and Initiative and Engagement; each with observable behaviors to guide learning and feedback. Implementing this framework in a hospital medicine observership program enhanced both faculty teaching and learner engagement, fostering reflection, professional growth, and a sense of belonging among international observers. As states explore alternate licensure pathways for IMGs to meet national workforce needs, defining observership competencies offers a timely, equitable, and scalable approach to preparing globally trained physicians for practice in US healthcare systems.</p>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"21 7","pages":"804-806"},"PeriodicalIF":1.8,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679667","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 progress note: Invasive meningococcal disease","authors":"Alaina Shine MD,&nbsp;Erin Chung MD, MS","doi":"10.1002/jhm.70208","DOIUrl":"10.1002/jhm.70208","url":null,"abstract":"<p>Invasive meningococcal disease due to <i>Neisseria meningitidis</i> in the United States has decreased since the late 1990s, leading to fewer practicing clinicians with first-hand experience in diagnosing and managing of the disease. However, since 2021, cases have increased, creating an urgency for clinicians to familiarize themselves with the signs and sequelae of severe invasive meningococcal disease and stay up to date with current vaccine recommendations. This review summarizes recent literature and guidance for clinicians on the prevention, early recognition, and management of this vaccine-preventable disease.</p>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"21 7","pages":"788-791"},"PeriodicalIF":1.8,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145380483","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":"Bridging the gap: Innovative workforce models to address healthcare shortages","authors":"Sophie Biyu Sun MD, PhD,&nbsp;Suchita Shah Sata MD","doi":"10.1002/jhm.70266","DOIUrl":"10.1002/jhm.70266","url":null,"abstract":"","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"21 7","pages":"824-825"},"PeriodicalIF":1.8,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640995","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":"Hospitalist perceptions of health equity in the inpatient setting: A multisite mixed-methods study","authors":"Elizabeth Le MD,&nbsp;Areeba Kara MD, MS,&nbsp;Amelita Woodruff MD,&nbsp;Jennifer K. Readlynn MD,&nbsp;Amit Kaushal MD, PhD,&nbsp;Marisha Burden MD, MBA,&nbsp;Archna Eniasivam MD,&nbsp;Nazima Allaudeen MD,&nbsp;Esteban Gershanik MD, MPH, MMSc,&nbsp;Ashley Jenkins MD, MSc,&nbsp;the HOMERuN HEARS (Health Equity, Advocacy, and Research Support) workgroup","doi":"10.1002/jhm.70252","DOIUrl":"10.1002/jhm.70252","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Efforts to advance health equity are essential in providing high-quality healthcare. The outpatient setting is where the majority of health equity work has been supported with longitudinal relationships, established metrics, and existing dashboards; similar work in the inpatient setting is lacking.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To understand the perspectives of frontline hospitalists regarding how health equity is approached and measured in the inpatient setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted an embedded mixed-methods study using semistructured focus groups and surveys. Participants were members of a national collaborative of hospital medicine groups partnering to improve healthcare delivery. Rapid qualitative methods including templated summaries and matrix analysis were used to identify key themes and subthemes using a mixed inductive and deductive approach.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-two participants engaged in five focus groups. Three key themes were identified: (1) there is no consensus on how to define and scope health equity in the inpatient setting, (2) organizational support and resources for addressing health equity in inpatient settings are variable, and (3) there is an emotional toll on hospitalists working in the face of health inequities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Advancing health equity in the inpatient setting is needed and will benefit from embracing clear definitions and scope, broad organizational support, and recognition of its impact on hospitalists.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"21 7","pages":"758-765"},"PeriodicalIF":1.8,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145859641","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":"Comparative diagnostic accuracy study of point of care ultrasound techniques for detection of left atrial enlargement by hospital medicine physicians from archived echocardiogram images","authors":"Christopher J. Smith MD,&nbsp;Jesse Umbra MHPTT, ACS, RDCS, RVT,&nbsp;Sofia Quintero MD,&nbsp;Austin Wilson MD,&nbsp;Elizabeth Lyden MS,&nbsp;Nidish Tiwari MD,&nbsp;Brian Shahan MD,&nbsp;Jana Wardian PhD, MSW","doi":"10.1002/jhm.70245","DOIUrl":"10.1002/jhm.70245","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Left atrial enlargement (LAE) is predictive of cardiovascular morbidity and mortality. Prior studies of point-of-care ultrasound (POCUS) interpretation methods for identifying LAE utilized older echocardiographic reference ranges.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Compare the test characteristics of hospitalist-performed POCUS techniques for identifying LAE as compared to contemporary echocardiographic reference ranges.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Fully paired, comparative diagnostic accuracy study of two index tests applied to archived echocardiogram images: visual assessment of the left atrium to aorta diameter (LAE sign) and left atrial (LA) anteroposterior diameter &gt;4 cm in the parasternal long axis view. The reference test was moderate to severe LAE by echocardiography-derived left atrial volumetric index.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After exclusion criteria, 239 of 321 (74.5%) exams were included. The LAE sign had a sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 67.5%, 71.4%, 32.1%, and 91.6%. LA diameter of &gt;4 cm had a sensitivity, specificity, PPV, and NPV of 87.5%, 75.9%, 42.2%, and 96.8%. The difference in sensitivity (<i>p</i> = .005) and specificity (<i>p</i> = .049) between the index tests was statistically significant. The diameter measurement had better positive and negative likelihood ratios (LR + 3.63, LR−0.16) than the LAE sign (LR + 2.36, LR− 0.46).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Both POCUS techniques for diagnosing LAE performed reasonably well compared to current echocardiographic reference ranges, with LA diameter &gt;4 cm having better sensitivity and specificity than visual estimation of the LAE sign. These tests can help identify patients at risk for cardiovascular disease who may benefit from echocardiogram referral.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"21 7","pages":"741-748"},"PeriodicalIF":1.8,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhm.70245","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145746347","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}