Journal of hospital medicine最新文献

{"title":"Clinical guideline highlight: Pediatric refractory constipation.","authors":"Katherine Krause, Elizabeth Mertens","doi":"10.1002/jhm.70072","DOIUrl":"https://doi.org/10.1002/jhm.70072","url":null,"abstract":"","PeriodicalId":94084,"journal":{"name":"Journal of hospital medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144183361","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":"Re-envisioning interhospital transfer: A qualitative study exploring alternatives to transfer.","authors":"Stephanie K Mueller, James D Harrison, Amy Yu, Caitlin Kelly, Luci K Leykum","doi":"10.1002/jhm.70083","DOIUrl":"https://doi.org/10.1002/jhm.70083","url":null,"abstract":"<p><strong>Background: </strong>Interhospital transfer (IHT, the transfer of patients between acute care hospitals) is often undertaken to provide patients with specialized care. However, mounting hospital capacity pressures suggest a need for re-envisioning IHT with consideration of alternatives to transfer in select patients.</p><p><strong>Methods: </strong>We conducted a qualitative focus group study with key informants involved in IHT, including patient/family representatives, accepting and transferring clinicians, and hospital leadership. We used case examples of distinct IHT scenarios and a semi-structured focus group guide to explore aspects of the IHT process and potential alternative modalities of care. Data were analyzed using thematic analysis, with data coded into sub-themes and higher order themes until thematic saturation was achieved.</p><p><strong>Results: </strong>We conducted a total of 7 focus groups, involving 6 patient/family representatives, 12 accepting clinicians, 9 transferring clinicians, and 12 hospital leadership from 13 geographically diverse hospitals. Within the higher order theme of \"clinically appropriate alternatives to transfer,\" we identified several sub-themes, including transferring hospital support, ambulatory alternatives, and patient and organizational risks and benefits. Within the higher order theme of \"feasibility and barriers to identified alternatives\" we identified three sub-themes, including clinician unease about expansion of clinical scope, lack of healthcare infrastructure to support tele-health care, and limited outpatient capacity.</p><p><strong>Discussion: </strong>In this qualitative study of key informants involved in IHT, we identified several viable alternatives to IHT and revealed potential barriers that could impede their widespread implementation. These insights provide optimal targets for advancing efforts to develop and operationalize new care models, re-envisioning IHT management.</p>","PeriodicalId":94084,"journal":{"name":"Journal of hospital medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144183412","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":"Team emotional intelligence matters for hospitalists: Unlocking a key driver for performance, learning, and well-being.","authors":"Justin J Choi","doi":"10.1002/jhm.70082","DOIUrl":"https://doi.org/10.1002/jhm.70082","url":null,"abstract":"","PeriodicalId":94084,"journal":{"name":"Journal of hospital medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164307","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":"The influence of intergenerational trauma in families of Chinese descent on perceptions of microaggressions.","authors":"Lucy Cheng, Sonya Tang Girdwood","doi":"10.1002/jhm.70081","DOIUrl":"https://doi.org/10.1002/jhm.70081","url":null,"abstract":"","PeriodicalId":94084,"journal":{"name":"Journal of hospital medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144145270","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":"Novel screening intervention to address food insecurity in hospitalized children.","authors":"Ariel Carpenter, Adolfo Molina, Mary Orr, Cassi Smola, Samantha Hanna, Chang L Wu, Dana Woodruff, Cindy Deerman, Erin E Shaughnessy","doi":"10.1002/jhm.70079","DOIUrl":"https://doi.org/10.1002/jhm.70079","url":null,"abstract":"<p><p>Despite efforts to standardize and optimize screening of hospitalized children for food insecurity, rates of identified food insecurity (4.1%) remained far below the known community rate (18.3%-23.3%). We aimed to improve identification of food insecure families through a novel screening method, utilizing a nonclinical screener at a time uncoupled from admission. The positive food insecurity rate resulting from this screen closely approximated the community rate (18.1%). In addition, the novel screening method better identified Spanish speaking and Latino/Hispanic families with food insecurity, highlighting a disparity in the standard screening process.