MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Journal of Hospital Medicine' source. Tue, 07 Feb 2012 02:52:40 +0100 http://www.medworm.com/index.php?rid=5644778&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.1006 (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5644778 Mon, 30 Jan 2012 05:00:00 +0100 5644778 http://www.medworm.com/index.php?rid=5625667&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.1905 CONCLUSIONS:An ImCU led by hospitalists showed encouraging results regarding patient survival and SAPS II is an useful tool for prognostic evaluation in this population. Intermediate care serves as an expansion of role for hospitalists; and clinicians, trainees and patients may benefit from co‐management and teaching opportunities at this unique level of care. Journal of Hospital Medicine 2012; © 2012 Society of Hospital Medicine (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5625667 Mon, 23 Jan 2012 05:00:00 +0100 5625667 http://www.medworm.com/index.php?rid=5625666&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.1906 DISCUSSION:Patients with this degree of severe malnutrition due to eating disorders are medically complex and relatively uncommon. Regionalized subspecialty centers of excellence, in which a multidisciplinary team is led by practitioners of hospital medicine who have developed expertise in a rare condition, may improve clinical outcomes, optimize healthcare resources, and provide unique professional and academic opportunities for the clinicians involved. Journal of Hospital Medicine 2012;. © 2012 Society of Hospital Medicine (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5625666 Mon, 23 Jan 2012 05:00:00 +0100 5625666 http://www.medworm.com/index.php?rid=5625665&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.1911 (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5625665 Mon, 23 Jan 2012 05:00:00 +0100 5625665 http://www.medworm.com/index.php?rid=5625664&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.1907 CONCLUSIONS:Work patterns, compensation, and hospitalists' priorities varied significantly across practice models. Overall job satisfaction and burnout were similar across models, despite these differences. Journal of Hospital Medicine 2012; © 2012 Society of Hospital Medicine (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5625664 Mon, 23 Jan 2012 05:00:00 +0100 5625664 http://www.medworm.com/index.php?rid=5625663&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.1912 (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5625663 Mon, 23 Jan 2012 05:00:00 +0100 5625663 http://www.medworm.com/index.php?rid=5644777&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.1903 AbstractShift work is necessary for hospitalists to provide on‐site 24‐hour patient care. Like all shift workers, hospitalists working beyond daylight hours are subject to a misalignment between work obligations and the endogenous circadian system, which regulates sleep and alertness patterns. With chronic misalignment, sleep loss accumulates and can lead to shift work disorder or other chronic medical conditions. Hospitalists suffering from sleep deprivation also risk increased rates of medical errors. By realigning work and circadian schedules, a process called circadian adaptation, hospitalists can limit fatigue and potentially improve safety. Adaptation strategies include improving sleep hygiene before work, caffeine use at the start of the night shift, bright light exposure and pl... Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5644777 Sun, 01 Jan 2012 05:00:00 +0100 5644777 http://www.medworm.com/index.php?rid=5625662&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.1904 CONCLUSION:In this large multicenter study of children hospitalized with M. pneumoniae pneumonia, empiric macrolide therapy was associated with a shorter hospital LOS. Macrolide therapy was not associated with 28‐day or 15‐month hospital readmission. Journal of Hospital Medicine 2012; © 2012 Society of Hospital Medicine (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5625662 Sun, 01 Jan 2012 05:00:00 +0100 5625662 http://www.medworm.com/index.php?rid=5534802&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.1900 CONCLUSIONS:Knowledge and timeliness are considered main priorities to improve pain control. NGT is an efficient tool for identifying general and context‐specific priority areas for quality improvement; teams of healthcare providers should consider using NGT to address their own challenges and barriers. Journal of Hospital Medicine 2012; © 2011 Society of Hospital Medicine (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5534802 Wed, 21 Dec 2011 05:00:00 +0100 5534802 http://www.medworm.com/index.php?rid=5534801&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.1901 CONCLUSION:Proton pump inhibitors are frequently inappropriately prescribed to Medicine inpatients who do not have a valid indication and this practice is associated with an increase in C. difficile infection. Interventions are needed to curtail this inappropriate prescribing practice. Journal of Hospital Medicine 2012; © 2011 Society of Hospital Medicine (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5534801 Wed, 21 Dec 2011 05:00:00 +0100 5534801 http://www.medworm.com/index.php?rid=5534800&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.986 CONCLUSIONS:While there are no published research studies that deal directly with this topic, knowledge, heuristics, experience, variable aversion to risk, and other features inherent in medical‐surgical education likely impact decisions to offer or withhold potentially life‐saving therapies of all kinds. Both surgeons and clinicians, who request surgical consultation for hospitalized patients, should consider these issues and politely pursue second opinions when there is any doubt whether forgoing surgery is in the patient's best interests. Similarly, while unilateral withholding of CPR is not commonly employed in some medical cultures, including the United States, beneficence can be facilitated through robust informed consent. Journal of Hospital Medicine 2012; © 2011 Society of Hos... Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5534800 Wed, 21 Dec 2011 05:00:00 +0100 5534800 http://www.medworm.com/index.php?rid=5513358&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.992 CONCLUSIONS:Nonmedical factors accounted for nearly one‐third of all long‐stay days in the hospitalized homebound population. Increased interdisciplinary collaboration may help address homebound patient LOS. Journal of Hospital Medicine 2011; © 2011 Society of Hospital Medicine. (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5513358 Thu, 15 Dec 2011 05:00:00 +0100 5513358 http://www.medworm.com/index.php?rid=5513357&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.1003 CONCLUSION:When administered daily, the mRASS has good sensitivity and specificity for incident delirium. Given the brevity of the instrument (<30 seconds), consideration should be given to incorporating the modified RASS as a daily screening measure for consciousness and delirium. Journal of Hospital Medicine 2012; © 2012 Society of Hospital Medicine (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5513357 Thu, 15 Dec 2011 05:00:00 +0100 5513357 http://www.medworm.com/index.php?rid=5455047&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.995 AbstractFor hospitalists, hypertriglyceridemia (HTG) is more than cardiovascular risk. Severe HTG occurs when serum triglycerides rise above 1000 mg/dL, and it carries a risk of abdominal pain and pancreatitis. The etiology of severe HTG is usually a combination of genetic and secondary factors. A detailed history with attention to family history, medications, and alcohol consumption can often lead to the cause. Physical examination findings may stretch across multiple organ systems. Patients with severe HTG should be admitted to the hospital for aggressive medical therapy if they develop symptoms such as abdominal pain or pancreatitis. Asymptomatic patients with severe HTG who have significant short‐term risk for developing symptoms require urgent consultation that may lead to a brief h... Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5455047 Tue, 29 Nov 2011 05:00:00 +0100 5455047 http://www.medworm.com/index.php?rid=5455050&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.936 CONCLUSION:The survey provides a snapshot of current attitudes of pediatric hospitalist involvement in transition of care. Pediatric hospitalists are interested in participating in healthcare transition. Although more research is needed to compare current models of transition services and a hospitalist model, the perception for inpatients is that better quality of care can be expected. Targeted educational modules might provide a foundation for pediatric hospitalists to build their scope of practice to include transition services. Journal of Hospital Medicine 2011. © 2011 Society of Hospital Medicine (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5455050 Mon, 28 Nov 2011 05:00:00 +0100 5455050 http://www.medworm.com/index.php?rid=5455049&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.947 CONCLUSIONS:A few beliefs about what happens at the time of death may characterize Americans in general; many other beliefs may characterize only certain ethnic groups, genders, or individuals. To identify such beliefs and to use them to guide end‐of‐life care, hospitalists and other health professionals may have to elicit them directly from patients or survivors. Journal of Hospital Medicine 2011. © 2011 Society of Hospital Medicine (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5455049 Mon, 28 Nov 2011 05:00:00 +0100 5455049 http://www.medworm.com/index.php?rid=5455048&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.991 CONCLUSION:This meta‐analysis showed statistical support for administering furosemide as a continuous infusion for greater diuresis and reduction in total body weight in patients hospitalized with ADHF. With the exception of greater diuresis, available data are homogenous for the reported outcomes but lack information on clinical endpoints. Larger studies are needed to provide robust recommendations for clinical practice. Journal of Hospital Medicine 2011. © 2011 Society of Hospital Medicine. (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5455048 Mon, 28 Nov 2011 05:00:00 +0100 5455048 http://www.medworm.com/index.php?rid=5438245&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.984 CONCLUSIONS:This inpatient stroke alert quality improvement initiative decreased median inpatient alert‐to‐CT time by 57%, and demonstrated that speed of in‐hospital stroke evaluation can be improved through systematic application of quality improvement principles. Journal of Hospital Medicine 2011; © 2011 Society of Hospital Medicine (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5438245 Mon, 21 Nov 2011 05:00:00 +0100 5438245 http://www.medworm.com/index.php?rid=5438244&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.990 CONCLUSION:A positive C. difficile toxin assay accurately reports the institutional incidence of disease and