Hospitalist Shared Leadership for Safety, Health, and Well-Being at Work: United States, 2022 ‒2023
Am J Public Health. 2024 Feb;114(S2):162-166. doi: 10.2105/AJPH.2024.307573.ABSTRACTWe assessed how hospitalists frame workplace safety, health, and well-being (SHW); their perception of hospital supports for SHW; and whether and how they are sharing leadership responsibility for each other's SHW. Our findings highlight the important role of local support for hospitalist SHW and reveal the systemic, hospital-wide problems that may impede their SHW. We believe that positioning hospitalists as leaders for SHW will result in systems-wide changes in practices to support the SHW of all care team members. (Am J Public Health. 20...
Source: American Journal of Public Health - February 14, 2024 Category: International Medicine & Public Health Authors: Natalie V Schwatka Angela Keniston Gopi Astik Anne Linker Matthew Sakumoto Gregory Bowling Andrew Auerbach Marisha Burden Source Type: research
Hospitalist Shared Leadership for Safety, Health, and Well-Being at Work: United States, 2022 ‒2023
Am J Public Health. 2024 Feb;114(S2):162-166. doi: 10.2105/AJPH.2024.307573.ABSTRACTWe assessed how hospitalists frame workplace safety, health, and well-being (SHW); their perception of hospital supports for SHW; and whether and how they are sharing leadership responsibility for each other's SHW. Our findings highlight the important role of local support for hospitalist SHW and reveal the systemic, hospital-wide problems that may impede their SHW. We believe that positioning hospitalists as leaders for SHW will result in systems-wide changes in practices to support the SHW of all care team members. (Am J Public Health. 20...
Source: Am J Public Health - February 14, 2024 Category: International Medicine & Public Health Authors: Natalie V Schwatka Angela Keniston Gopi Astik Anne Linker Matthew Sakumoto Gregory Bowling Andrew Auerbach Marisha Burden Source Type: research
Clinicians' interpretation of thresholds in hospital antibiograms for gram ‐negative rod infections: A survey and contingent valuation study of hospitalists
AbstractClinical guidelines suggest that hospital antibiograms are a key component when deciding empiric therapy, but little is known about how often clinicians use antibiograms and how they influence clinicians' empiric therapy decisions. We surveyed hospitalists at seven healthcare systems in the United States on their reported practices related to antibiograms and their hypothetical prescribing for four clinical scenarios associated with gram-negative rod pathogens. Each was given a randomly assigned antibiogram susceptibility percentage, and we used contingent valuation analysis to assess whether the antibiogram suscep...
Source: Journal of Hospital Medicine - February 14, 2024 Category: Hospital Management Authors: Shinya Hasegawa,
Che M. Harris,
Vineet Gupta,
Matthew Pappas,
Valerie M. Vaughn,
Eli N. Perencevich,
Kimberly C. Dukes,
Michihiko Goto Tags: BRIEF REPORT Source Type: research
Virtual Obstetric Hospitalist Support for Obstetric Emergencies and Deliveries: The Mayo Clinic Experience
Telemedicine and e-Health, Ahead of Print. (Source: Telemedicine and e-Health)
Source: Telemedicine and e-Health - February 13, 2024 Category: Information Technology Authors: Regan N. Theiler Vanessa Torbenson Jessica C. Schoen Hollie Stegemann Heather A. Heaton Katy B. Kozhimannil Jennifer L. Fang Annie Sadosty Source Type: research
Leadership & professional development: Cultivating a path for hospitalist educators to achieve scholarly success
Visual abstract (Source: Journal of Hospital Medicine)
Source: Journal of Hospital Medicine - February 2, 2024 Category: Hospital Management Authors: Doris Lin Tags: LEADERSHIP & PROFESSIONAL DEVELOPMENT Source Type: research
How much magnesium sulfate is needed to “keep total serum magnesium above 2.0 mg/dL”?
AbstractFor patients at increased risk of life-threating ventricular arrythmias, hospitalists often administer intravenous magnesium sulfate to maintain total serum magnesium concentration (TsMg) above 2 mg/dL. How long each dose keeps TsMg above this threshold is not well known, however. We collected TsMg values from 12,618 veterans who were given 24,363 doses of intravenous magnesium sulfate during 14,901 hospitalizations for acute heart failure. Across dose amounts, the average TsMg dropped be low 2.0 mg/dL within 24 h of administration. When we limited our analysis to 2 g doses (the most common dose) and adjus...
Source: Journal of Hospital Medicine - February 2, 2024 Category: Hospital Management Authors: JooEun Kwon,
Brian P. Lucas,
Arthur T. Evans Tags: BRIEF REPORT Source Type: research
Adult Hospitalizations from Immigration-detention Facilities
Dr. Woodruff
Clinical question: What are the causes of hospitalizations from immigration-detention facilities and what is their relative morbidity?
Background: Over the last three decades, an exponential increase in detained individuals has overwhelmed the capabilities of immigration jails and prisons to attend to people’s basic health needs, prevent the spread of infectious diseases, and address the well-known psychiatric impacts of immigration detention and incarceration. Despite mortality case reports, little is known about this vulnerable population’s morbidity or other health outcomes.
