Journal of hospital medicine最新文献_第6页

Journal of hospital medicine Pub Date : 2025-01-18 DOI: 10.1002/jhm.13591

Samir S Shah, Manpreet Malik

引用次数: 0

The secret to saying no: A decision framework for physicians. 说不的秘诀：医生的决策框架。

Journal of hospital medicine Pub Date : 2025-01-16 DOI: 10.1002/jhm.13590

Samir S Shah

引用次数: 0

Accuracy of pathogen diagnostic codes for acute hematogenous musculoskeletal infections in children. 儿童急性血源性肌肉骨骼感染病原体诊断代码的准确性。

Journal of hospital medicine Pub Date : 2025-01-13 DOI: 10.1002/jhm.13584

Justin B Searns, Matt Hall, Meghan Birkholz, Kevin J Downes, Brittany B Hubbell, Andrew S Kern-Goldberger, Jessica L Markham, Jason G Newland, Stephanie L Rolsma, Marie E Wang, Sean T O'Leary, Samuel R Dominguez, Sarah K Parker, Matthew P Kronman

{"title":"Accuracy of pathogen diagnostic codes for acute hematogenous musculoskeletal infections in children.","authors":"Justin B Searns, Matt Hall, Meghan Birkholz, Kevin J Downes, Brittany B Hubbell, Andrew S Kern-Goldberger, Jessica L Markham, Jason G Newland, Stephanie L Rolsma, Marie E Wang, Sean T O'Leary, Samuel R Dominguez, Sarah K Parker, Matthew P Kronman","doi":"10.1002/jhm.13584","DOIUrl":"https://doi.org/10.1002/jhm.13584","url":null,"abstract":"Administrative databases are powerful tools for pediatric research but lack patient-level microbiology results. This study aimed to determine the accuracy of pathogen discharge diagnosis codes for children hospitalized with acute hematogenous musculoskeletal infections (MSKIs). Medical records for 244 children hospitalized with acute hematogenous MSKIs were manually reviewed to determine which bacterial pathogen, if any, was identified for each MSKI based on microbiology results obtained during the hospitalization. Microbiology results for each patient were then compared to their discharge diagnoses in the Pediatric Health Information System (PHIS) database to determine the accuracy of pathogen discharge codes. Discharge diagnostic codes correctly matched the microbiology results in 89.3% of encounters. Sensitivity and specificity for Staphylococcus aureus discharge diagnostic codes were 88.6% and 96.4% respectively for methicillin-susceptible S. aureus and 92.9% and 99.5% for methicillin-resistant S. aureus. Pathogen discharge codes are reliable surrogates that accurately reflect the microbiology results for children with MSKIs.","PeriodicalId":94084,"journal":{"name":"Journal of hospital medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142981087","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}

引用次数: 0

Dying in the hospital: Spiritual-based care at the end of life. 在医院里死去：生命结束时的精神护理。

Journal of hospital medicine Pub Date : 2025-01-13 DOI: 10.1002/jhm.13588

Hafsa Bhatty, Ashima Lal, Emily Pinto Taylor

引用次数: 0

Health conditions seen frequently in hospitalized United States Veterans who served after 9/11/2001: A scoping review. 2001年9月11日之后服役的住院美国退伍军人常见的健康状况：范围审查。