is more reliable than ICD‐9 query. This process can be instituted at a fraction of the cost of the standard chart review, and enables governmental agencies to inexpensively add CDAD to their list of reportable diseases. Journal of Hospital Medicine 2011; © 2011 Society of Hospital Medicine. (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5438244 Mon, 21 Nov 2011 05:00:00 +0100 5438244 http://www.medworm.com/index.php?rid=5438243&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.1005 (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5438243 Mon, 21 Nov 2011 05:00:00 +0100 5438243 http://www.medworm.com/index.php?rid=5419061&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.944 CONCLUSIONS:We found a very small but consistent association between use of UpToDate and reduced length of stay, lower risk‐adjusted mortality rates, and better quality performance, at least in the smaller, non‐teaching institutions. These findings may suggest that computerized tools such as UpToDate could be helpful in improving care. Journal of Hospital Medicine 2011. © 2011 Society of Hospital Medicine. (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5419061 Wed, 16 Nov 2011 05:00:00 +0100 5419061 http://www.medworm.com/index.php?rid=5419068&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.975 CONCLUSION:The majority of terminally ill inpatients did not have a documented discussion of hospice with their care provider. Educating physicians to recognize the stepwise decline of most illnesses and hospice admission criteria will facilitate a more informed decision‐making process for patients and their families. A consistent commitment to offer hospice earlier than the terminal admission would increase access to community or home‐based care, potentially increasing quality of life. Journal of Hospital Medicine 2011;. © 2011 Society of Hospital Medicine. (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5419068 Tue, 15 Nov 2011 05:00:00 +0100 5419068 http://www.medworm.com/index.php?rid=5419067&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.939 This article will evaluate common causes for hospital admissions in the post‐bariatric surgery population as they relate to the hospitalist who is often responsible for their care. Here we provide an overview of the most common bariatric procedures currently performed, early postoperative complications, late medical complications (ie, abdominal complaints, weight fluctuations, nutritional deficiencies, and metabolic bone disease), and late surgical complications that often affect these patients and result in hospital admissions. Special attention will be paid to radiologic pearls that can assist in the initial evaluation and diagnosis of these patients. Journal of Hospital Medicine 2011;. © 2011 Society of Hospital Medicine (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5419067 Tue, 15 Nov 2011 05:00:00 +0100 5419067 http://www.medworm.com/index.php?rid=5419066&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.977 CONCLUSION:Iatrogenic hypoglycemia, as a result of treatment for hyperkalemia, is a common occurrence. Hyperkalemia occurs disproportionately in patients with acute kidney injury or end‐stage renal disease, and these patients are predisposed to an increased risk of hypoglycemia. The risk of severe hypoglycemia escalates in patients with lower body weight and creatinine clearance. Hypoglycemia risk can be minimized by providing sufficient dextrose in the treatment regimen, however, patient variability in treatment response dictates careful blood glucose monitoring before and after treatment. Journal of Hospital Medicine 2011;. © 2011 Society of Hospital Medicine. (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5419066 Tue, 15 Nov 2011 05:00:00 +0100 5419066 http://www.medworm.com/index.php?rid=5419065&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.946 CONCLUSIONS:We conclude that nephrotoxicity, with higher trough levels occurring at ≥5 days of vancomycin therapy, was uncommon at our institution and typically reversible. Journal of Hospital Medicine 2011;. © 2011 Society of Hospital Medicine (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5419065 Tue, 15 Nov 2011 05:00:00 +0100 5419065 http://www.medworm.com/index.php?rid=5419064&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.945 CONCLUSIONS:Resident‐led modified RCAs are an effective method of integrating QI efforts into resident training. As front line providers, residents are uniquely positioned to identify and implement system changes that benefit patients. Conferences were implemented without overburdening facilitators or participants. Journal of Hospital Medicine 2011;. © 2011 Society of Hospital Medicine (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5419064 Tue, 15 Nov 2011 05:00:00 +0100 5419064 http://www.medworm.com/index.php?rid=5419063&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.941 CONCLUSIONS:A simple post‐discharge intervention and needs assessment may be associated with reduced recurrent hospitalization rates in a cohort of chronically ill Medicaid managed care patients with diverse care needs. Journal of Hospital Medicine 2011;. © 2011 Society of Hospital Medicine (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5419063 Tue, 15 Nov 2011 05:00:00 +0100 5419063 http://www.medworm.com/index.php?rid=5419062&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.954 (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5419062 Tue, 15 Nov 2011 05:00:00 +0100 5419062 http://www.medworm.com/index.php?rid=5398049&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.994 