The Hospitalist ’ s Editorial Board Members ’ Must-attend SHM Converge 2023 Sessions
SHM Converge 2023 offers world-class education for hospitalists, led by award-winning faculty. Engage with your global hospitalist community March 26-29, 2023, in Austin, Texas.
With more than 150 learning and networking opportunities—ranging from sessions, workshops, advanced learning courses, and special interest forums—spread across two and a half days, there’s a lot to be excited about at this year’s annual meeting.
Members of The Hospitalist’s editorial board share some of their top picks for must-attend sessions.
Dr. Green
Amanda Green, MD, FACP, HMDC, CPPS, FHM, chief medical officer, Paris Regional Me...
Source: The Hospitalist - February 1, 2023 Category: Hospital Management Authors: Ronda Whitaker Tags: SHM Converge Source Type: research
Escape Room Medical Simulations
Medical simulations allow health care professionals to practice and hone skills in a low-risk environment, enabling them to better handle real-life emergencies.
Medical simulation has come a long way in recent years, providing a safe and controlled environment in which health care professionals can practice and improve their skills.1 Gone are the days of simple mannequin simulations. Today’s medical simulations are highly realistic and interactive, using advanced technology such as virtual reality and high-fidelity mannequins that can mimic real human physiology including bleeding and crying.
Medical simulations allow h...
Source: The Hospitalist - February 1, 2023 Category: Hospital Management Authors: Ronda Whitaker Tags: Education Source Type: research
SHM Converge 2023 —Reconnect Again!
Get ready for an exciting, dynamic, inspiring event in the Lone Star State’s capital at SHM Converge 2023!
We’re truly excited to see you all again, following our grand collective reconnection in Nashville, Tenn. for a stellar SHM Converge 2022. What better place to do this in 2023 than in a city that boasts 300 days of sunshine a year, an average temperature of 71 degrees in November, amazing outdoor activities, and hundreds of live music venues? Yes—it’s Austin, Texas, the live music capital of the world!
The Annual Conference Committee has once again put in a tremendous amount of time and energy to bring you a...
Source: The Hospitalist - February 1, 2023 Category: Hospital Management Authors: Ronda Whitaker Tags: SHM Converge Source Type: research
Breaking News: X-waiver Eliminated
On January 12, 2023, the U.S. Drug Enforcement Administration (DEA) and the Substance Abuse
and Mental Health Services Administration (SAMHSA) announced the immediate elimination of the X-waiver for prescribing buprenorphine, as required by the omnibus bill passed in December 2022. SHM celebrates this change as a major victory for our collective advocacy efforts and for improving the care of patients with opioid use disorder (OUD).
The removal of the X-waiver requirement has been one of SHM’s top policy priorities since 2018, as we viewed the X-waiver as an inappropriate and outdated barrier to treating OUD. Over the p...
Source: The Hospitalist - January 25, 2023 Category: Hospital Management Authors: Lisa Casinger Tags: Addiction Medicine Advocacy Clinical Guidelines Drug Therapy Health Policy Hospital Medicine Opioid Resource Center Source Type: research
What Does it Mean to Die?
What does it mean to die?
Is it the abrupt ceasing of the heart,
Or is it the transcendence into a new dimension,
As your soul slowly departs.
What does it mean to die?
Is death the mere absence of life,
Or is the other way somehow,
A wormhole of eternal strife.
What does it mean to die?
If you died, for instance, on Mars,
Or does it not matter where you die,
Since life is but a farce.
What does it mean to die?
If living was a chore,
Or would it still matter because,
You wouldn’t live anymore.
What does it mean to die?
She asked again, in a somberly curious way,
Would you like to be resuscitat...
Source: The Hospitalist - January 20, 2023 Category: Hospital Management Authors: Lisa Casinger Tags: Poetry Source Type: research
Waffles
As a transplant, I wasn’t familiar with the city’s geography. But I knew where the streets were, and that’s where we went. We all piled into the van—the outreach coordinator, nurse, attending, and I—and headed to the edges of town.
