Journal of hospital medicine最新文献

{"title":"Things We Do for No Reason™: Prescribing gabapentinoids for pain","authors":"Niti G. Patel MD, PharmD,&nbsp;David Goese MD,&nbsp;Steven M. Belknap MD,&nbsp;Charles L. Madeira MD,&nbsp;Jeffrey H. Barsuk MD, MS","doi":"10.1002/jhm.70286","DOIUrl":"10.1002/jhm.70286","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 <p>Gabapentin and pregabalin are among the most frequently prescribed medications in the United States, with gabapentin in the top 10 and pregabalin in the top 100. Despite FDA approval for only select neuropathic conditions, most use is for off-label pain indications. Randomized trials show minimal or clinically insignificant benefit for most off-label pain syndromes. In contrast, gabapentinoids are associated with sedation, falls, delirium, respiratory depression, misuse, and hospitalization, especially with opioids or renal impairment. Given limited efficacy and harms, they should not routinely substitute for opioids. Clinicians should reassess indications, deprescribe when appropriate, and prioritize nonpharmacologic strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"21 6","pages":"670-676"},"PeriodicalIF":2.3,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhm.70286","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146204544","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":"Development and evaluation of a multilingual caregiver electronic rounds summary","authors":"Alexander F. Glick MD, MS,&nbsp;Nicholas C. Kuzma MD,&nbsp;Glenn Rosenbluth MD,&nbsp;Daniel J. Kats MD,&nbsp;H. Shonna Yin MD, MS,&nbsp;Andy Weng Zheng BA,&nbsp;Angela L. Fan BA,&nbsp;Rachel D'Anna MB,&nbsp;Marwa Elborki BA,&nbsp;Kathryn P. Gray PhD,&nbsp;Cara Texler MD, MPH,&nbsp;Dale Micalizzi AAS,&nbsp;Joelle Kane MD, MEd,&nbsp;Helen Haskell,&nbsp;Sally Coghlan McDonald,&nbsp;Erin Abu-Rish Blakeney PhD, RN,&nbsp;Zia Bismilla MD,&nbsp;Wilma Alvarado-Little MA, MSW,&nbsp;Alisa Khan MD, MPH,&nbsp;I-PASS LISTEN Language and Structured Communication Subcommittees","doi":"10.1002/jhm.70291","DOIUrl":"10.1002/jhm.70291","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Health literacy-informed and language-concordant written materials can promote caregiver understanding of care plans although are not commonly used in inpatient rounds.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>We sought to develop and evaluate a health literacy-informed, multilingual electronic real-time summary of rounds for hospitalized patients (the Rounds eSummary).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A multidisciplinary team developed the Rounds eSummary using health literacy, communication, and language equity best practices and multiple rounds of piloting. To generate the eSummary, clinicians completed a link with closed-ended options for various rounds components (e.g., illness severity, plan), caregiver's preferred language, and contact information. This generated an electronic PDF rounds summary (15 possible languages) emailed or texted to the family. We used descriptive statistics to analyze eSummaries (<i>n</i> = 437) created from October 25, 2024 to February 1, 2025. Separately, for a purposive sample of English eSummaries (<i>n</i> = 12) that represented different diagnoses and plans, two independent raters examined reading grade level (average of five formulas), understandability, and actionability (Patient Education Materials Assessment Tool for Printable Materials).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Rounds eSummaries were generated in eight languages across three sites; the most common languages were English (89%), Spanish (6.2%), and Portuguese (1.8%). Plans commonly included medicines (42%), nutrition (30%), and oxygen (24%). More than half (61%) were accessed at least once by the patient/caregiver; of the eSummaries accessed, the average engagement time was 29.1 s (standard deviation 25.2). The average reading grade level was 6.8 (standard deviation 0.6, range 5.8–7.8). Overall understandability and actionability scores were 87% and 60%, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We designed a usable Rounds eSummary that addressed language and health literacy barriers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>ClinicalTrials.gov identifier: NCT05591066.