CONCLUSIONS:No differences in clinical or microbiologic cure rates, LOS, or mortality were identified between the groups. Various factors may have contributed to the significantly higher recurrence of VRE bacteremia in daptomycin patients. This study suggests that linezolid and daptomycin appear equally efficacious in the treatment of VRE bacteremia. Journal of Hospital Medicine 2011;. © 2011 Society of Hospital Medicine. (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5398049 Thu, 10 Nov 2011 05:00:00 +0100 5398049 http://www.medworm.com/index.php?rid=5398050&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.972 CONCLUSIONS:The adjusted mortality and LOS demonstrated no statistically significant difference between hospitalist and intensivist‐led ICU models. Mechanically ventilated patients with intermediate illness severity showed improved LOS and a trend towards improved mortality when cared for by an intensivist‐led ICU teaching team. Journal of Hospital Medicine 2011;. © 2011 Society of Hospital Medicine (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5398050 Tue, 08 Nov 2011 05:00:00 +0100 5398050 http://www.medworm.com/index.php?rid=5377635&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.963 (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5377635 Fri, 04 Nov 2011 04:00:00 +0100 5377635 http://www.medworm.com/index.php?rid=5377634&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.976 CONCLUSIONS:The mechanisms and the countermeasures for each type of workplace violence at those high‐risk areas should be investigated. Journal of Hospital Medicine 2011;. © 2011 Society of Hospital Medicine. (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5377634 Fri, 04 Nov 2011 04:00:00 +0100 5377634 http://www.medworm.com/index.php?rid=5534799&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.1002 CONCLUSIONS:The time course of VTE in medical patients shows that risk of symptomatic VTE is highest during the first 19 days after hospital admission, and extends into the period after discharge. Future research is warranted to investigate risks and benefits of reducing the incidence of VTE after discharge, including the role of improving thromboprophylaxis practices in the inpatient setting and extending thromboprophylaxis after hospitalization. Journal of Hospital Medicine 2012;. © 2011 Society of Hospital Medicine (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5534799 Tue, 01 Nov 2011 04:00:00 +0100 5534799 http://www.medworm.com/index.php?rid=5513356&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.1001 CONCLUSIONS:This is the first national data on self‐perceived learning needs of PA hospitalists. The results may prove helpful for both PAs entering hospitalist careers and for the physician groups looking to hire them. Journal of Hospital Medicine 2012;. © 2012 Society of Hospital Medicine (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5513356 Tue, 01 Nov 2011 04:00:00 +0100 5513356 http://www.medworm.com/index.php?rid=5502224&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.1000 (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5502224 Tue, 01 Nov 2011 04:00:00 +0100 5502224 http://www.medworm.com/index.php?rid=5466459&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.998 (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5466459 Tue, 01 Nov 2011 04:00:00 +0100 5466459 http://www.medworm.com/index.php?rid=5466458&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.997 (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5466458 Tue, 01 Nov 2011 04:00:00 +0100 5466458 http://www.medworm.com/index.php?rid=5466457&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.931 CONCLUSIONS:QDUs can manage the diagnosis of patients with potentially severe diseases equally as well as traditional hospitalization, and saves costs. QDU patients expressed a high degree of satisfaction, with most preferring this model to hospitalization. Journal of Hospital Medicine 2011. © 2011 Society of Hospital Medicine (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5466457 Tue, 01 Nov 2011 04:00:00 +0100 5466457 http://www.medworm.com/index.php?rid=5377647&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.918 CONCLUSIONS:Heart failure represents a common and serious perioperative condition in hip fracture patients. Hip fracture patients with and without heart failure carry higher postoperative risk than guidelines may suggest. Future work must focus on the perioperative management of hip fracture patients with and without heart failure to mitigate postoperative morbidity. Journal of Hospital Medicine 2011; © 2011 Society of Hospital Medicine. (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5377647 Mon, 31 Oct 2011 04:00:00 +0100 5377647 http://www.medworm.com/index.php?rid=5377646&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.921 CONCLUSIONS:Composite SMRT‐CO had a better combination of sensitivity and specificity than CURB‐65 for predicting early ICU transfers. Prospective studies to confirm our findings are needed. Journal of Hospital Medicine 2011;. © 2011 Society of Hospital Medicine. (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5377646 Mon, 31 Oct 2011 04:00:00 +0100 5377646 http://www.medworm.com/index.php?rid=5377645&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.924 CONCLUSIONS:Helping resident physicians with the discharge process improves many aspects of discharge communication and patient follow‐up, and saves residents' time, but had no effect on hospital reutilization for a general medicine population. Journal