The Hospitalist

This month’s feature highlights evidence-based medicine and its application at point-of-care. Three hospitalists, Dr. Daniel Steinberg, Dr. Daniel Dressler, and Dr. Ed Vasilevskis, talk about the resources they use to stay on top of the science of medicine at point of care, including the importance of timely information access in evidence-based point-of-care medicine, and use of a virtual file cabinet to gather and store information and use in bedside clinical care.

This month in our issue, we examine issues surrounding system-wide improvement in healthcare and the fiscal challenges of healthcare reform. Dr. Rick Hilger tells why he thinks a population-health approach is the best hope for improving the system and why eliminating waste may yield ways to reduce healthcare spending. Dr. Joshua Lenchus talks about how the administrative tasks of healthcare reform will impact hospitalists’ daily workflow and workload. Elsewhere in this issue, we feature a special report on the impact Obamacare will have on hospitals and hospital medicine, review changes to ABIM’s Focused Practice in Hospital Medicine MOC program, and examine the two-midnight rule on hospital admissions for Medicare patients.

This month in our issue, we look at the challenges and rewards of palliative care practice. Dr. Porter Storey, the Executive Vice President of the American Academy of Hospice and Palliative Medicine explains how palliative care can help physicians truly meet patients’ needs and goals. Also featured on our cover this month is the story, Ten Things Urologists Think Hospitalists Need to Know, with insight into common urological problems and a review of recommendations on urinary catheterization. Elsewhere in this issue, experts discuss improving outcomes for patients with atrial fibrillation and our key clinical question addresses when anticoagulants and antiplatelet agents should be restarted after a gastrointestinal bleed.

This month in our issue, we address the growing problem of antibiotic-resistant infections, which strike more than two million people annually, according to the CDC. Dr. Jean Patel, deputy director of the office of antimicrobial resistance at CDC, calls the numbers sobering and says hospitalists can help identify and prevent future infections. On another front, Divya Parikh, director of research and loss prevention at the medical liability insurance trade association PIAA, comments on malpractice and hospitalists, and why he thinks cases can arise from communication issues. Likewise, Mike Matray, editor of Medical Liability Monitor, talks about trends in medical liability insurance rates. Also in this issue, we look at the challenges and opportunities of clinical observation units, the VA’s National Quality Scholars program, and our Key Clinical Question covers how acute hip fracture can be managed perioperatively.

This month’s feature highlights an initiative of the Society of Hospital Medicine aimed at helping hospitalists drive team-based medication reconciliation programs. Dr. Jeffrey Schnipper, director of clinical research for the hospitalist service at Brigham and Women’s Hospital and associate professor of medicine at Harvard Medical School, both in Boston, discusses the opportunities and challenges of med-rec and why he thinks med-rec shouldn’t be viewed as just a regulatory issue. Dr. Stephanie Mueller, a clinician investigator and hospitalist researcher at Brigham and Women’s Hospital, talks about how MARQUIS components were developed and the role patients can play in med-rec. Dr. Amanda Salanitro, a hospitalist at the VA Tennessee Valley Healthcare System and an instructor at Vanderbilt University, both in Nashville, shares why she sees accountability as a critical component of med-rec quality improvement and her thoughts about how IT can help the process.

This month in our issue, hospitalists weigh in on our cover story about data mining and data analytics in healthcare. Paul Roscoe, CEO of Crimson, a technology solutions company, tells why he thinks the term “big data,” has more subtlety and context, while Dr. Steven Deitelzweig, assistant chair of hospital medicine at Ochsner Health in New Orleans and chair of SHM’s practice management committee, discusses how data analytics could help reduce hospital readmissions and improve delivery of patient care. Dr. Kamal S. Ajam, a hospitalist board-certified in chronic pain management, co-authored our cover story this month on nine things chronic pain specialists want hospitalists to know. Dr. Ajam, assistant clinical professor at Wake Forest University and a physician at the Carolinas Pain Institute, shares his recommendations on managing chronic pain. Our Key Clinical Question this month features a reprint of our popular column on treating community-acquired cellulitis, as well as a report on heart failure. Dr. Weijen Chang examines palliative care in pediatrics, and Dr. Win Whitcomb reports on the impact of CMS’ value-based purchasing mandate with the start of the 2014 fiscal year on Oct. 1. Visit TheHospitalist.org for exclusive online-only content, freshly pressed eWire reports, and subscribe to the SHM Live channel on YouTube for video features on hot topics in hospital medicine.

This month’s edition features a discussion about improving patient satisfaction scores, a topic covered at a popular HM13 workshop last spring. Session speaker Dr. Peter Short, chief medical officer for Addison Gilbert and Beverly Hospital at Lahey Health in Boston, talks about measuring patient satisfaction and why he thinks a patient’s experience determines a hospital’s success. Also from the session, Dr. Richard Slataper, medical director of hospital medicine service at Our Lady of the Lake Regional Medical Center in Baton Rouge, Louisiana, shares his observations about patient satisfaction surveys and thoughts about how hospitalists might influence other clinicians to improve patient satisfaction. Fellow session speaker, Dr. Steven Deitelzweig, assistant chair of hospital medicine at Ochsner Health in New Orleans, and chair of SHM’s Practice Management committee, tells why he thinks patient satisfaction is based on a solid connection between physicians and patients.

