Journal of hospital medicine最新文献

{"title":"Our purpose, our voice: Navigating uncertain times","authors":"Samir S. Shah MD, MSCE, MHM","doi":"10.1002/jhm.70024","DOIUrl":"10.1002/jhm.70024","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 4","pages":"331-332"},"PeriodicalIF":2.3,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhm.70024","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143545445","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 knowledge for hospital medicine through structured clinical offerings","authors":"Lily L. Ackermann MD, ScM,&nbsp;Jagriti Chadha MD, MPH,&nbsp;Joseph R. Sweigart MD,&nbsp;Jan Bowman,&nbsp;Nick Marzano,&nbsp;Ebrahim Barkoudah MD, MPH, MBA,&nbsp;For the SHM RCU – Education Committee","doi":"10.1002/jhm.70023","DOIUrl":"10.1002/jhm.70023","url":null,"abstract":"<p>Society of Hospital Medicine Rapid Clinical Updates (RCUs) was developed as a tool for healthcare professionals to bridge the gap between the latest advancements and standard clinical practice. An online seminar series with nationally recognized speakers was developed with input from hospitalists and literature review. For each session, a subspecialist was paired with a hospitalist to present the latest medical research and practical implementation into clinical practice. Active audience participation was encouraged, and survey data were collected on the quality of the sessions and their impact on clinical practice. Over the past 4 years, this virtual platform has consistently been rated as high-quality and impacting clinical practice.</p>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 6","pages":"655-660"},"PeriodicalIF":2.3,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143545443","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":"Medical debt in America, part III: Debt collection","authors":"Luke Messac MD, PhD,&nbsp;Blake N. Shultz MD, JD,&nbsp;Ahmed M. Ahmed MD, MPP, MSc","doi":"10.1002/jhm.70011","DOIUrl":"10.1002/jhm.70011","url":null,"abstract":"<p>In the first two parts of the series, we described the sources of high prices in health care and the severe constraints faced by low-income patients when seeking to access care without incurring medical debt. In this third and final installment, we examine the origins of aggressive medical debt collection practices, their deleterious consequences for patients, and potential solutions.</p>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 7","pages":"784-786"},"PeriodicalIF":2.3,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhm.70011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143538269","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":"Secure messaging in medical training: Carving a path for trainee development in the digital age","authors":"Preston Simmons MD,&nbsp;James Bowen MD,&nbsp;Matthew Molloy MD, MPH,&nbsp;Brooke Luo MD","doi":"10.1002/jhm.70021","DOIUrl":"10.1002/jhm.70021","url":null,"abstract":"","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 9","pages":"1015-1017"},"PeriodicalIF":2.3,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143506670","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":"Clinician perspectives on electronic health record behavioral alerts and hospital workplace violence prevention: A mixed methods study at 20 organizations","authors":"Himali Weerahandi MD, MPH,&nbsp;Marisha Burden MD, MBA,&nbsp;Zoë Kopp MD,&nbsp;Catherine Callister MD,&nbsp;Jamie Burke BS,&nbsp;Khooshbu Dayton MD,&nbsp;Angela Keniston PhD, MSPH,&nbsp;Russell Ledford MD,&nbsp;Katie E. Raffel MD,&nbsp;Jeffrey Schnipper MD, MPH,&nbsp;Andrew Auerbach MD, MPH","doi":"10.1002/jhm.70018","DOIUrl":"10.1002/jhm.70018","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Workplace violence prevention programs are important for safety, but little is known about how they are perceived by clinicians or whether electronic health record (EHR) behavioral alerts are perceived as effective.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To understand perspectives on the use of EHR behavioral alerts as part of workplace violence prevention programs in hospitals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Mixed methods study utilizing semi-structured focus groups with a structured survey. Focus group participants were members of a national hopsitalist consortium.