of Hospital Medicine 2011;. © 2011 Society of Hospital Medicine. (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5377645 Mon, 31 Oct 2011 04:00:00 +0100 5377645 http://www.medworm.com/index.php?rid=5377644&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.970 AbstractRecognizing the importance of teamwork in hospitals, senior leadership from the American College of Physician Executives (ACPE), the American Hospital Association (AHA), the American Organization of Nurse Executives (AONE), and the Society of Hospital Medicine (SHM) established the High Performance Teams and the Hospital of the Future project. This collaborative learning effort aims to redesign care delivery to provide optimal value to hospitalized patients. With input from members of this initiative, we prepared this report which reviews the literature related to teamwork in hospitals. Teamwork is critically important to provide safe and effective hospital care. Hospitals with high teamwork ratings experience higher patient satisfaction, higher nurse retention, and lower hospital ... Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5377644 Mon, 31 Oct 2011 04:00:00 +0100 5377644 http://www.medworm.com/index.php?rid=5377643&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.925 CONCLUSIONS:Lower health literacy, lower cognitive function, and higher number of medications each were independently associated with less understanding of the preadmission medication regimen. Clinicians should be aware of these factors when considering the accuracy of patient‐reported medication regimens, and counseling patients about safe and effective medication use. Journal of Hospital Medicine 2011;. © 2011 Society of Hospital Medicine (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5377643 Mon, 31 Oct 2011 04:00:00 +0100 5377643 http://www.medworm.com/index.php?rid=5377642&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.927 CONCLUSIONS:The behaviors observed may enhance a QI team's ability to motivate the various disciplines involved, understand the care process they must change, be responsive to front‐line concerns while maintaining control over the improvement process, and share information across all levels of the hospital hierarchy. Teams in successful hospitals did not avoid interdisciplinary conflict, but rather allowed each discipline to contribute to the team from its own perspective. Successful QI teams addressed the concerns of each involved discipline, modified protocols guided by clinical outcomes, and became conduits of information on changes to care processes to both executive managers and front‐line staff. Journal of Hospital Medicine 2011;. © 2011 Society of Hospital Medicine (Source: Jou... Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5377642 Mon, 31 Oct 2011 04:00:00 +0100 5377642 http://www.medworm.com/index.php?rid=5377641&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.938 CONCLUSIONS:Errors associated with insulin in the hospital are common and reveal a number of system errors that should be addressed. These data provide a foundation for future performance improvement. Journal of Hospital Medicine 2011;. © 2011 Society of Hospital Medicine (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5377641 Mon, 31 Oct 2011 04:00:00 +0100 5377641 http://www.medworm.com/index.php?rid=5377640&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.973 CONCLUSIONS:Patients appear similarly satisfied with inpatient care provided by several hospitalist models and by primary care physicians. Journal of Hospital Medicine 2011;. © 2011 Society of Hospital Medicine. (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5377640 Mon, 31 Oct 2011 04:00:00 +0100 5377640 http://www.medworm.com/index.php?rid=5377639&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.981 AbstractBilateral pleural effusions usually have a single causative factor, such as heart failure or malignancy. Contarini's syndrome refers to the occurrence of bilateral pleural fluid accumulation which can be explained by a different cause for each side. Literature search finds, along with 5 new descriptions from our center, totaled 12 cases. A frequent combination is that of a parapneumonic effusion that triggers heart failure, which in turn produces a contralateral transudate. Journal of Hospital Medicine 2011;. © 2011 Society of Hospital Medicine (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5377639 Mon, 31 Oct 2011 04:00:00 +0100 5377639 http://www.medworm.com/index.php?rid=5377638&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.979 CONCLUSIONS:A pediatric hospitalist sedation service with proper training and oversight can successfully augment sedation provided by anesthesiologists. Journal of Hospital Medicine 2011;. © 2011 Society of Hospital Medicine (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5377638 Mon, 31 Oct 2011 04:00:00 +0100 5377638 http://www.medworm.com/index.php?rid=5377637&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.932 CONCLUSIONS:The PREP score performed comparably to the PESI score for identifying PE patients at low risk for short‐term and intermediate‐term mortality. Journal of Hospital Medicine 2011;. © 2011 Society of Hospital Medicine (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5377637 Mon, 31 Oct 2011 04:00:00 +0100 5377637 http://www.medworm.com/index.php?rid=5377636&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.937 CONCLUSIONS:Formal incorporation of the HQPS Competencies into professional development programs, and innovative educational initiatives and curricula, will help provide