The Value of Cultural Exchange in Health Care
On a Tuesday in February 2002, a happy little boy left home for school. Two hours later, he started feeling unwell, and his parents were called to pick him up. The next day, he insisted on going back to school, even though he was still unwell, and his parents allowed him. He got worse and was picked up early again and taken to the hospital. Heartbreakingly, he passed away the next day, on Thursday morning. That little boy was my younger brother, and he was only 12 years old.
I was devastated and could not process what had happened. He was young, full of life and energy, and smart! In fact, I believe he was the smartest in ...
Source: The Hospitalist - August 1, 2023 Category: Hospital Management Authors: Ronda Whitaker Tags: Diversity in Medicine Practice Management Source Type: research
MRSA Nasal PCR ’ s Role in Empiric Antibiotic Selection
Case
A 67-year-old man with chronic obstructive pulmonary disease (COPD) was admitted to inpatient general medicine from his nursing home for pneumonia. He reported a 10-day history of an upper respiratory viral infection with symptoms improving until two days ago. Initial evaluation revealed a temperature of 100.5° F, heart rate of 95 beats per minute, blood pressure of 147/89 mmHg, respiratory rate of 25 per minute, and O2 saturation of 92% on room air. His white blood cell count was 14,000. Both a COVID-19 and methicillin-resistant Staphylococcus aureus (MRSA) nasal polymerase chain reaction (PCR) assay were negative. ...
Source: The Hospitalist - August 1, 2023 Category: Hospital Management Authors: Ronda Whitaker Tags: Clinical Guidelines Interpreting Diagnostic Tests Source Type: research
How Having a Medical Writer on Staff Can Help Your Team
Mary Ann Kirkconnell Hall:
Hospitalists face numerous demands, and those in academic medicine are also expected to write and publish their work in peer-reviewed journals, present at conferences, and give lectures and talks. We’re all familiar with the “publish or perish” cliché, but almost no one goes into hospital medicine intending primarily to be a researcher. Hospitalists are smart people, and they’ve dedicated their careers to a specialty that isn’t superficially glamorous or notably high-paying, but that virtually all of us will someday need. Hospitalists’ awareness of the needs and experiences of our si...
Source: The Hospitalist - August 1, 2023 Category: Hospital Management Authors: Ronda Whitaker Tags: Career People in HM Practice Management Source Type: research
A Vantage Point Amidst Chaos
Photos are taken from the campus of EvergreenHealth in Kirkland, Wash.
The hospital is a vantage point,
A window into human existence,
Where we see proof daily,
That almost everything is temporary.
From the colors of the leaves
to the snow on the ground.
Even what we feel,
Excitement, despair, anger, or fear,
These are all fleeting moments,
amongst a grander scheme.
The foremost example is life itself,
With its inherent fragility.
On one floor alone,
Welcoming all three of my children,
crying and screaming into the world,
Soothing them gently in my arms.
Just down the hall and around the corner,
Navigating critical illness...
Source: The Hospitalist - July 31, 2023 Category: Hospital Management Authors: Lisa Casinger Tags: Art Poetry Source Type: research
Dr. Readlynn Enjoys the Team-based Care of HM and Working with Learners
Q & A with Jennifer K. Readlynn, MD, FHM, adult hospitalist and clinician educator, University of Rochester School of Medicine & Dentistry, Rochester, N.Y.
Whether it’s working with her clinical unit-based team, leading medical learners, interacting with patients and families, or sharing her knowledge with The Hospitalist’s editorial board, Dr. Readlynn enjoys people.
Connecting with patients, their families, and staff on our unit-based teams makes even the hardest situations a bit easier.
Dr. Readlynn
Q: Why did you choose a career in hospital medicine?
A: I really enjoy the team-based care in the hos...