</p>","PeriodicalId":94084,"journal":{"name":"Journal of hospital medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144145268","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":"Comparison of inpatient subspecialty care delivery models: Clinical outcomes and racial disparities in dedicated versus consultative pulmonary care.","authors":"Bhavik P Patel, Caitlin B Clancy, Scott D Halpern, Rachel Kohn","doi":"10.1002/jhm.70078","DOIUrl":"https://doi.org/10.1002/jhm.70078","url":null,"abstract":"<p><strong>Background: </strong>Subspecialty inpatient care is associated with improved outcomes in various clinical settings. However, clinical outcomes and racial disparities between dedicated inpatient pulmonary care and general medicine services with pulmonary consultation remain unknown.</p><p><strong>Objective: </strong>To compare clinical outcomes between dedicated and consultative inpatient pulmonary care and evaluate whether racial disparities in outcomes differ by care model.</p><p><strong>Methods: </strong>Retrospective cohort study of 1072 self-identified Black and White adults admitted to dedicated pulmonary or general medicine services with pulmonary consultation (April 2017-February 2020) at an academic medical center. Exposures included the care model, race, and the interaction between the two. Outcomes included hospital length of stay (LOS; modeled as risk of discharge alive using competing risk models), hospital readmissions, and outpatient pulmonary follow-up. We performed multivariable regression models with interaction terms adjusted for demographics, comorbidities, clinical severity, and pulmonary diagnosis.</p><p><strong>Results: </strong>Dedicated pulmonary service patients had shorter LOS (subdistribution hazard ratio [SHR]: 1.38, 95% confidence interval [CI]: 1.14-1.67, p = .001) and improved 90-day outpatient follow-up (odds ratio [OR]: 1.63, 95% CI: 1.07-2.49, p = .023). The interaction between care model and race demonstrated significantly lower odds of 30-day follow-up among Black patients admitted to the dedicated service versus those with consultations; no other significant racial disparities in outcomes were demonstrated.</p><p><strong>Conclusions: </strong>Dedicated pulmonary inpatient care was associated with shorter hospital LOS and higher 90-day outpatient follow-up without significant racial disparities in most outcomes. Hospitals could consider pilot-testing dedicated inpatient pulmonary care models, as more work is needed to validate these findings in broader settings.</p>","PeriodicalId":94084,"journal":{"name":"Journal of hospital medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129870","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":"Safety in a hybrid hospital-at-home program versus traditional inpatient care: A pragmatic randomized controlled trial.","authors":"Michael J Maniaci, Lindsey R Sangaralingham, Emma M Behnken, Melissa S Hart, Shealeigh A Inselman, Margaret Paulson, Chad R Nelson, Rachel A Gothot, Yu-Hui H Chang, Kristine T Hanson, Yvonne M Larson Smith, Sey V Oloyede, Sarah L Gifford, Josh D Taylor, Ajani N Dunn, Shannon M Dunlay, Sean C Dowdy, Elizabeth B Habermann, Wendelyn Bosch, Jennifer B Cowart, Xiaoxi Yao","doi":"10.1002/jhm.70076","DOIUrl":"https://doi.org/10.1002/jhm.70076","url":null,"abstract":"<p><strong>Background: </strong>Hospital-at-home programs (HaH) in the United States have evolved to include a virtual-hybrid delivery model, where all physician encounters are virtual and partnered with a home care team.</p><p><strong>Objective: </strong>To examine whether a virtual hybrid HaH program enabled by technology has similar clinical outcomes to traditional brick-and-mortar (B&M) hospital care.