current hospitalists and the next generations of hospitalists with the needed skills to be successful. Journal of Hospital Medicine 2011;. © 2011 Society of Hospital Medicine (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5377636 Mon, 31 Oct 2011 04:00:00 +0100 5377636 http://www.medworm.com/index.php?rid=5377653&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.969 CONCLUSIONS:Severe AH appears common and its prevalence varies by underlying clinical condition. Severe AH is associated with excess in‐hospital mortality for patients with nervous system diseases and, for most disease categories, prolongs hospitalization. Journal of Hospital Medicine 2011;. © 2011 Society of Hospital Medicine (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5377653 Fri, 28 Oct 2011 04:00:00 +0100 5377653 http://www.medworm.com/index.php?rid=5377652&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.964 CONCLUSIONS:Early unplanned ICU transfers—even within 8 hours of hospitalization—are associated with increased mortality; outcomes vary by elapsed time to transfer and admitting diagnosis. Journal of Hospital Medicine 2011;. © 2011 Society of Hospital Medicine. (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5377652 Fri, 28 Oct 2011 04:00:00 +0100 5377652 http://www.medworm.com/index.php?rid=5377651&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.952 CONCLUSIONS:Significant variation exists in how pediatric teaching services provide overnight coverage. While hospitalists are prevalent in pediatric training programs (84% overall, 67% day only), their role in direct patient care during the overnight hours has been limited thus far. New work hour restrictions will promote the need for more hospitalists. Journal of Hospital Medicine 2011;. © 2011 Society of Hospital Medicine. (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5377651 Fri, 28 Oct 2011 04:00:00 +0100 5377651 http://www.medworm.com/index.php?rid=5377650&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.942 CONCLUSIONS:Select guideline‐defined criteria predicted CAP‐resistance. A cohort‐developed model based primarily on prior MRSA history, nursing home residence, and specific antibiotic exposures provided improved prediction of CAP‐resistant organisms in HCAP. Journal of Hospital Medicine 2011; © 2011 Society of Hospital Medicine. (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5377650 Fri, 28 Oct 2011 04:00:00 +0100 5377650 http://www.medworm.com/index.php?rid=5377649&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.934 CONCLUSIONS:A pocket feedback card and dedicated feedback session improved the quantity and quality of feedback delivered to IM residents by their attendings on the inpatient wards. Journal of Hospital Medicine 2011;. © 2011 Society of Hospital Medicine (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5377649 Fri, 28 Oct 2011 04:00:00 +0100 5377649 http://www.medworm.com/index.php?rid=5377648&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.929 CONCLUSIONS:A considerable barrier to optimal DVT prophylaxis utilization may be that those healthcare providers best able to conduct a daily assessment of patients' need for prophylaxis underrecognize the problem that prophylaxis is underutilized in this population. Interventions to bridge the gap between knowledge and practice should consider preprinted orders outlining DVT risk factors, and educating front‐line care providers prior to implementation of a top‐down approach. Journal of Hospital Medicine 2011;. © 2011 Society of Hospital Medicine (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5377648 Fri, 28 Oct 2011 04:00:00 +0100 5377648 http://www.medworm.com/index.php?rid=5356536&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.985 CONCLUSIONS:Recent hospitalization, pre‐morbid ambulation impairment, and atypical presentation were independently associated with higher 30‐day mortality among older persons hospitalized for pneumonia, after adjusting for severity of illness. These factors could be considered in addition to PSI when performing risk stratification and adjustment in this setting. Journal of Hospital Medicine 2011;. © 2011 Society of Hospital Medicine. (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5356536 Wed, 26 Oct 2011 04:00:00 +0100 5356536 http://www.medworm.com/index.php?rid=5356535&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.949 CONCLUSIONS:Observation is a variably applied patient status, defined differently by individual hospitals. Consistency in the designation of patients under observation status among hospitals and payers may be necessary to compare quality outcomes and costs, as well as optimize models of pediatric observation care.Journal of Hospital Medicine 2011;. © 2011 Society of Hospital Medicine. (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5356535 Wed, 26 Oct 2011 04:00:00 +0100 5356535 http://www.medworm.com/index.php?rid=5322190&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.962 CONCLUSIONS:PH have a role in physician training. While PHM has become a career consideration for trainees, more work needs to be done to improve the perception of PHM as a viable long‐term career. Journal of Hospital Medicine 2011;. © 2011 Society of Hospital Medicine (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5322190 Thu, 13 Oct 2011 04:00:00 +0100 5322190 http://www.medworm.com/index.php?rid=5322189&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.958 CONCLUSION:The prevalence of being overweight or obese was high in this nationally representative cohort of minority surgical patients. Although