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-eight individuals from 20 different organizations participated in focus groups, with 24 (86%) completing the survey. There was broad uncertainty in best practices for inpatient workplace violence prevention. There was also wide variation in EHR behavioral alert use across multiple domains, including how and why the alerts are placed and how they are used by the end user. Finally, focus groups had mixed sentiments on the potential impacts of these alerts; among participants who responded to surveys, half (50%) noted that alerts caused deviations in care and 21% indicated they witnessed instances where behavioral alerts led to adverse patient outcomes. Most (67%) survey respondents did not think EHR behavioral alerts prevented workplace violence. The majority (88%) of respondents also reported that patient demographic factors impacted whether an alert was placed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Limitations</h3>\u0000 \u0000 <p>The study focused on clinician experience at academic hospitals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions and Relevance</h3>\u0000 \u0000 <p>Reports of uncertainty in best practices for deploying EHR behavioral alerts, along with perceptions of variability in implementation and potential biases in alert usage, raise concerns about their effectiveness and potential for worsening disparities. Standardized, evidence-based practices that safeguard healthcare workers without compromising patient care and equity are needed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 8","pages":"837-846"},"PeriodicalIF":2.3,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143470438","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":"Please listen","authors":"Courtney Burnett MD","doi":"10.1002/jhm.70016","DOIUrl":"10.1002/jhm.70016","url":null,"abstract":"<p>I wake, eyes fluttering open</p><p>from an anesthesia-induced slumber</p><p>Across from me in the post-anesthesia care unit</p><p>I hear machines beeping, coarse breathing, gasping,</p><p>wheezing and fear</p><p>A man nearby sounds like he is drowning</p><p>in his own secretions</p><p>An exacerbation of congestive heart failure</p><p>my own post-craniotomy brain tells me</p><p>I am a physician, but today I am a patient</p><p>This is a new role for me. In many ways,</p><p>it is much harder</p><p>I hear the nurse page anesthesia overhead</p><p>Respiratory assistance needed stat, bed two</p><p>In bed three, I open my lips and whisper</p><p><i>He needs diuretics, positive pressure ventilation</i></p><p>I can help. Let me help</p><p>I try to get someone's attention</p><p>But I am a patient, lying alone in a bed</p><p>with a bandage on my skull and blood on my cheek</p><p>Yesterday, I worked in this hospital</p><p>now I am a patient, unable to assist</p><p>My autonomy is gone, expertise unknown</p><p>My badge removed and stuffed in a bag</p><p>with my belongings and my voice</p><p>The nurse finally sees me</p><p><i>Are you in pain?</i> He asks</p><p>I try to say no, but my words slur and disappear</p><p>I feel vulnerable and alone,</p><p>thrust to the other side, where I am seen as patient</p><p>and nothing more</p><p><i>Do all of my patients feel this way?</i> I wonder</p><p>I hear the team arrive to help bed two</p><p>What happened? A resident asks, panic in her voice</p><p>I am an internist. I can help him</p><p><i>Please listen</i>.</p><p><i>Diuretics, positive airway pressure, elevate his head</i></p><p><i>the man in bed two. That is what he needs</i>. I whisper again</p><p>The team sees a postoperative patient mumbling words</p><p><i>Why won't they listen?</i></p><p>My identity is reduced to the patient in bed three</p><p>My words go unheard</p><p><i>Is this what it feels like to be a patient?</i></p><p><i>I must never forget this</i></p><p>When my patients speak, I promise to listen</p><p>The author declares no conflicts of interest.</p>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 8","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhm.70016","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143461254","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 art of attention","authors":"Megan Brandeland MD","doi":"10.1002/jhm.70019","DOIUrl":"10.1002/jhm.70019","url":null,"abstract":"","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 9","pages":"1037-1038"},"PeriodicalIF":2.3,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143470439","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":"Musings on the oncology floor","authors":"Zhaohui Su PhD","doi":"10.1002/jhm.70014","DOIUrl":"10.1002/jhm.70014","url":null,"abstract":"","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 7","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143443071","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":"Performance of electronic medical record tool in predicting 6-month mortality in hospitalized patients with cancer","authors":"Nita S. Kulkarni MD,&nbsp;Matthew P. Landler MD,&nbsp;Elaine R. Cohen MEd,&nbsp;Diane B. Wayne MD,&nbsp;Eytan Szmuilowicz MD","doi":"10.1002/jhm.70012","DOIUrl":"10.1002/jhm.70012","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>A systematic tool to identify hospitalized patients with high mortality risk may be beneficial for targeting palliative care to those in greatest need.