I noticed I was the only member of the team dressed in scrubs; the rest of the group opted for regular clothes. Despite wearing what was typically deemed “casual” for our profession, I felt conspicuous. Luckily, our patients didn’t seem to mind.
“Street rounds” began outside a restaurant. The first gentleman we came across had been living unhoused in the area for ages. Up...
Source: The Hospitalist - January 19, 2023 Category: Hospital Management Authors: Lisa Casinger Tags: Essay Source Type: research
Aggressive IV Fluids Plus Rectal NSAIDs Don ’ t Prevent Post-ERCP Pancreatitis
Dr. Moulder
Clinical question: Does the addition of aggressive intravenous hydration to rectal nonsteroidal anti-inflammatory drugs (NSAIDs) help prevent post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis?
Background: Pancreatitis is a common complication of ERCP. The use of prophylactic rectal NSAIDs reduces the development of post-ERCP pancreatitis. Evidence has emerged that aggressive periprocedural hydration using lactated Ringer’s solution reduces the risk of post-ERCP pancreatitis, though this was not studied in combination with rectal NSAIDs.
This trial aimed to evaluate the value of aggressi...
Source: The Hospitalist - January 3, 2023 Category: Hospital Management Authors: Ronda Whitaker Tags: In the Literature Pancreas and Biliary Tract Source Type: research
Syncopal Event Doesn ’ t Necessarily Mean Driving Restriction
Dr. Young
Clinical question: Do patients with first syncopal events suffer more motor vehicle collisions (MVCs) than patients without syncope?
Background: Recommendations for driving restrictions after an initial episode of syncope depend on the suspected cause of syncope and local guidelines. Given the relative incidence of syncope, this study examines whether we should continue to affect patients through these restrictions.
Study design: A retrospective, observational, cohort study
Setting: Six emergency departments (EDs) in British Columbia (BC), Canada
Synopsis: The use of universal health insurance records and a sing...
Source: The Hospitalist - January 3, 2023 Category: Hospital Management Authors: Ronda Whitaker Tags: In the Literature Source Type: research
Legionella Risk Model Guides Appropriate Testing
This study may overestimate Legionella cases by including only patients that underwent Legionella testing. Furthermore, the practicality of this model is limited by requiring clinicians to know about recent Legionella outbreaks at their institution. The author’s Legionella risk calculator can be accessed at https://riskcalc.org/Legionella.
Bottom line: A logistic regression model-based risk calculator likely outperforms clinical gestalt and IDSA/ATS guidelines in predicting Legionella infection; though an appropriate threshold for testing remains undetermined and the practicality of this model is limited by requiring cli...
Source: The Hospitalist - January 3, 2023 Category: Hospital Management Authors: Ronda Whitaker Tags: Diagnostic In the Literature Infectious Diseases Source Type: research
Initiation of Empagliflozin in Hospitalized Patients with Acute Decompensated HF Improves Clinical and Symptomatic Outcomes at 90 Days
Dr. Kerley
Clinical question: Does initiation of empagliflozin in hospitalized patients with acute decompensated heart failure improve clinical outcomes and symptom burden?
Background: Studies have outlined the clinical benefit of empagliflozin and sodium-glucose cotransporter-2 inhibitors in the ambulatory setting. However, little is known about initiation in hospitalized patients with acute decompensated heart failure and its impact on both clinical and symptomatic outcomes.
Study design: Randomized, double-blinded, placebo-controlled trial
Setting: 118 centers across 15 countries
Synopsis: 530 hospitalized patients wer...
Source: The Hospitalist - January 3, 2023 Category: Hospital Management Authors: Ronda Whitaker Tags: Cardiology In the Literature Source Type: research
Issues Related to Testing are the Most Common Source of Diagnostic Errors in Primary Care
Dr. Dreicer
Clinical question: How can we categorize diagnostic pitfalls leading to diagnostic errors in primary care?
