Journal of hospital medicine最新文献

{"title":"The impact of climate change induced natural disasters on healthcare: Rethinking intravenous fluids.","authors":"Elizabeth A Cerceo, Katherine T Liu, Evans K H Brown, Catherine Chen","doi":"10.1002/jhm.13578","DOIUrl":"https://doi.org/10.1002/jhm.13578","url":null,"abstract":"","PeriodicalId":94084,"journal":{"name":"Journal of hospital medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873692","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":"Effect of the COVID-19 pandemic on unmet healthcare needs after hospital discharge in acute respiratory failure survivors: A multicenter prospective cohort study.","authors":"Harris L Carmichael, Danielle Groat, Victor D Dinglas, Somnath Bose, Mustafa Mir Kasimov, James C Jackson, Naga Preethi Kadiri, Maria Isabel Trejo-Zambrano, Carla M Sevin, Tom Green, Dale M Needham, Samuel M Brown","doi":"10.1002/jhm.13576","DOIUrl":"https://doi.org/10.1002/jhm.13576","url":null,"abstract":"<p><p>Survivors of acute respiratory failure (ARF) have complex healthcare needs postdischarge, frequently resulting in unmet needs. This prospective multicenter study explores the association between COVID-19 status and unmet healthcare needs in survivors of ARF following hospital discharge. We analyzed patient characteristics and unmet healthcare needs by COVID-19 status using a multivariable regression model with propensity weights. Among 195 patients in the final analysis, 54% were COVID-19+, 53% were female, 42% were non-White, and the median (interquartile range [IQR]) age was 54 (42-63). The median (IQR) percentage of unmet healthcare needs was 26% (17%-36%), with follow-up appointments accounting for most unmet needs. Unmet medication needs were found to be very low at 6%. Despite the challenges in healthcare delivery during the COVID-19 pandemic, our data suggest COVID status had no observable effect on unmet healthcare needs for ARF survivors, after controlling for patient baseline and clinical status.</p>","PeriodicalId":94084,"journal":{"name":"Journal of hospital medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866344","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":"Standardizing imaging practices: An opportunity to leverage modern measurement tools.","authors":"Alaina Shine, Reto Baertschiger, Samantha A House","doi":"10.1002/jhm.13579","DOIUrl":"https://doi.org/10.1002/jhm.13579","url":null,"abstract":"","PeriodicalId":94084,"journal":{"name":"Journal of hospital medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142857404","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":"Indications and outcomes of pediatric high flow nasal cannula use in the home setting.","authors":"David D'Arienzo, Liam Sanvido, Reshma Amin, Catherine Diskin, Eyal Cohen","doi":"10.1002/jhm.13571","DOIUrl":"https://doi.org/10.1002/jhm.13571","url":null,"abstract":"<p><strong>Objective: </strong>To describe the patient characteristics, indications, and clinical outcomes of home high flow nasal cannula (HFNC) among pediatric patients. To evaluate secular trends in home HFNC initiation between 2013 and 2022.</p><p><strong>Methods: </strong>A retrospective review of all children on home HFNC between 2013 and 2023 was conducted at a tertiary care pediatric hospital in Ontario, Canada. Descriptive statistics were used to summarize results and identify indications for home HFNC initiation. Mann-Kendall Trend test was used to assess trends in HHF initiation between 2013 and 2022.</p><p><strong>Results: </strong>A total of 35 patients, ages 6 months-14 years old, were started on home HFNC between 2013 and 2023. HFNC initiation increased over time, from 0 patients in 2013-2016 to nine patients per year in 2021 and 2022 (p < .001). Home HFNC was almost exclusively prescribed for children with multisystem conditions, 77% with an underlying genetic disorder, and 77% with prior home feeding tube use. Most children (83%) had multiple indications leading to initiation of home HFNC. The main indications included the following: (i) upper airway obstruction (66%), (ii) clearance of retained CO₂ (57%), (iii) increased work of breathing without sleep-disordered breathing (29%), (iv) promotion of secretion clearance/plastic bronchitis (29%), and (v) palliative care (14%). In addition, 37% did not tolerate a previous trial of Continuous/Bi-Level Positive Airway Pressure. Complications were rare, with only two children developing epistaxis requiring an emergency department visit and 4 children requiring escalation in home respiratory support to CPAP or BiPAP.</p><p><strong>Conclusion: </strong>HFNC is increasingly being initiated among children in the home setting for varied indications. Preliminary data suggests few complications and a need for escalation of therapy with home HFNC.</p>","PeriodicalId":94084,"journal":{"name":"Journal of hospital medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848662","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":"Optimizing learners on direct care teaching services: A qualitative study of hospitalist clinicians at 26 sites.","authors":"Catherine Callister, Gopi Astik, R Matthew Atkins, Angela Alday, Khooshbu Dayton, Angela Keniston, Anne Linker, Lauren McBeth, John Merriman, Sara Westergaard, Amy Yu, Andrew Auerbach, Marisha Burden","doi":"10.1002/jhm.13561","DOIUrl":"https://doi.org/10.1002/jhm.13561","url":null,"abstract":"<p><strong>Background: </strong>Academic medical centers are experiencing rapid clinical growth which has outpaced traditional teaching services. Learners such as medical students, advanced practice provider fellows, and residents may be placed onto direct care teaching services (i.e., inpatient services where attendings provide both direct care to patients and supervise learners) creating potential challenges for attending physicians due to clinical demands.