Journal of hospital medicine最新文献

{"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}

{"title":"Time to evolve? Modernizing the hospital ethics committee.","authors":"Julie R Bloom, Kunal K Sindhu","doi":"10.1002/jhm.70074","DOIUrl":"https://doi.org/10.1002/jhm.70074","url":null,"abstract":"","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":"144083000","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":"Interventions to reduce readmissions after pneumonia hospitalization: A systematic review and meta-analysis.","authors":"Sarah A Phillips, Julie D Sill, Rehan Qayyum","doi":"10.1002/jhm.70073","DOIUrl":"https://doi.org/10.1002/jhm.70073","url":null,"abstract":"<p><strong>Background: </strong>Preventable hospital readmissions, reflecting suboptimal healthcare quality and increased costs, highlight the need for evidence to shape healthcare delivery.</p><p><strong>Objectives: </strong>This systematic review assesses interventions to reduce readmissions following pneumonia-related hospitalizations.</p><p><strong>Methods: </strong>PubMed, Cochrane Library, and CINAHL were searched from inception to May 29, 2024. English language peer-reviewed studies examining interventions to reduce readmissions after pneumonia hospitalization were selected. Two authors independently extracted data, assessed risk of bias, and evaluated certainty of evidence using standardized assessment tools. When possible, study results were pooled using random-effects models.</p><p><strong>Results: </strong>Of the 601 articles initially identified, 15 studies met inclusion criteria. Eight interventions were evaluated from eight retrospective cohort studies, five randomized controlled trials, and two pre-post trials. Hospital-based skilled nursing facilities, patient education, early postdischarge follow-up, nutrition supplementation, and a high physician-to-bed ratio were linked to reduced readmissions. Early mobilization also showed a significant reduction in readmissions (pooled odds ratio = 0.84, 95% confidence interval [CI]: 0.75, 0.95; p = .005). Hospital participation in Accountable Care Organizations did not affect readmissions, and pharmacist-involved discharge similarly found no significant impact (pooled odds ratio = 0.66, 95% CI: 0.44, 1.01; p = .06). Risk of bias was high across most studies due to inadequate controlling for confounding variables.</p><p><strong>Conclusion: </strong>Certainty of evidence was high for early mobilization, low for hospital-based skilled nursing facilities, and very low for pharmacist-involved discharge processes. Small sample size and single-center intervention implementation limited study generalizability. Randomized controlled trials are needed to determine the efficacy of interventions for reducing readmissions after pneumonia hospitalization.</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":"144082998","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":"Just my luck: Diagnosed difficult.","authors":"Nike Izmaylov, Michelle Izmaylov","doi":"10.1002/jhm.70067","DOIUrl":"https://doi.org/10.1002/jhm.70067","url":null,"abstract":"","PeriodicalId":94084,"journal":{"name":"Journal of hospital medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033010","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":"Improving promptness and quality of hospitalist-consultant interactions at an academic teaching hospital.","authors":"John M Cunningham, Robert Leverence, Nico Gotera, Phillip A Minor, Nathan Sevigny, Ankur Segon","doi":"10.1002/jhm.70047","DOIUrl":"https://doi.org/10.1002/jhm.70047","url":null,"abstract":"<p><p>Communication between consulting and consultant services is essential to provide high-value care. We implemented a collaborative project between hospital medicine (HM), emergency medicine (EM), and departmental leadership of the major consulting services to provide feedback regarding consultant communication, promptness, and follow-up planning. We conducted pre- and postintervention surveys of HM and EM clinicians and measured the mean turnaround time (TAT) from consult order to consultant note completion. Perceptions of consultant promptness and follow-up communication improved postintervention. Mean TAT was significantly reduced postintervention (1098 vs. 1011 min, p = .002, confidence interval [CI]: 30.7-143.3). A collaborative approach using interdepartmental feedback improved perceptions of the quality of interactions with consulting services.</p>","PeriodicalId":94084,"journal":{"name":"Journal of hospital medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000993","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":"Point-counterpoint: What is the best strategy for developing generative AI for hospital medicine?","authors":"Hannah Kerman, Andre Kumar, Byron Crowe, William Collins","doi":"10.1002/jhm.70070","DOIUrl":"https://doi.org/10.1002/jhm.70070","url":null,"abstract":"<p><p>Generative Artificial Intelligence (Gen AI) shows significant promise as a technology that could improve healthcare delivery, but its implementation will be influenced by the spheres in which it is studied and the limited resources of hospitals. The Point authors argue that we should focus on is the cognitive abilities of GenAI or we risk being left out of a technological leap that will change the way doctors practice. The Counterpoint argues that we should focus on using GenAI to ease system burdens and address workflow issues, focusing our efforts on fixing the problems that would improve doctors' quality of life and increase time spent with patients.