</p><p><strong>Methods: </strong>We conducted a pragmatic trial at three hospitals, randomizing 1150 acutely ill patients requiring hospital care between July 10, 2023, and October 31, 2023 one-to-one into two groups: intervention (HaH) and control (B&M). The primary analysis was an intention-to-treat non-inferiority analysis of the primary outcome, which was a composite of 30-day all-cause mortality and unplanned readmissions. Secondary outcomes included 30-day readmission, all-cause mortality, and patient experience.</p><p><strong>Results: </strong>The mean age was 67.8 (standard deviation [SD] 16.3) years, and 52.2% were female. The primary outcome occurred in 99 (17.3%) HaH patients and 114 (19.8%) B&M patients (odds ratio [OR] 0.85, 95% confidence interval [CI] 0.63-1.14, p = .28), meeting the non-inferiority criterion. Thirty-day unplanned readmission occurred in 84 (14.7%) HaH patients and 101 (17.5%) B&M patients (OR 0.81, 95% CI 0.59-1.11, p = .19). Thirty-day all-cause mortality occurred in 25 (4.4%) HaH patients and 19 (3.3%) B&M patients (OR 1.34, 95% CI 0.73-2.46, p = .35). No HaH patients died while receiving their hospital care at home. HaH program was associated with a higher likelihood of patients reporting feeling extremely comfortable or very comfortable (84.4% HaH; 60.9% B&M, p = .001).</p><p><strong>Conclusion: </strong>A hybrid HaH model is a safe and comfortable alternative to traditional B&M hospital care.</p>","PeriodicalId":94084,"journal":{"name":"Journal of hospital medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121775","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 progress note: Pertussis.","authors":"Samantha Hanna, Nicole Samies","doi":"10.1002/jhm.70080","DOIUrl":"https://doi.org/10.1002/jhm.70080","url":null,"abstract":"<p><p>Pertussis, commonly known as whooping cough, is a vaccine-preventable respiratory disease with rising incidence due to declining vaccination rates and waning immunity. The most severe disease course is seen in unvaccinated or incompletely vaccinated infants less than 2 months of age, accounting for the largest burden of hospitalization and death, but adolescents and adults play an important role in pertussis transmission and outbreaks. Prompt recognition and diagnosis remain critical for hospitalists in the management of pertussis disease and prevention.</p>","PeriodicalId":94084,"journal":{"name":"Journal of hospital medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096403","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":"Code status discussions with families of children with medically complexity need to happen sooner.","authors":"Lauren Agoratus","doi":"10.1002/jhm.70075","DOIUrl":"https://doi.org/10.1002/jhm.70075","url":null,"abstract":"","PeriodicalId":94084,"journal":{"name":"Journal of hospital medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096406","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":"The core competencies in hospital medicine: Procedures 2025 update.","authors":"Satyen Nichani, Megan E Brooks, Christine Bryson, Nick Fitterman, Meltiady Issa, Michael Lukela, Nick Marzano, Kelly Sopko, Joseph R Sweigart","doi":"10.1002/jhm.70042","DOIUrl":"https://doi.org/10.1002/jhm.70042","url":null,"abstract":"<p><p>This article presents an updated framework from the Society of Hospital Medicine for individual learning objectives related to key procedures in hospital medicine. Building upon the 2017 framework, these objectives have been revised to reflect evolving clinical evidence, advancements, and shifts in hospital medicine practice patterns. The methodology included a comprehensive literature review, expert consensus panels, and feedback from practicing hospitalists across diverse clinical settings. The updated learning objectives address procedural competencies for the most common interventions in hospital medicine, including arthrocentesis, emergency procedures, interpretation of chest radiographs and electrocardiograms, lumbar puncture, paracentesis, thoracentesis, and vascular access. These revised learning objectives provide a framework to guide curricular development, continuing medical education, and hospital medicine practitioners in developing and maintaining procedural competence essential for high-quality inpatient care.</p>","PeriodicalId":94084,"journal":{"name":"Journal of hospital medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082999","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}