BMI class is a significant predictor of 30‐day mortality, the effect appeared paradoxical. The poorest outcomes were in the underweight and normal BMI patients. Severely obese patients had the lowest risk of mortality, even after experiencing a major postoperative complication. Journal of Hospital Medicine 2011; © 2011 Society of Hospital Medicine. (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5322189 Thu, 13 Oct 2011 04:00:00 +0100 5322189 http://www.medworm.com/index.php?rid=5322188&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.957 AbstractHealthcare's improvement efforts have focused on the point of care, targeting specific processes such as preventing central line infections, while paying relatively less attention to the larger issues of organizational structure and leadership. Interestingly, the business community has long recognized that poor management and structure can thwart improvement efforts. Perhaps the corporate world's best‐known study of these issues is found in the book Good to Great, which identifies top‐performing corporations, compares them to carefully selected organizations that failed to achieve similar levels of performance, and gleans lessons from these analyses. In this article, we analyze the feasibility of carefully applying Good to Great's methods for analyzing organizational structure ... Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5322188 Thu, 13 Oct 2011 04:00:00 +0100 5322188 http://www.medworm.com/index.php?rid=5322187&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.956 DISCUSSION:Expansion of our database to all safety incidents beyond SEs provides a resource for communicating safety opportunities between hospitals. We demonstrate how the ICPS classifications can be migrated into a decision support tool that has potential for standardizing root cause analyses, disseminating action plans, and improving patient safety. Journal of Hospital Medicine 2011;. © 2011 Society of Hospital Medicine. (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5322187 Thu, 13 Oct 2011 04:00:00 +0100 5322187 http://www.medworm.com/index.php?rid=5311965&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.911 CONCLUSIONS:Causative bacteria were infrequently identified in children with complicated pneumonia. Broad‐range 16S rRNA PCR only modestly improved the microbiologic yield over conventional culture methods. Journal of Hospital Medicine 2011. © 2011 Society of Hospital Medicine (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5311965 Wed, 12 Oct 2011 04:00:00 +0100 5311965 http://www.medworm.com/index.php?rid=5311964&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.950 AbstractGiven the growing field of Pediatric Hospital Medicine (PHM) and the need to define strategic direction, the Society of Hospital Medicine, the American Academy of Pediatrics, and the Academic Pediatric Association sponsored a roundtable to discuss the future of the field. Twenty‐one leaders were invited plus a facilitator utilizing established health care strategic planning methods. A “vision statement” was developed. Specific initiatives in 4 domains (clinical practice, quality of care, research, and workforce) were identified that would advance PHM with a plan to complete each initiative. Review of the current issues demonstrated gaps between the current state of affairs and the full vision of the potential impact of PHM. Clinical initiatives were to develop an educational ... Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5311964 Wed, 12 Oct 2011 04:00:00 +0100 5311964 http://www.medworm.com/index.php?rid=5282556&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.959 CONCLUSIONS:Differences in LOS between uninsured, publicly insured, and privately insured children with CAP raise concerns about potential differences in hospital discharge practices related to insurance status and type. As healthcare reform is implemented, policy makers should strengthen efforts to reduce these disparities in order to achieve health for the population. Journal of Hospital Medicine 2011. © 2011 Society of Hospital Medicine. (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5282556 Mon, 03 Oct 2011 04:00:00 +0100 5282556 http://www.medworm.com/index.php?rid=5282555&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.951 CONCLUSION:Hospitalists can improve the quality and efficiency of inpatient care in the pediatric population, but the effect is not universal, and mechanisms underlying demonstrated improvements are poorly understood. We propose 4 components to improve quality and value in hospital medicine systems: investment in comparative effectiveness research involving delivery system interventions, development and implementation of pediatric quality measures, better understanding of improvement mechanisms for hospital medicine systems, and increased focus on quality and value delivered by hospital medicine groups and individuals. Journal of Hospital Medicine 2011. © 2011 Society of Hospital Medicine (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5282555 Mon, 03 Oct 2011 04:00:00 +0100 5282555 http://www.medworm.com/index.php?rid=5282554&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.948 CONCLUSIONS:Cost‐related underuse is common among hospitalized patients. Individuals of black race appear to be particularly at risk. Strategies should be developed to address this issue around the time of hospital discharge. Journal of Hospital Medicine 2011. © 2011 Society of Hospital Medicine (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5282554 Mon, 03 Oct 2011 04:00:00 +0100 