Source: The Hospitalist - July 21, 2023 Category: Hospital Management Authors: Lisa Casinger Tags: Career Leadership People in HM Profiles Source Type: research
Movers and Shakers, July 2023
Dr. Chudgar
Saumil Chudgar, MD, MS, SFHM, a hospitalist at Duke University Hospital, Durham, N.C., and associate professor of medicine and assistant dean for clinical education at Duke University School of Medicine, is the recipient of the School of Medicine Master Clinician/Teacher Award. The award honors faculty for accomplishment and service in the area of teaching in the School of Medicine or Medical Center and recognizes their extraordinary commitment to teaching and students.
Dr. Chudgar earned his medical degree from Duke University School of Medicine and completed his residency at Duke University Medical Center....
Source: The Hospitalist - July 6, 2023 Category: Hospital Management Authors: Lisa Casinger Tags: Career People in HM Source Type: research
Improving Communications Between ED and Hospitalist Physicians, Viewpoints from Both Perspectives
Conclusion—documenting plan and planning, if needed, to reconnect. A bedside handoff often would be ideal, with a discussion of the next steps.
They discussed that burnout can be an issue resulting in poor communication, with 60% of ED physicians and 52% of hospitalist physicians reporting burnout. Three pillars were noted to support professionals’ intrinsic motivation and psychological well-being—autonomy, competence, and relatedness. These pillars are often an important part of the perceived conflict between ED physicians and hospitalists. Word clouds were presented as related to ED patient experiences that sh...
Source: The Hospitalist - July 5, 2023 Category: Hospital Management Authors: Ronda Whitaker Tags: Career Employees Leadership Practice Management Quality Improvement Source Type: research
Pediatric Update: Top 10 Articles of 2022
This study shows a surge in pediatric firearm injuries presenting to US children’s hospitals during the COVID-19 pandemic. The unequal rates of injury in black children and children with public insurance reflects the disproportionate impact of COVID-19 in minority groups due to the exacerbation of previously present healthcare disparities. This data should be used to support advocacy efforts and healthcare policy aimed at injury prevention.
Common Diagnoses and Costs in Pediatric Hospitalization in the U.S.
Kaiser SV, et al. Common diagnoses and costs in pediatric hospitalization in the US. JAMA Pediatr. 2022;176(3):316...
Source: The Hospitalist - July 5, 2023 Category: Hospital Management Authors: Ronda Whitaker Tags: Adolescent Medicine Business of Medicine Hospital Medicine Pediatrics Transitions of Care Source Type: research
Mid-career “Phronesis”
The 2023 SHM Converge Conference in Austin, Texas was the backdrop for a chance encounter between two old friends. We and our spouses met during residency 20 years ago, became fast friends, and then parted ways as one went off to begin an academic hospitalist practice in the Gold Coast of Australia, and the other remained in an academic hospitalist career in the Pacific Northwest. We had kids, built homes, and gathered a few times over the years for multi-family vacations, but had not seen one another since 2018 before the global pandemic and its era of isolation.
We found ourselves bonding over updates on our families, mi...
Source: The Hospitalist - July 5, 2023 Category: Hospital Management Authors: Ronda Whitaker Tags: Career Essay Hospital Medicine SHM Converge Source Type: research
High-Value Care/Things We Do For No Reason
In this impactful session, Dr. Lee defined value as the sum of quality of care, equity, patient outcome, and experience divided by costs of care and nonfinancial risks and harms. High-value care provides the best care most efficiently and achieves optimal results for each patient. In the U.S., the cost of care continues to rise, but many outcomes are inferior to those in other countries. Between 25 and 34% of U.S. health care expenditures are considered waste, including in pediatrics. Waste can be due to clinician, clinical, and patient factors, culture, economics, and technology.
Dr. Lee identified four practices within p...