</p><p><strong>Objective: </strong>Characterize the hospitalist experience with direct care teaching services.</p><p><strong>Methods: </strong>Embedded mixed methods study with a 16-question survey and semistructured focus groups using rapid qualitative methods.</p><p><strong>Setting and participants: </strong>Virtual focus groups in the Hospital Medicine Reengineering Network (HOMERuN).</p><p><strong>Main outcome and measures: </strong>Qualitative themes.</p><p><strong>Results: </strong>Thirty-eight hospitalist clinicians from 26 hospital systems across five geographic regions participated in the focus groups. Thirty-four (89%) of participants responded to the survey and were predominantly physicians (97%). Most participants preferred traditional teaching services compared with direct care teaching services with 82% replying somewhat or to a great extent. Thematic analysis identified three themes: (1) Hospitalists prefer traditional teaching services in part due to a time and workload mismatch in direct care teaching services; (2) Adaptations can support attending physicians in direct care teaching services such as adjusting workloads based on the level of learners; and (3) Direct care teaching services were perceived to serve an important role by providing direct and personalized teaching, and offering teaching opportunities.</p><p><strong>Conclusion: </strong>Direct care teaching services pose challenges given clinical workloads, time constraints for educational activities. Addressing these challenges may make these types of services more sustainable.</p>","PeriodicalId":94084,"journal":{"name":"Journal of hospital medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142831464","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":"Physician advisor rotation-Filling a gap in resident education.","authors":"Bina Patel, James Kelly, Susan Fisher, Christopher Boyle","doi":"10.1002/jhm.13575","DOIUrl":"https://doi.org/10.1002/jhm.13575","url":null,"abstract":"","PeriodicalId":94084,"journal":{"name":"Journal of hospital medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142831480","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":"Measuring the association between diagnostic errors and neighborhood disadvantage.","authors":"Farah A Kaiksow, Marina Brendel, Colin C Hubbard, Tiffany Lee, David Chia, Katherine Brooks, Gregory W Ruhnke, Katie E Raffel, Abhishek Goyal, Molly A Kantor, A Shams Helminski, Angela Alday, Gopi J Astik, Peter Barish, Jeffrey L Schnipper, Andrew D Auerbach","doi":"10.1002/jhm.13574","DOIUrl":"https://doi.org/10.1002/jhm.13574","url":null,"abstract":"<p><p>Patients who reside in areas of high neighborhood disadvantage have poorer health outcomes; the mechanisms for this disparity are complex. We sought to determine if there was an association between neighborhood disadvantage and diagnostic error among a cohort of adult inpatients who experienced either an ICU transfer or in-hospital death. Using a sample of 527 patients from seven geographically diverse academic medical systems, we compared diagnostic error rates to patients' neighborhood disadvantage levels as measured by the Area Deprivation Index, a validated composite measure of socioeconomic status. In contrast to previous studies that found differences in hospital care based on socioeconomic status, we found no difference in diagnostic error rate between patients based on neighborhood disadvantage. Once a patient reaches the hospital, their risk of diagnostic error is not related to the neighborhood in which they live.</p>","PeriodicalId":94084,"journal":{"name":"Journal of hospital medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820510","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":"Things We Do for No Reason™: Avoiding naltrexone for alcohol use disorder in liver disease.","authors":"Dustin P Kee, John J Buyske, Susan L Calcaterra","doi":"10.1002/jhm.13569","DOIUrl":"https://doi.org/10.1002/jhm.13569","url":null,"abstract":"<p><p>Hospitalizations related to alcohol use disorder (AUD) are common. Yet, few patients receive pharmacotherapy consistent with guideline recommendations. Previous concerns over the potential hepatotoxicity of naltrexone have been disproven and recent studies have shown its safety and efficacy in patients with cirrhosis. Naltrexone is an effective therapy to reduce heavy alcohol consumption, however, lack of knowledge among prescribers inhibits greater uptake. Hospitalization is an opportune time for change-naltrexone can promote the reduction or cessation of unhealthy alcohol consumption, as well as subsequent readmissions or progression of alcohol-related liver disease. Hospitalists should stop avoiding naltrexone in the treatment of AUD.</p>","PeriodicalId":94084,"journal":{"name":"Journal of hospital medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142804179","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 SafeTy And Resource (STAR) Clinician: Improving care and hospitalist satisfaction with a novel support role.","authors":"Amy W Baughman, William C Hillmann, Emily Hughes, Zachary Ranta, Cindy Yu, Denisa Gace, Meghan Meehan, Candice Couture, Holly Jackson, Kerry Maloney, Melissa L P Mattison","doi":"10.1002/jhm.13563","DOIUrl":"https://doi.org/10.1002/jhm.13563","url":null,"abstract":"","PeriodicalId":94084,"journal":{"name":"Journal of hospital medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142804171","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":"How hospitalists can improve the effectiveness of code status conversations.","authors":"Nikhil Sood, Gagandeep Dhillon, Venkata Buddhavarapu, Rohini Garg, Anthony D Slonim","doi":"10.1002/jhm.13570","DOIUrl":"https://doi.org/10.1002/jhm.13570","url":null,"abstract":"","PeriodicalId":94084,"journal":{"name":"Journal of hospital medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142788178","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}