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"21 6","pages":"620-628"},"PeriodicalIF":2.3,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147286815","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":"Hospital-at-home for COPD: A retrospective comparison with brick-and-mortar settings","authors":"Hieu M. Nguyen MS,&nbsp;Marc Kowalkowski PhD,&nbsp;Timothy C. Hetherington MS,&nbsp;McKenzie Isreal MPH,&nbsp;Stephanie Murphy DO","doi":"10.1002/jhm.70277","DOIUrl":"10.1002/jhm.70277","url":null,"abstract":"<p>The recent Acute Hospital Care at Home (AHCaH) initiative has increased Hospital-at-Home (HaH) access and utilization, but it is unknown how care delivery differs between AHCaH-compliant HaH programs and brick-and-mortar (BaM) inpatient care—specifically for common, costly hospital conditions like chronic obstructive pulmonary disease (COPD). In this retrospective cohort study, we compared management and outcomes for adults hospitalized with COPD treated in HaH and BaM settings in 2022. We analyzed EHR data from 297 adults who were eligible for HaH, including 119 who remained in BaM and 178 in HaH. HaH patients had higher likelihood of orders for supplemental oxygen (risk ratio [RR]: 1.04, 95% confidence interval [CI]: 1.01–1.09) and bronchodilators (RR: 1.12, 95% CI: 1.04–1.20), compared to BaM. HaH patients also had higher mean 30-day acute care-free days alive (mean ratio [MR]: 1.04, 1.01–1.08). Our findings suggest similar or improved guideline-directed therapy and outcomes for COPD patients treated in HaH.</p>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"21 6","pages":"645-649"},"PeriodicalIF":2.3,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146120925","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":"Measuring system readiness for equity in sepsis care: Survey development and psychometrics","authors":"Sinem Toraman Turk PhD,&nbsp;Emily Cherlin PhD,&nbsp;Dowin Boatright MD,&nbsp;Leslie A. Curry PhD,&nbsp;Erika L. Linnander DrPH","doi":"10.1002/jhm.70231","DOIUrl":"10.1002/jhm.70231","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Achieving racial equity in sepsis care is a complex challenge that requires organizational readiness across multiple domains, such as culture and capacity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study provides a validated tool to empirically measure health system readiness to address structural racism in sepsis care, essential for improving health equity and patient outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study employed a mixed methods approach involving three key steps: adaptation, cognitive interviews, and psychometric analysis. The novel survey was first adapted based on a literature review and expert input. Cognitive interviews were conducted with healthcare professionals to refine the survey items. Finally, reliability testing was performed for psychometric analysis in measuring health system readiness to address structural racism in sepsis care. The survey was developed in the context of Champions Advancing Racial Equity in Sepsis (CARES), a coalition-based leadership intervention to equip health systems and their surrounding communities to identify and address racial inequities in sepsis care and outcomes. Senior and mid-level and front-line champions from across disciplines and departments that influence sepsis care (<i>N</i> = 30) participated in the survey.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The survey consisted of five domains: learning and problem solving (10 items, Cronbach's <i>α</i> = 0.815), stress/pressure in the system (4 items, Cronbach's α = .779), psychological safety (7 items, Cronbach's <i>α</i> = .515), senior leadership support (4 items, Cronbach's <i>α</i> = .744), and strategic planning process (5 items, Cronbach's <i>α</i> = .918). Overall, the entire scale (30 items) was found to have excellent reliability (Cronbach's <i>α</i> = .908).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study adapted and validated a novel survey to measure health system readiness to address structural racism in sepsis care, providing a reliable tool for identifying areas for improvement and guiding targeted interventions to enhance health equity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"21 6","pages":"629-637"},"PeriodicalIF":2.3,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhm.70231","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145440321","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":"Bridging the language gap: Multilingual rounding summaries","authors":"Katherine Salada MD,&nbsp;Laura P. Chen MD","doi":"10.1002/jhm.70327","DOIUrl":"10.1002/jhm.70327","url":null,"abstract":"","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"21 6","pages":"689-690"},"PeriodicalIF":2.3,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147694372","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":"Considerations for evaluating the impact of GLP-1 receptor agonist use on inpatient outcomes","authors":"Jessica L Schwartz MD, MHS,&nbsp;S. Michelle Ogunwole MD, PHD","doi":"10.1002/jhm.70275","DOIUrl":"10.1002/jhm.70275","url":null,"abstract":"","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"21 6","pages":"685-686"},"PeriodicalIF":2.3,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146168758","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 “5L” framework of diagnostic reasoning: A stepwise