Source: The Hospitalist - July 5, 2023 Category: Hospital Management Authors: Ronda Whitaker Tags: Business of Medicine Clinical Guidelines Hospital Medicine Pediatrics Quality Improvement Source Type: research
Strategies for Dysfunctional Teams and Groups
Drs. Russo and Boer began by outlining the differences between high-performing and dysfunctional teams. High-performing teams are not afraid of face-to-face communication, authentically give and receive appreciation, invest time in getting to know one another, and have more strategic meetings. These behaviors are associated with high performance—superior and on-time results with higher team engagement and less turnover.
In contrast, dysfunctional teams are characterized by poor communication and attitude, authoritarian leadership, unproductive meetings, interpersonal conflict, and artificial harmony. These team dynamics ...
Source: The Hospitalist - July 5, 2023 Category: Hospital Management Authors: Ronda Whitaker Tags: Business of Medicine Career Education Employees Uncategorized Source Type: research
Syncope Evaluation: Evidence-Based and Economical
This study eliminated low-risk syncope patients and those with non-syncope transient loss of consciousness, such as seizure and head trauma, using a structured approach in the emergency department (ED), with only high-risk syncope patients being admitted. These high-risk syncope patients made up 28% of the patients included in the study. After admission, a simplified Wells’ pulmonary embolism criteria score was calculated, and a D-dimer was obtained. If either was high, the patient was scanned for PE and 17% were found to be positive, with two-thirds of those being found to have large-vessel pulmonary emboli. The bottom ...
Source: The Hospitalist - July 5, 2023 Category: Hospital Management Authors: Ronda Whitaker Tags: Clinical Guidelines Source Type: research
Standardizing the Recruitment Process for Hospitalist Programs
This workshop discussed ideas to standardize the recruitment process, ask more informative interview questions, and minimize unconscious bias to create a diverse hospitalist group. The audience was separated into three small groups: single-center academic hospitalists, multi-center hospitalists, and community hospitalists.
Each group first discussed the members of a comprehensive recruitment team and how to advertise to solicit a diversity of applications appropriate for their clinical-center type. The next small group discussion focused on questions to elicit how a candidate will perform, rather than superficial demograph...
Source: The Hospitalist - July 5, 2023 Category: Hospital Management Authors: Ronda Whitaker Tags: Business of Medicine Career Employees Leadership Source Type: research
The 2022 AAP Newborn Jaundice Guideline: Management of Hyperbilirubinemia in the Newborn Infant 35 or More Weeks of Gestation
Dr. Holmes presented the 2022 American Academy of Pediatrics Clinical Practice Guideline for Management of Hyperbilirubinemia in the Newborn Infant 35 or More Weeks of Gestation. A large, diverse committee developed the guideline over eight years. Dr. Holmes emphasized that the guideline is only intended for U.S. hospital systems. The purpose is to prevent chronic bilirubin encephalopathy (CBE). CBE manifests as choreoathetosis, hearing loss, and only a mild IQ effect, and occurs at an average bilirubin of 40 mg/dL.
Dr. Homes first talked through key action statements for prevention. She highlighted that identifying infan...
Source: The Hospitalist - July 5, 2023 Category: Hospital Management Authors: Ronda Whitaker Tags: Clinical Guidelines Liver Disease Neonatal Medicine Pediatrics Quality Improvement Source Type: research
Inpatient Management of Decompensated Cirrhosis
In this clinical-pearl-packed session, Dr. Suchita Shah Sata from Duke University Hospital in Durham, N.C., recaps the breadth of knowledge needed by hospitalists to manage this complex patient population. Outlining the objectives of the talk, Dr. Sata describes the pathophysiology of cirrhosis and how this leads to the complications that are seen in the decompensated state, suggests a framework for evaluating the etiologies of decompensated cirrhosis, and applies current evidence to delineate best practices in inpatient management of common complications of cirrhosis.
Reviewing the pathophysiology of decompensated cirrhos...
Source: The Hospitalist - July 5, 2023 Category: Hospital Management Authors: Ronda Whitaker Tags: Clinical Guidelines Liver Disease Source Type: research