Study design: Cross-secti...
Source: The Hospitalist - February 1, 2024 Category: Hospital Management Authors: Ronda Whitaker Tags: In the Literature Patient Care Source Type: research
Virtual Care Team Increases the Number of Patients with CHF on GDMT During Hospitalization
Dr. Pahwa
Clinical question: Can a virtual care team increase the number of patients with chronic heart failure (CHF) on goal-directed therapy during hospitalization?
Background: Maximizing goal-directed medical therapy (GDMT) in patients with CHF with reduced ejection fraction improves mortality. However, on discharge, 40% of patients are on a beta blocker, angiotensin-converting enzyme inhibitors (ACE inhibitors), or angiotensin II receptor blockers (ARBs), and mineralocorticoid receptor antagonists. The study team piloted a virtual care team to optimize the intensity of medications for patients with CHF who were hospit...
Source: The Hospitalist - February 1, 2024 Category: Hospital Management Authors: Ronda Whitaker Tags: Cardiology In the Literature Source Type: research
Fewer COPD Exacerbations and Pneumonia Hospitalizations with LABA-LAMA Inhalers Compared to ICS-LABA in COPD
Dr. Coursen
Clinical question: Is a long-acting beta agonist and long-acting muscarinic antagonist (LABA-LAMA) inhaler combination better than an inhaled corticosteroid and long-acting beta agonist (ICS-LABA) combination to improve clinical outcomes in patients with chronic obstructive pulmonary disease (COPD)?
Background: Clinical guidelines recommend LABA-LAMA over ICS-LABA in COPD patients but randomized clinical trials have shown mixed data on clinical outcomes comparing these maintenance combination inhalers.
Study design: Large retrospective cohort study
Setting: National insurance database
Synopsis: From a national...
Source: The Hospitalist - February 1, 2024 Category: Hospital Management Authors: Ronda Whitaker Tags: In the Literature Pulmonology Source Type: research
No Clear Benefit to the Use of Haloperidol for ICU Delirium
Dr. Leventhal
Clinical question: Does the use of haloperidol versus placebo for delirium in ICU patients improve mortality and increase the chance of hospital discharge at 90 days?
Background: Haloperidol is the most commonly used medication for delirium in ICU patients but was not found to be effective in prior clinical trials. The goal of this trial was to determine if the use of haloperidol for delirium in ICU patients, compared to a placebo, would lead to a greater number of days alive and out of the hospital.
Study design: Blinded, placebo-controlled, randomized, controlled trial
Setting: 16 general ICUs in Denmark, ...
Source: The Hospitalist - February 1, 2024 Category: Hospital Management Authors: Ronda Whitaker Tags: Drug Therapy In the Literature Source Type: research
Transcatheter Repair of Secondary Mitral Regurgitation Improves Outcomes
This study assessed outcomes after a five-year follow-up.
Study design: Open-label randomized-controlled trial
Setting: Multicenter study across 78 centers in the U.S. and Canada
Synopsis: 614 patients with ischemic or nonischemic cardiomyopathy and ejection fraction 20% to 50% with both moderate-to-severe or severe secondary mitral regurgitation by TTE and NYHA II or greater functional status were randomized to undergo guideline-directed medical therapy with or without transcatheter mitral valve repair. Those who underwent transcatheter repair were noted to have an average annual hospitalization rate of 33.1% compared to ...
Source: The Hospitalist - February 1, 2024 Category: Hospital Management Authors: Ronda Whitaker Tags: Cardiology In the Literature Source Type: research
Abatacept and Infliximab May Improve Mortality in Patients Hospitalized with COVID-19 Pneumonia
This study further supports adding another immunomodulatory agent to corticosteroids when treating hospitalized patients with COVID-19 pneumonia. Which agent is best and if multiple agents should be used remains unknown. Stronger evidence supports the use of either IL-6 inhibitors or Janus kinase inhibitors; abatacept or infliximab are unlikely to become recommended on par with these treatments.
Bottom line: Abatacept and infliximab should not replace IL-6 or Janus kinase inhibitors as the recommended non-corticosteroid immunomodulators for treating hospitalized patients with COVID-19 pneumonia.
Citation: O’Halloran JA...
Source: The Hospitalist - February 1, 2024 Category: Hospital Management Authors: Ronda Whitaker Tags: COVID-19 Drug Therapy In the Literature Source Type: research
Risk Stratification of Patients with HF in the ED Coupled with Close Outpatient Follow-up Reduces Mortality and CV Rehospitalization
Dr. Latifi
Clinical question: In patients presenting to the emergency department (ED) with heart failure (HF) symptoms, are patient outcomes affected by the use of a risk stratification tool to guide the need for admission or discharge with close outpatient follow-up?
Background: ED physicians often rely on clinical judgment to determine if patients presenting with heart failure symptoms need hospital admission or can be safely discharged with outpatient plan follow-up. Lack of access to timely outpatient care is a barrier to safe discharge planning from the ED and can lead to higher rates of hospitalization.
Study design...
Source: The Hospitalist - February 1, 2024 Category: Hospital Management Authors: Ronda Whitaker Tags: Cardiology In the Literature Source Type: research
