Journal of hospital medicine最新文献

{"title":"Methodological progress note: Social network analysis as a community health research tool","authors":"Kimberly Martini-Carvell MA, Melissa C. Miller MPH, Paul H. Dworkin MD","doi":"10.1002/jhm.13451","DOIUrl":"10.1002/jhm.13451","url":null,"abstract":"","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"19 12","pages":"1165-1169"},"PeriodicalIF":2.4,"publicationDate":"2024-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141474012","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":"SIMPLE procedures: Survey of Internal Medicine Providers' Limitations and Experiences with procedures and medical procedure services","authors":"Joséphine A. Cool MD,&nbsp;Andrew R. Lai MD, MPH,&nbsp;Henry Kramer MD,&nbsp;Amiran Baduashvili MD","doi":"10.1002/jhm.13443","DOIUrl":"10.1002/jhm.13443","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In response to a decline in bedside procedures performed by hospitalists, some hospital medicine groups have created medical procedure services (MPSs) concentrating procedures under the expertise of trained hospitalist-proceduralists.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To characterize the structure, breadth, and heterogeneity of academic medical center MPSs, as well as compare the procedural landscape for groups with and without an MPS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The Survey of Internal Medicine Providers' Limitations and Experiences with Procedures and MPSs, is a cross-sectional study, conducted in the United States and Canada through a web-based survey administered from October 2022 to March 2023. We used convenience and snowball sampling to identify eligible study participants. The survey explored presence of MPS, procedure volumes, patient safety, and educational practices. For MPSs, we explored onboarding, staffing, skill maintenancy, funding, and barriers to growth.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Forty institutions (response rate 97.5%), represented by members of the Procedural Research and Innovation for Medical Educators (PRIME) consortium participated in the survey. MPSs were found in 75% of the surveyed institutions. Most MPSs (97%) involved trainees and were staffed by internists (100%) who often had additional clinical duties (70%). The majority (83%) of MPSs used checklists and procedural safety guidelines, but only 53% had a standardized process for tracking complications. There was significant variability in determining procedural competency and supervising trainees. Groups with an MPS reported higher procedure volume compared to those without.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>MPSs were highly prevalent among the participating institutions, offered a broad array of bedside procedures, and often included trainees. There was a high variability in funding models, procedure volumes, patient safety practices, and skill maintenance requirements.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"19 11","pages":"1019-1027"},"PeriodicalIF":2.4,"publicationDate":"2024-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141474013","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™: Routine renal ultrasound testing for patients presenting with or developing acute kidney injury in the hospital","authors":"Anjali Bhatla MD, MBA,&nbsp;Steven Menez MD, MHS,&nbsp;Leonard Feldman MD, MHM","doi":"10.1002/jhm.13446","DOIUrl":"10.1002/jhm.13446","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 2","pages":"182-184"},"PeriodicalIF":2.4,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141474014","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":"Leadership & professional development: The science of motivating change","authors":"Katarina Leyba MBA, MD,&nbsp;Samuel Porter MD","doi":"10.1002/jhm.13445","DOIUrl":"10.1002/jhm.13445","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":"19 9","pages":"816-817"},"PeriodicalIF":2.4,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141474011","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":"Parenteral versus enteral fluids for infants hospitalized with bronchiolitis: The PREFER shared decision-making prospective observational study protocol","authors":"Peter J. Gill MD, DPhil, MSc,&nbsp;Francine Buchanan MLIS, PhD,&nbsp;Christine Fahim PhD, MSc,&nbsp;Cornelia M. Borkhoff PhD, M.Sc,&nbsp;Shamama Raza BScH,&nbsp;Melanie Buba MD,&nbsp;Gita Wahi MD, PhD, MSc,&nbsp;Ann Bayliss MD,&nbsp;Kim Zhou MD,&nbsp;Ronik Kanani MD,&nbsp;Mahmoud Sakran MD,&nbsp;Kim De Castris-Garcia,&nbsp;Nicholas Barrowman PhD,&nbsp;Terry Klassen MD, MSc,&nbsp;Suzanne Schuh MD,&nbsp;Jessie Hulst MD, PhD,&nbsp;Sharon Straus MD, MSc,&nbsp;Colin Macarthur MBChB, PhD, MSc,&nbsp;Aubrey Sozer RN,&nbsp;Glyn Elwyn MD, PhD, MSc,&nbsp;Karen Breen-Reid RN,&nbsp;Sanjay Mahant MD, MSc,&nbsp;The Canadian Pediatric Inpatient Research Network (PIRN)","doi":"10.1002/jhm.13426","DOIUrl":"10.1002/jhm.13426","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Incorporating shared decision-making (SDM) with children and families in hospitals was a top priority identified by patients, caregivers, and clinicians. Bronchiolitis, a common and costly reason for hospitalization in children, is an exemplar condition to study SDM in hospitals. Internationally, clinical practice guidelines differ when recommending intravenous (IV or parenteral) or nasogastric (NG or enteral) fluids for hospitalized infants with bronchiolitis who are unsafe to be fed orally. While evidence indicates that either IV or NG fluids are safe and effective, parent involvement in SDM in selecting IV or NG fluids is unknown. Our aim is to generate knowledge of SDM with parents in choosing between IV or NG fluids and the benefits and harms of these two treatment options for hospitalized children with bronchiolitis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>This is a multicenter, prospective, observational study, including children aged &lt;12 months admitted to hospital with bronchiolitis requiring supplemental IV or NG fluids. The primary outcome will evaluate the extent of SDM in choosing IV versus NG fluids using the validated CollaboRATE tool. Secondary outcomes include the