Background: Diagnostic errors are a leading cause of malpractice claims and are difficult to mitigate with system-level changes, as they are often multifactorial. The term “diagnostic pitfalls” to describe the circumstances leading to a diagnostic error is at least a century old but the authors offered a new definition of “clinical situations and scenarios that are vulnerable to errors that may lead to missed, delayed, or wrong diagnoses.”
Study design: Retrospective analysis of varied sources of ...
Source: The Hospitalist - January 3, 2023 Category: Hospital Management Authors: Ronda Whitaker Tags: Diagnostic In the Literature Source Type: research
Rivaroxaban Monotherapy is Preferable to Combination Therapy with Antiplatelets with Regards to Total Cardiovascular and Bleeding Events in Patients with AF and Stable CAD
In this study conducted across 294 centers, 2,215 patients were randomly assigned to rivaroxaban monotherapy, or therapy with rivaroxaban in combination with aspirin or a P2Y12 inhibitor. All patients were diagnosed with AF with a CHADS2 score greater than one, as well as confirmed CAD without percutaneous coronary intervention (PCI) or coronary artery bypass grafting within 12 months. Primary endpoints were the total number of first and subsequent bleeding and thrombotic events over a 24-month follow-up period. Thrombotic events included ischemic stroke, systemic embolism, myocardial infarction, and unstable angina requir...
Source: The Hospitalist - January 3, 2023 Category: Hospital Management Authors: Ronda Whitaker Tags: CAD & Atherosclerosis Cardiology In the Literature Source Type: research
Update: Caring for COVID-19 Patients in the Hospital
Severe cases of COVID-19 infections continue to necessitate hospitalization more than two and a half years after the pandemic first hit.
A total of 26,996 patients were hospitalized with COVID-19 in the U.S. as of Nov. 30, 2022, according to the Centers for Disease Control and Prevention’s COVID-19 Tracker,1 with a seven-day average of new deaths at 317 as of Nov. 16, 2022. This is down 5.3% from the previous seven-day average.
But in contrast to the panic, emergency response, and mobilization for the pandemic’s early stages and steepest surges, managing COVID-19 in the hospital today has become relatively straightforw...
Source: The Hospitalist - January 3, 2023 Category: Hospital Management Authors: Ronda Whitaker Tags: Clinical Guidelines COVID-19 Drug Therapy Hospital Medicine Source Type: research
Potential Role for Hospitalist: Physician Advisor
Dr. Green
While the role of physician advisor in a hospital can be as varied as that of the chief medical officer, depending on the needs of the hospital, there are some universal tasks that leaders in this position perform.
Hospital utilization management (UM) plans are fairly common, as much of their language is set by the Centers for Medicare & Medicaid Services and insurers. These UM plans define the basic roles of a physician advisor. Hospitalists are well-versed in all the areas where physician advisors work in depth.
What do they do?
Completing chart reviews for observation, inpatient status, or medical necessi...
Source: The Hospitalist - January 3, 2023 Category: Hospital Management Authors: Ronda Whitaker Tags: Career Education Hospital Medicine Leadership Source Type: research
Five Approaches to Change Management in Quality Improvement and Operational Initiatives
Dr. McIlraith
Dr. Ansari
“Victorious warriors win first and then go to war, while defeated warriors go to war first and then seek to win.” Sun Tzu, The Art of War
The U.S. has the world’s largest economy and devotes a larger share of its gross domestic product to medical services than any other developed nation. Historic market “disruptors” such as Amazon have identified the health care market as an area to expand their footprint and are actively working to infiltrate and overhaul sectors of the U.S. health care market.1
Threats like these to existing health care markets are real and growing and require hosp...
Source: The Hospitalist - January 3, 2023 Category: Hospital Management Authors: Ronda Whitaker Tags: Business of Medicine Career Education Employees Leadership Quality Improvement Source Type: research