Journal of hospital medicine Pub Date : 2025-01-09 DOI: 10.1002/jhm.13586

Joel C Boggan, Nazima Allaudeen, Heather Shaw, Sarah Cantrell, Joyce Akwe

{"title":"Health conditions seen frequently in hospitalized United States Veterans who served after 9/11/2001: A scoping review.","authors":"Joel C Boggan, Nazima Allaudeen, Heather Shaw, Sarah Cantrell, Joyce Akwe","doi":"10.1002/jhm.13586","DOIUrl":"https://doi.org/10.1002/jhm.13586","url":null,"abstract":"Background: Hospitalists working outside the Veterans Affairs (VA) system frequently will serve Veterans receiving care for acute conditions and/or awaiting transfer to VA facilities.Objective: To perform a scoping review of health conditions and associated outcomes relevant to hospital medicine in US Veterans who served in active duty or reserve deployed roles after November 9, 2001.Methods: A search of MEDLINE and Embase was performed using a combination of terms related to military service period and health conditions, yielding 5634 citations published after January 1, 2013.Study selection and data extraction: Two reviewers performed independent screening at the title/abstract and later at the full-text levels. Conflicts at both stages were resolved through discussion. Single reviewers extracted data and synthesized results into three categories: (1) mental health and nonblast trauma, (2) neurologic outcomes, and (3) other conditions, including cardiovascular and respiratory outcomes.Results: Of 85 included studies, 19 focused on cardiovascular, respiratory, autoimmune, and multisystem outcomes; 38 focused on mental health and nonblast trauma; and 28 focused on traumatic brain injury and neurologic outcomes. Studies showed high rates of comorbid mental health diagnoses and suicide-related behaviors relative to non-Veteran populations, as well as relatively younger incidence of cardiovascular and respiratory chronic conditions, such as atrial fibrillation.Conclusions: Most studied health conditions among Veterans of post-9/11 conflicts have focused on areas of particular importance to the VA. However, significant gaps remain, particularly in understanding the correlation between specific exposures and clinical outcomes currently observed and to be anticipated in the future in this population.","PeriodicalId":94084,"journal":{"name":"Journal of hospital medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960666","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}

引用次数: 0

Prevalence of burnout and impact of workload on physician wellness: A cross-sectional survey of hospitalists in British Columbia, Canada. 职业倦怠的普遍程度以及工作量对医生健康的影响：对加拿大不列颠哥伦比亚省医院医生的横断面调查。

Journal of hospital medicine Pub Date : 2025-01-01 DOI: 10.1002/jhm.13577

Vandad Yousefi

{"title":"Prevalence of burnout and impact of workload on physician wellness: A cross-sectional survey of hospitalists in British Columbia, Canada.","authors":"Vandad Yousefi","doi":"10.1002/jhm.13577","DOIUrl":"https://doi.org/10.1002/jhm.13577","url":null,"abstract":"Background: Hospitalists in British Columbia care for a large percentage of hospitalized patients across 21 acute care facilities.Objective: We aimed to characterize the demographic and work attributes of the workforce and to understand levels of burnout and the relationship between workload and job satisfaction.Methods: We conducted a cross-sectional survey of individuals participating in hospitalist programs in BC.Results: Almost all individuals (96%) were involved in the care of patients with COVID-19 in 2021, the height of the pandemic. High rates of burnout were demonstrated among hospitalists, with a large number of providers planning to significantly reduce or stop their involvement in acute care. Regression analysis identified workload as an important factor associated with burnout. Older physicians, those who had been practising for longer, and those with moderate to high number of shifts were more likely to consider reducing their involvement with their programs.Conclusions: High levels of burnout are associated with a desire to reduce work involvement among BC hospitalists. Health system leaders need to consider factors contributing to burnout as a key aspect of broader health human resource planning efforts.","PeriodicalId":94084,"journal":{"name":"Journal of hospital medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916451","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}

引用次数: 0

Psychology insights on apologizing to patients. 向病人道歉的心理学见解。

Journal of hospital medicine Pub Date : 2024-12-30 DOI: 10.1002/jhm.13585

Donald A Redelmeier, Jada Roach

引用次数: 0

Physician inpatient handoffs-Patient and physician outcomes: A systematic review. 住院病人的医生交接--病人和医生的结果：系统综述。

Journal of hospital medicine Pub Date : 2024-12-29 DOI: 10.1002/jhm.13583

Joshua Allen-Dicker, Matthew Kerwin, Joseph S Wallins, Nisha Rao, Rezana Mara, Marina Chilov, Chanan Batra, Susan Chimonas, Deborah Korenstein