scaffold to support clinician educators","authors":"Olivia Brumfield MD,&nbsp;Amal Mohamed MBBCH,&nbsp;Shuhan He MD,&nbsp;Cory Rohlfsen MD","doi":"10.1002/jhm.70312","DOIUrl":"10.1002/jhm.70312","url":null,"abstract":"<p>Diagnostic reasoning (DR) is a core clinical skill, yet its teaching remains variable. We introduce the “5L” framework as a bedside teaching scaffold that gives educators and learners a shared, stepwise set of prompts for DR during individual encounters. By asking, “What's Lethal? What's Likely? What's Logical? What's Lurking? and What's Lingering?, we use a clinical case to systematically illustrate its use in guiding probability assessment, diagnostic fit, uncertainty reduction, and shared decision-making. This theoretically informed framework aims to standardize DR instruction and improve integration of risk, probability, illness scripts, problem representation, uncertainty, and patient values. Future work should evaluate its impact on learning and patient outcomes.</p>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"21 6","pages":"665-669"},"PeriodicalIF":2.3,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhm.70312","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147617202","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":"Pediatric hospital condition consolidation in US hospitals","authors":"Matt Hall PhD,&nbsp;Mitch Harris PhD,&nbsp;Jess Bettenhausen MD,&nbsp;Madelyn Hall,&nbsp;Vineeta Mittal MD,&nbsp;S. Margaret Wright MD, MPH,&nbsp;Jeffrey D. Colvin MD, JD","doi":"10.1002/jhm.70233","DOIUrl":"10.1002/jhm.70233","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objectives</h3>\u0000 \u0000 <p>While children's hospitals (CH) tend to be the locus of specialized hospital care, they also care for common conditions. There is no system to understand the distribution of hospital days within CHs and non-CHs (NCH) based on how ubiquitous conditions are across hospitals. We develop a method to classify conditions based on their commonality and consolidation within hospitals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a retrospective study of the 2022 Healthcare Cost and Utilization Project (HCUP) Kids’ Inpatient Database, excluding normal newborns. For the 441 conditions, the volume of hospital days and the distribution of days across hospitals using the Hospital Days Consolidation Index (HDCI) were determined. Conditions were categorized into four groups based on <i>k</i>-means clustering of hospital days and HDCI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 1.5 million hospitalizations from 123 CH and 3366 NCH. There were 54 conditions representing 85.7% of hospital days classified as Very High Days &amp; Very Low Consolidation (i.e., commodity conditions); 47.2% of these hospital days were at a CH. At the other extreme, there were 50 conditions classified as Very Low Days &amp; Very High Consolidation (e.g., chronic lymphocytic leukemia) representing &lt;1% of hospital days; 75.3% at CH. Among all hospital days for commodity conditions, 52.8% were at NCH and 47.2% were at a CH. However, for the remaining condition groups, 27.3% of days were at an NCH and 72.7% at a CH.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We identified commodity conditions but also conditions that are consolidated, typically within CH. Consolidation can be quantified, compared, and tracked using the HDCI.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"21 6","pages":"638-644"},"PeriodicalIF":2.3,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145535083","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":"Healing after the best of us","authors":"Preston Simmons MD","doi":"10.1002/jhm.70205","DOIUrl":"10.1002/jhm.70205","url":null,"abstract":"","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"21 6","pages":"683-684"},"PeriodicalIF":2.3,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145282358","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: Respiratory syncytial virus","authors":"Justin B. Searns MD,&nbsp;Sean T. O'Leary MD","doi":"10.1002/jhm.70206","DOIUrl":"10.1002/jhm.70206","url":null,"abstract":"<p>Globally, respiratory syncytial virus (RSV) is responsible for more than 3.6 million hospitalizations and 100,000 deaths every year. Since 2023, three immunizations have been approved for clinical use, each targeting a different patient population. These newly available RSV immunizations are poised to prevent hospitalizations, reduce costs for healthcare systems, and save lives. This review will discuss the evidence behind these immunization strategies and examine their potential to blunt the global impact from RSV.</p>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"21 6","pages":"660-664"},"PeriodicalIF":2.3,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145282328","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}