Journal of hospital medicine最新文献

{"title":"From frameworks to the frontline: Hospitalist perspectives on diagnostic excellence programs.","authors":"Angela Keniston, Raymond M Klein, Michael Tozier, Andrew Auerbach, Peter Barish, Molly A Kantor, Dev Patel, Katie Raffel, Sumant Ranji, Jeff Schnipper","doi":"10.1002/jhm.70453","DOIUrl":"https://doi.org/10.1002/jhm.70453","url":null,"abstract":"<p><strong>Background: </strong>The National Academies' Improving Diagnosis in Health Care report outlined eight goals for improving the diagnostic process and building a culture of diagnostic excellence. Despite a decade passing since these recommendations, development of programs remains inconsistent.</p><p><strong>Objectives: </strong>To explore diagnostic excellence improvement efforts across hospital medicine divisions in largely academic settings to identify opportunities.</p><p><strong>Methods: </strong>This study used rapid qualitative methods to analyze focus groups with hospitalist clinicians recruited from sites participating in an AHRQ-funded study. After creating focus group summaries and an analytical matrix, thematic analysis was conducted using a mixed inductive and deductive method at the semantic level.</p><p><strong>Results: </strong>Seven focus groups were conducted with 30 participants across 14 hospitals. Participants described more than 80 interventions, programs, and tools to improve diagnostic processes. Five themes were identified: (1) current diagnostic excellence efforts were weighted toward reactive rather than proactive interventions; (2) successful diagnostic excellence programs need to focus on both systems issues and clinician performance; (3) clinicians desired greater support in the diagnostic process, especially when cognitive load impairs clinical reasoning; (4) clinicians desired a supportive culture for feedback; and (5) for new ideas to succeed, context of care and resource constraints will need to be considered.</p><p><strong>Discussion: </strong>Our findings highlight limited scope in diagnostic safety efforts, which remain largely centered on retrospective case reviews and conferences. Clinicians desire system-level redesign encompassing improved team dynamics, reduced cognitive load, psychologically safe feedback, and optimization of the electronic health record. This shift is hindered by cultural, leadership, and resource-related barriers.</p>","PeriodicalId":94084,"journal":{"name":"Journal of hospital medicine","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","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: Diagnosis and management of community-acquired pneumonia.","authors":"Duong T Hua, Pei-Yu Fu, Charles D","doi":"10.1002/jhm.70441","DOIUrl":"https://doi.org/10.1002/jhm.70441","url":null,"abstract":"","PeriodicalId":94084,"journal":{"name":"Journal of hospital medicine","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Look without fear.","authors":"Yasuhiro Kano","doi":"10.1002/jhm.70444","DOIUrl":"https://doi.org/10.1002/jhm.70444","url":null,"abstract":"","PeriodicalId":94084,"journal":{"name":"Journal of hospital medicine","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Partnering with the VA: Hospital medicine's high-impact learning health system.","authors":"Carlos Irwin A Oronce, Robert E Burke","doi":"10.1002/jhm.70466","DOIUrl":"https://doi.org/10.1002/jhm.70466","url":null,"abstract":"<p><p>The Veterans Health Administration, the nation's largest integrated health care system, is uniquely positioned to serve as hospital medicine's next high-impact Learning Health System. Its integrated structure, nationwide scale, and established implementation science infrastructure support the development, evaluation, and diffusion of care delivery innovations. By partnering with the Veterans Health Administration, hospitalists can accelerate the field's evolution by enabling evidence-based interventions to be tested and scaled up into routine practice.</p>","PeriodicalId":94084,"journal":{"name":"Journal of hospital medicine","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Defining the Director of Education in hospital medicine: A cross-sectional descriptive study.","authors":"Margot E Cohen, Catherine Callister, Shannon K Martin","doi":"10.1002/jhm.70440","DOIUrl":"https://doi.org/10.1002/jhm.70440","url":null,"abstract":"<p><strong>Background: </strong>Hospital medicine (HM) groups must balance an expanding clinical enterprise with their educational mission. In response, many have established the role of Director of Education (DOE) to lead and support educational efforts. The structure, expectations, and impact of this role remain poorly defined.</p><p><strong>Objective: </strong>To characterize the current landscape of the DOE role, including prevalence, funding, responsibilities, and evaluation strategies.</p><p><strong>Methods: </strong>We conducted a cross-sectional survey of hospitalists serving as DOEs or HM leaders familiar with the role at a sample of highly ranked academic HM groups.