This month in our issue, a roundup of past winners of SHM’s Research, Innovations, and Clinical Vignettes (RIV) poster competition discuss what the award has meant to their career. Dr. Kristin Wise of Medical University of South Carolina in Charleston talks about her poster on mortality and length of ICU stay. Dr. Greg Maynard discusses his winning research about a VTE risk assessment model and protocol, and Dr. Paul Grant, a 2006 winner, talks about competition insights that don’t make it into published literature. Dr. Vineet Arora, a winner in 2006, discusses mentoring her student to a RIV poster competition prize. Our Key Clinical Question this month addresses indications for blood transfusions, and we cover the use of copper surfaces to combat infections. In The Hospitalist online-only exclusives this month, Dr. Luke Hansen discusses Project BOOST.

This month’s edition features a discussion from a session at SHM’s HM13 meeting about evidence-based medicine and how hospitalists can incorporate EMB into their daily routine. Dr. Scott Kaatz, chief of hospital medicine and chief quality officer at Hurley Medical Center in Flint, Michigan shares his approach to making the best clinical evidence part of his daily practice. Dr. Dan Elliot, associate chair of research at Christina Care Health System in Wilmington, Delaware discusses the “straight As,” of EMB, while Dr. Craig Umscheid, internist and epidemiologist at University of Pennsylvania in Philadelphia talks about how to define a clinical question and why synthesizing evidence via systematic review is important.

This month’s edition features a discussion about identifying and preventing cognitive diagnostic errors. The topic was covered at an HM13 workshop last spring, presented by a team of hospitalists from the Hospital of the University of Pennsylvania. Dr. Jennifer Myers, the hospital’s patient safety officer and director of quality and safety education, talks about how medical residents have influenced her thinking on the subject. Dr. James Reilly, a research associate professor of pathology and laboratory medicine at UPenn, talks about the hospital’s campaign to teach medical students how to identify errors, and Dr. Jeffrey Greenblatt, assistant professor of clinical medicine at UPenn, tells why hospitalists are ideally poised to lead the charge on diagnostic error prevention.

This month in our issue, Dr. Mike Guthrie, Executive in Residence at the University of Colorado Denver School of Business’s Program in Healthcare Administration, talks about pursuing an MBA to go with his MD and career advancement opportunities for doctors. Dr. John Vasquez discusses improvements in patient care that can result when hospitalists and neurologists collaborate, and Dr. John Womble talks about how communities in and around Moore, Oklahoma are coping with the loss of Moore Medical Center, destroyed by the powerful tornado that swept through the region last May. Our Key Clinical Question this month addresses pain management in patients with renal insufficiency or end-stage renal disease, and we carry the American College of Gastroenterology’s 2013 recommendations for managing and preventing C. diff infections. In The Hospitalist online-only exclusives this month, hospitalists discuss two paths to advancement in hospital medicine: advanced training, and quality expertise.

This month in our issue, learn why hospitalists are vulnerable to the traumatic stress disorder known as compassion fatigue, and how they can counter it. Dr. Melissa Parkhurst of the University of Kansas Medical Center discusses the problem of malnutrition among hospitalized patients and explains how hospitalists can make a difference, and Dr. Monty Duke of Lancaster General Hospital in Lancaster Pennsylvania describes how hospitalists can drive better patient outcomes in the era of ACOs and pay-for-performance health care. We also hear first-hand what Boston hospitals were like the day of the Boston Marathon bombing. Other features include an interview with hospital medicine innovator, John Holbrook, a clinical discussion on preventing tumor lysis syndrome, and a look at how robotics are helping in hospital infection control.

In our issue this month, new SHM president Dr. Eric Howell talks about his plan for recruiting new members to the society. Dr. Brad Rosen, who leads the hands-on ultrasound procedures courses at SHM meetings, explains how these popular courses stay relevant, Dr. Todd Hecht tells us why he participated in the poster contest at HM13, and Dr. Thomas Frederickson discusses what value-based purchasing really means to health care. Also in this issue, pediatric hospitalist Dr. Mark reflects on his career—so far—in hospital medicine for his farewell column, and our key clinical question explores the management of hereditary angioedema.

This month’s edition features a lively discussion among hospitalists who took part in a workshop on cost transparency at HM13 last month. Session leader, UCSF School of Medicine clinical instructor Dr. Christopher Moriates, explains why now is the right time to tackle hospital costs and says improving cost transparency is a win-win proposition. Fellow hospitalist, Dr. Andrew Lai, comments on cost-awareness principles, and their UCSF colleague, Dr. Niraj Sehgal, describes why patients and doctors should work together to create cost transparency.

In this special edition, hospitalist leaders share their messages from HM13. Conference committee chair Dr. Dan Brotman finds the chance to interact with, and learn from, fellow hospitalists among the most rewarding aspects of attending. Following a day of pre-course sessions, Dr. Thomas Fraser lets us in on the one thing he’d most like hospitalists to know about avoiding hospital-acquired infections, and Dr. Weijen Chang tells why he wanted to teach a course on medical procedures for hospitalists at the conference. From his opening day address, Dr. Patrick Conway shares his view of hospitalists as agents for change in health care and Dr. David Feinberg expresses his approach to healing one patient at a time. Other highlights include Dr. Gordon Guyatt on evidence-based medicine, the term he coined; and Dr. Michael Janjigian on why it’s important for hospitalists to keep their bedside physical exam skills sharp. Fresh from the event, hospitalists weigh in on a host of hot topics, including transparency and accountability, diagnostic errors, and preventing errors through physical exams, among many others.