{"title":"Physician inpatient handoffs-Patient and physician outcomes: A systematic review.","authors":"Joshua Allen-Dicker, Matthew Kerwin, Joseph S Wallins, Nisha Rao, Rezana Mara, Marina Chilov, Chanan Batra, Susan Chimonas, Deborah Korenstein","doi":"10.1002/jhm.13583","DOIUrl":"https://doi.org/10.1002/jhm.13583","url":null,"abstract":"Background: Prior reviews have shown that interventions to improve inpatient handoffs are inconsistently associated with improvement in patient outcomes. This systematic review examines the effectiveness of inpatient handoff interventions on outcomes affecting patients and physicians, including objective measures when reported (PROSPERO ID: CRD42022309326).Methods: Pubmed, Embase, and Cochrane Central Register of Controlled Trials were searched on January 13th, 2022. We included experimental or quasi-experimental studies that examined handoff communication between inpatient physicians and reported patient clinical, patient experiential, physician experiential, or cost and utilization outcomes. Studies were excluded if they examined handoffs between facilities or levels of care, or only reported subjective measures of patient safety or physician experience. Risk of bias was assessed using the ROBINS-1 and RoB-2 tools.Results: Of the 42 included studies, six were randomized controlled trials. Most studies were conducted at academic centers (67%) and involved only residents (64%). An educational intervention was used in 52% of studies and a structural intervention was used in 43%, with 9% using both. Adverse events were significantly improved in three of 16 studies, medical errors in three of seven studies, and length of stay in three of seven studies. Four studies examined mortality, and none reported a significant improvement. Studies that used both structural and educational components reported significant improvements more frequently.Conclusions: The literature is mixed on the impact of efforts to improve handoffs, though there are few randomized trials. Few studies reported patient experiential or cost/utilization outcomes, or involved hospitalist physicians, which represent potential areas for future research.","PeriodicalId":94084,"journal":{"name":"Journal of hospital medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142904650","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}

引用次数: 0

Big brother or big opportunity? Utilization of EHR use metadata in the inpatient setting: A mixed methods study at 16 organizations. 老大哥还是大机遇？在住院环境中使用电子病历使用元数据：对 16 家机构进行的混合方法研究。

Journal of hospital medicine Pub Date : 2024-12-25 DOI: 10.1002/jhm.13572

Marisha Burden, Angela Keniston, Lauren McBeth, Gopi Astik, Kirsten N Kangelaris, Aveena Kochar, Michelle Knees, Ankur Segon, Sara Westergaard, Amy Yu, Matthew Sakumoto, Romil Chadha

{"title":"Big brother or big opportunity? Utilization of EHR use metadata in the inpatient setting: A mixed methods study at 16 organizations.","authors":"Marisha Burden, Angela Keniston, Lauren McBeth, Gopi Astik, Kirsten N Kangelaris, Aveena Kochar, Michelle Knees, Ankur Segon, Sara Westergaard, Amy Yu, Matthew Sakumoto, Romil Chadha","doi":"10.1002/jhm.13572","DOIUrl":"https://doi.org/10.1002/jhm.13572","url":null,"abstract":"Background: Clinician electronic actions within the electronic health record (EHR) are captured seamlessly in real-time during regular work activities in all major EHRs. Analysis of this EHR use metadata, such as audit log data, is increasingly used to understand the impact of work design on critical patient, workforce, and organizational outcomes.Objective: Understand experiences and perspectives influencing the use and implementation of audit log data into practice.Methods: Mixed methods design utilizing focus groups and embedded survey with hospitalist group leaders attending a national society special interest group. Themes and subthemes were identified.Results: Seven semistructured virtual focus groups were held with 16 individuals from 16 different organizations on December 12, 2023, with a 100% survey response rate. Survey results highlighted the lack of familiarity with audit log data, the lack of tools and training for use, and the lack of established protocols to respond to insights, with some concerns for the accuracy of the data. Four themes and multiple subthemes were identified and included: (1) Limited, but widely variable use of audit log data driven by a lack of access, resources, skills, and knowledge, (2) mistrust and skepticism about the data, including concerns about potential misuse and a lack of best practices and standards, (3) perspectives around audit log data are culture and context driven, and (4) excitement for the many potential use cases.Conclusion: Despite all major EHRs having audit log data, participants had limited access, training, and knowledge. Although there was mistrust, many opportunities were identified.","PeriodicalId":94084,"journal":{"name":"Journal of hospital medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142901469","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}

引用次数: 0

The virtue of vulnerability. 脆弱的美德。

Journal of hospital medicine Pub Date : 2024-12-22 DOI: 10.1002/jhm.13582

Justin J Roesch

引用次数: 0