</p><p><strong>Results: </strong>Of 50 HM groups surveyed, 31 responded (62% response rate). Overall, 68% (21/31) of respondents reported having a DOE, with 76% (16/21) of DOEs receiving FTE support. Eighty-one percent (17/21) of DOEs lacked performance metrics. All DOEs held concurrent leadership roles in undergraduate or graduate medical education or within hospital medicine. The most cited goals of the educational mission were improving teaching quality (76%, 16/21), mentoring HM faculty educators (67%, 14/21), and expanding HM faculty teaching opportunities (57%, 12/21). Core responsibilities included developing internal HM education-related faculty development (100%), liaising with UME, GME, and CME leadership (71%, 15/21), and leading strategic planning to integrate learners into clinical services (57%, 12/21). Among institutions without a DOE, key barriers included lack of precedent (70%, 7/10), distributed responsibilities (60%, 6/10), and insufficient funding (60%, 6/10).</p><p><strong>Conclusions: </strong>The DOE plays a key role in aligning educational priorities with clinical operations within academic HM groups, with responsibilities spanning strategic planning, program development, and faculty support.</p>","PeriodicalId":94084,"journal":{"name":"Journal of hospital medicine","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methodological progress note: Applying co-production methods in hospital medicine research to increase impact.","authors":"Peter J Gill, Lisa Strifler, Francine Buchanan, Michelle Quinlan, Colin Macarthur, Sanjay Mahant","doi":"10.1002/jhm.70464","DOIUrl":"https://doi.org/10.1002/jhm.70464","url":null,"abstract":"<p><p>Research co-production-engaging key partners such as patients, families, clinicians, hospital administrators, and/or policymakers early and throughout the research process-enhances research impact. Through authentic, meaningful, and sustained partnerships, research co-production helps generate evidence that is relevant and useful for patients, clinical practice, policy, and the healthcare system. This methodological progress note introduces the concept of research co-production and provides practical strategies and real-world examples to guide hospitalists in applying this approach to accelerate the uptake and impact of hospital medicine research.</p>","PeriodicalId":94084,"journal":{"name":"Journal of hospital medicine","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Turning mid-career into a milestone for professional growth and fulfillment.","authors":"Farzana Hoque","doi":"10.1002/jhm.70469","DOIUrl":"https://doi.org/10.1002/jhm.70469","url":null,"abstract":"","PeriodicalId":94084,"journal":{"name":"Journal of hospital medicine","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revisiting the impact on mortality of intravenous iron administration during acute inpatient infections.","authors":"Richard Wu, Yu Rim Park, Lyndon P James, Omar El-Fadel, Nicholas A Bosch","doi":"10.1002/jhm.70457","DOIUrl":"https://doi.org/10.1002/jhm.70457","url":null,"abstract":"<p><p>The safety of iron repletion during acute infections has long been debated. A recent retrospective analysis reported significant and rapid mortality benefits from inpatient iron infusions given to patients with acute infections. This potential paradigm shift in inpatient management of iron deficiency anemia puts into question whether current common practice of withholding iron during infections is not only unnecessary, but actively harming patients. Our analysis utilizing the same database but with adjustments for additional confounders largely identified no difference in mortality in hospitalized patients with iron deficiency anemia who survived at least 7 days after being admitted for an infection, and suggests further studies are needed to truly clarify the safety and role for intravenous iron during acute infections.</p>","PeriodicalId":94084,"journal":{"name":"Journal of hospital medicine","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AI told my cat he's terminally ill.","authors":"Jamila Mammadova","doi":"10.1002/jhm.70449","DOIUrl":"https://doi.org/10.1002/jhm.70449","url":null,"abstract":"","PeriodicalId":94084,"journal":{"name":"Journal of hospital medicine","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148883090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reducing inpatient falls with a mobility-first, multidisciplinary intervention at a VA Medical Center.","authors":"Ryan Duffy, Padideh Imenikashani, Tymeeka Davis, Steven Fairbanks, Folake Ogunmola, Laura Previll, Brian Schneider","doi":"10.1002/jhm.70418","DOIUrl":"https://doi.org/10.1002/jhm.70418","url":null,"abstract":"<p><p>Inpatient falls are a common and preventable source of harm among hospitalized patients. At a Veterans Health Affairs medical center, we implemented a mobility-first, multidisciplinary intervention using sequential Plan-Do-Study-Act cycles, including redesigned activity orders to \"mobilize unless contraindicated,\" physical therapist-led education, and interdisciplinary fall huddles with rapid feedback. Over 18 months, total falls decreased by 34%, from 7.6 to 5.0 per 1000 bed-days, and injurious falls decreased by 46%, from 2.4 to 1.3 per 1000 bed-days, with no increase in staff injuries. This low-cost, scalable intervention suggests that standardizing mobility assessment, communication, and execution may reduce inpatient falls.</p>","PeriodicalId":94084,"journal":{"name":"Journal of hospital medicine","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}