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Evaluate the performance of the End-of-life Index (EOLI; Epic Systems Corporation) in identifying patients at the highest 6-month mortality risk among hospitalized patients with cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective study of adults with cancer admitted to oncology services in a 959-bed hospital between July 1 and December 31, 2023. We evaluated EOLI score performance in determining mortality risk using the area under the receiver operating characteristic curve (AUC). The primary outcome was 6-month mortality for patients with an EOLI score above and below the optimal threshold value. Secondary outcomes included in-hospital mortality, 30-day mortality, length of stay, intensive care unit (ICU) utilization, palliative care consultation, do-not-resuscitate status on discharge, and discharge disposition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The EOLI score had moderate accuracy in identifying patients at higher risk of 6-month mortality (AUC: 0.71) with an optimal threshold value of 40. For patients with EOLI &gt; 40 and &lt; 40, the 6-month mortality was 45.9% and 16.3%, respectively (<i>p</i> &lt; .001). Patients with EOLI &gt; 40 had higher ICU utilization (12.4% vs. 6.5%, <i>p</i> = .002) and were more likely to be discharged to a location other than home (13.5% vs. 5.3%; <i>p</i> &lt; .001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>For hospitalized patients with cancer, the EOLI shows moderate accuracy in identifying patients with a high risk of 6-month mortality. As a screening tool, the EOLI can be used to identify patients who may benefit from timely palliative care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 8","pages":"829-836"},"PeriodicalIF":2.3,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhm.70012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143443080","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":"Sarcopenia and sarcopenic obesity: Their association with postoperative outcomes in patients with hip fractures","authors":"Betül Gülsüm Yavuz Veizi MD,&nbsp;Valbona Imeri MD,&nbsp;Ömer Faruk Naldöven MD,&nbsp;Şahan Güven MD","doi":"10.1002/jhm.70007","DOIUrl":"10.1002/jhm.70007","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Sarcopenia, characterized by age-related loss of muscle mass and function, significantly impacts the quality of life of older adults. This condition is prevalent among elderly patients with hip fractures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate the association of sarcopenia and sarcopenic obesity with mortality and length of hospital stay in patients admitted for hip fracture. Additionally, this study aims to investigate possible risk factors associated with higher mortality rates in the same patient groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective cohort study was conducted involving patients aged 60 and older who underwent hip fracture surgery between February 2019 and April 2023 at a single tertiary care hospital. Sarcopenia was defined using appendicular skeletal muscle mass index (ASMI) and psoas muscle index values derived from preoperative computed tomography scans. Patients were categorized into sarcopenic, sarcopenic obese, and non-sarcopenic groups. Primary outcomes included 1-year mortality, and secondary outcomes included hospital stay duration. Cox regression and binary logistic regression analyses were performed, adjusting for potential confounders including age, sex, and comorbidities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study included 311 patients (mean age 79.7 years). After adjustment for confounders, sarcopenia, as defined by ASMI, was associated with a higher 1-year mortality risk (hazard ratio [HR]: 1.80, 95% confidence interval [CI]: 1.04–3.13, <i>p</i> = .034). Sarcopenic obesity further increased mortality risk (HR: 2.68, 95% CI: 1.10–2.57, <i>p</i> = .016). Sarcopenia alone was not significantly associated with prolonged hospital stays after adjustment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Sarcopenia remained independently associated with mortality in patients with hip fractures after adjustment for various factors. Sarcopenic obesity was associated with a higher risk of mortality than sarcopenia alone. These findings underscore the prognostic significance of sarcopenia in this vulnerable population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 8","pages":"816-823"},"PeriodicalIF":2.3,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434750","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}