</p>","PeriodicalId":94084,"journal":{"name":"Journal of hospital medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016040","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":"Disparities in specialist palliative care for Taiwanese children and young adults impacted by local digital development and noncancer diagnoses.","authors":"Shih-Chun Lin, Chi-Yin Kao, Hsueh-Fen Chen, Sriyani Padmalatha Konara Mudiyanselage, Hsiang-Ying Lu, Mei-Chih Huang","doi":"10.1002/jhm.70068","DOIUrl":"https://doi.org/10.1002/jhm.70068","url":null,"abstract":"<p><strong>Background: </strong>Disparities in specialist palliative care (SPC) are complex. Families of children and young adults with life-limiting conditions in digitally advanced areas have better access to health information and services.</p><p><strong>Objectives: </strong>To examine SPC and end-of-life care for these patients, focusing on SPC referral rates and associated disparities.</p><p><strong>Methods: </strong>A retrospective study used national health insurance data in Taiwan. Patients aged 1-25 years who died with life-limiting conditions between 2009 and 2017 were included in this study (n = 6863). The main focus was on referrals to SPC, identified through service codes for palliative shared care, home care, and inpatient hospice.</p><p><strong>Results: </strong>A total of 979 patients (14.3%) received SPC at least 3 days before death. Cancer patients were over 10 times more likely to receive SPC than noncancer patients, with an odds ratio of 10.77 (95% confidence interval [CI]: 9.08-12.77). Conversely, patients with congenital, hematological, neurological, or respiratory conditions were over 60% less likely to receive SPC than those without such conditions. Patients in well-digitally developed townships had higher SPC referrals rates (adjusted odds ratio [aOR]: 1.28; 95% CI: 1.11-1.48). SPC was associated with longer hospital stays in the last month of life (aOR: 2.64; 95% CI: 2.28-3.06) and increased hospital deaths (aOR: 8.36; 95% CI: 5.66-12.35), but less likely to be admitted to hospitals in the last 5 days of life (aOR: 0.61; 95% CI: 0.50-0.74).</p><p><strong>Conclusions: </strong>Few patients in Taiwan received SPC, highlighting that diagnosis is a significant predictor. This suggests a need for further investigation into resources for SPC.</p>","PeriodicalId":94084,"journal":{"name":"Journal of hospital medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048524","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":"Intervention for hospitalized people with chronic pain and elevated risk for opioid-related harm: A pilot randomized controlled trial.","authors":"Melissa B Weimer, Michele J Buonora, Alexandra M Hajduk, Adam L Ackerman, Krishna R Daggula, William C Becker, Sarwat I Chaudhry, David A Fiellin","doi":"10.1002/jhm.70066","DOIUrl":"https://doi.org/10.1002/jhm.70066","url":null,"abstract":"<p><strong>Background: </strong>The management of analgesia in people hospitalized with chronic pain and elevated risk for opioid-related harm is challenging. While opioid stewardship programs could provide guidance, their feasibility in this population has not been examined.</p><p><strong>Objectives: </strong>To develop a case identification tool and evaluate the feasibility of an electronic medical record (EMR)-delivered opioid stewardship and pain intervention among hospitalized people with chronic pain and elevated risk for opioid-related harm.</p><p><strong>Methods: </strong>After developing and evaluating the operating characteristics of a case identification tool to identify people with chronic pain and elevated risk for opioid-related harm, hospitalized adults with chronic pain and elevated risk for opioid-related harm were randomized to an EMR-delivered opioid stewardship and pain intervention versus usual care. Primary outcomes were feasibility-based. Exploratory outcomes were pain-related clinical outcomes.</p><p><strong>Results: </strong>The case identification tool had a sensitivity of 88.9% and a specificity of 95.7%. The trial recruited 52/97 (54%) of potential participants who completed 52/52 (100%) potential assessments and of whom 45/52 (87%) were retained in the study at 4 weeks, demonstrating feasibility. On average, both treatment arms received 56% of the recommended guideline-concordant care and there was no significant difference in opioid and pain-related care in the two groups.</p><p><strong>Conclusion: </strong>It is both feasible to develop an EMR-based tool to prospectively identify hospitalized people with chronic pain and elevated risk for opioid-related harm as well as recruit these individuals to an EMR-delivered opioid stewardship and pain intervention. Additional strategies to support the provision of guideline-concordant care may be warranted.</p>","PeriodicalId":94084,"journal":{"name":"Journal of hospital medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002002","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}