proportion of parents provided a choice of IV versus NG fluids; parent knowledge of fluid therapy; rate of fluids; length of hospital stay; and complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>This study will evaluate the extent of SDM in hospitalized infants with bronchiolitis who require IV or NG fluids and will evaluate both patient-centered and clinical outcomes that are relevant to clinical practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"19 11","pages":"1090-1099"},"PeriodicalIF":2.4,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhm.13426","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141461461","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":"Guiding while growing: The dual role of early career mentors","authors":"Samir S. Shah MD, MSCE, MHM","doi":"10.1002/jhm.13447","DOIUrl":"10.1002/jhm.13447","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":"19 11","pages":"991-992"},"PeriodicalIF":2.4,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhm.13447","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141461460","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":"From motivation to mastery","authors":"Samir S. Shah MD, MSCE, MHM","doi":"10.1002/jhm.13450","DOIUrl":"10.1002/jhm.13450","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 3","pages":"217-218"},"PeriodicalIF":2.4,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhm.13450","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141461459","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":"To give or not give corticosteroids; that is the question","authors":"Claire E. Ciarkowski MD, MSc,&nbsp;Valerie M. Vaughn MD, MSc","doi":"10.1002/jhm.13444","DOIUrl":"10.1002/jhm.13444","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":"19 11","pages":"1082-1083"},"PeriodicalIF":2.4,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141461464","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":"Point/counterpoint: Should we stop writing and reading letters of recommendation for residency selection?","authors":"Matthew Kelleher MD, MEd,&nbsp;Benjamin Kinnear MD, MEd,&nbsp;Danielle E. Weber MD, MEd,&nbsp;Michelle I. Knopp MD,&nbsp;Daniel Schumacher MD, MEd, PhD,&nbsp;Eric Warm MD","doi":"10.1002/jhm.13440","DOIUrl":"10.1002/jhm.13440","url":null,"abstract":"&lt;p&gt;As hospitalists involved in internal medicine and pediatrics residency selection, each of us have read letters of recommendation (LORs) like the one in Box 1. As part of the process of selecting candidates for residency training, LORs hold significant implications for both applicants and programs and are tainted by deep-rooted flaws. These defects continue largely because of our collective failure to confront and address the glaring issues within the process. At best, LORs offer marginal benefit in selecting residents; at worst, they become overt channels for bias, inequity, inequality, and arbitrariness, often devolving into exercises of inanity, untruthfulness, obfuscation, and even propaganda. As such, they decrease the integrity and purpose of the residency selection process.&lt;/p&gt;&lt;p&gt;For example, gender bias in residency application LORs has been noted for Radiology, Orthopedic Surgery, Female Pelvic Medicine and Reconstructive Surgery, Cardiovascular Surgery, Emergency Medicine, Pediatrics, Anesthesiology, Radiation Oncology, Ophthalmology, Internal Medicine, and General Surgery, among others.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Women often find themselves described in these letters with communal traits, such as &lt;i&gt;helpful&lt;/i&gt; and &lt;i&gt;caring&lt;/i&gt;.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; In contrast, men are more likely to be portrayed with agentic traits, including &lt;i&gt;leader&lt;/i&gt; and &lt;i&gt;taking initiative&lt;/i&gt;. LORs for women also tend to focus more on personal appearance (such as the misogynistic but real-life example about Ms. J. Smiths' figure in the above letter) and personal life. They also contain more doubt raisers (e.g., “it appears her health and personal life are stable”&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt;), including hesitancy from the recommender, use of faint praise, potentially negative comments, unexplained comments, and irrelevancies.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Ethnic and racial biases are also prominent in residency LORs, where differences in language can subtly influence readers' perceptions of candidates.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; As with gender, agentic and communal terms are used differently based on a candidate's ethnicity or race. Even apart from bias, LORs compound inequity. The process of obtaining LORs favors already advantaged groups who are more likely to have access to the most influential letter writers. Students often spend an inordinate amount of time searching for the “right” letter writer, often choosing those with titles or positions of power over those who know them best. LORs also tend to focus only on positive aspects of applicants, neglecting the comprehensive portrayal of a candidate's journey, struggles, and growth. This one-sided representation undermines the principle of holistic review (a balanced assessment of an applicant's experiences, attributes, and academic metrics&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt;) by not fully acknowledging the resilience and perseverance shown in overcoming challenges, especially among disadvantaged applicants. Even wo","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"19 9","pages":"858-862"},"PeriodicalIF":2.4,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhm.13440","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141461462","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":"A more opportune moment","authors":"Samir S. Shah MD, MSCE, MHM","doi":"10.1002/jhm.13448","DOIUrl":"10.1002/jhm.13448","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 2","pages":"107-108"},"PeriodicalIF":2.4,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhm.13448","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141461456","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}