5282554 http://www.medworm.com/index.php?rid=5455046&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.996 AbstractDabigatran etexilate (dabigatran) is a novel, oral, reversible, direct thrombin inhibitor that exhibits several advantages over warfarin for therapeutic anticoagulation. The predictable pharmacokinetic profile and minimal food and drug interactions of dabigatran allow for a fixed‐dosing regimen and obviate the need for routine laboratory monitoring. Dabigatran has been approved in the United States for prevention of stroke in patients with nonvalvular atrial fibrillation and in the European Union and other countries for primary prevention of thromboembolic events after total knee or hip replacement. More indications for the use of dabigatran are under review by regulatory authorities and are undergoing active clinical investigation. Due to its rapid onset of action, dabigatran ma... Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5455046 Sat, 01 Oct 2011 04:00:00 +0100 5455046 http://www.medworm.com/index.php?rid=5438242&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.993 CONCLUSIONS:The PICU delivered critical care services most of the time, but periods of non–critical care services represented a significant amount of time. In particular, periods with no bed available for new patients were associated with at least 1 or more PICU beds being used for non–critical care activities. The method should be reproducible in other settings to learn more about the structure and processes of care and patient flow and to make improvements. Journal of Hospital Medicine 2011; © 2011 Society of Hospital Medicine (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5438242 Sat, 01 Oct 2011 04:00:00 +0100 5438242 http://www.medworm.com/index.php?rid=5419060&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.971 CONCLUSIONS:We identified a set of characteristics associated with clinical deterioration in children. Used in combination as a score, these characteristics may be useful in triaging the intensity of monitoring and surveillance for deterioration that children receive while hospitalized on non‐ICU units. Journal of Hospital Medicine 2011; (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5419060 Sat, 01 Oct 2011 04:00:00 +0100 5419060 http://www.medworm.com/index.php?rid=5398048&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.982 (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5398048 Sat, 01 Oct 2011 04:00:00 +0100 5398048 http://www.medworm.com/index.php?rid=5377633&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.968 CONCLUSIONS:The higher drug cost of enoxaparin was offset by the reduction in clinical events as compared to the use of UFH for VTE prophylaxis after an AIS, particularly in patients with severe stroke. Journal of Hospital Medicine 2011;. © 2011 Society of Hospital Medicine. (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5377633 Sat, 01 Oct 2011 04:00:00 +0100 5377633 http://www.medworm.com/index.php?rid=5356534&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.898 DISCUSSION:When applied to patient educational material, GT performed comparably to professional human translation in terms of preserving information and meaning, though it was slightly worse in preserving grammar. In situations where professional human translations are unavailable or impractical, online translation may someday fill an important niche. Journal of Hospital Medicine 2011. © 2011 Society of Hospital Medicine (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5356534 Sat, 01 Oct 2011 04:00:00 +0100 5356534 http://www.medworm.com/index.php?rid=5332283&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.955 CONCLUSION:The radiographic finding of an alveolar infiltrate is very reliable among pediatric radiologists, whereas the finding of an interstitial infiltrate is less reliable. Journal of Hospital Medicine 2011; © 2011 Society of Hospital Medicine. (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5332283 Sat, 01 Oct 2011 04:00:00 +0100 5332283 http://www.medworm.com/index.php?rid=5322186&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.953 CONCLUSIONS:A hospitalist‐led MET decreased code call rates but did not affect mortality rates. Journal of Hospital Medicine 2011;. © 2011 Society of Hospital Medicine (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5322186 Sat, 01 Oct 2011 04:00:00 +0100 5322186 http://www.medworm.com/index.php?rid=5311975&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.902 (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5311975 Sat, 01 Oct 2011 04:00:00 +0100 5311975 http://www.medworm.com/index.php?rid=5311974&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.928 CONCLUSIONS:We found that the use of baclofen was associated with a significant reduction in the use of high doses of benzodiazepine (lorazepam) in the management of symptomatic AWS. The use of low‐dose baclofen in the management of AWS deserves further study, as reduced dependence on high‐dose benzodiazepines in AWS management could improve patient safety. Journal of Hospital Medicine 2011;6:474–479. © 2011 Society of Hospital Medicine (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5311974 Sat, 01 Oct 2011 04:00:00 +0100 5311974 http://www.medworm.com/index.php?rid=5311973&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.905 CONCLUSIONS:While Joint Commission‐accredited hospitals already outperformed non‐accredited hospitals on publicly reported quality measures in the early days of public reporting, these differences became significantly more pronounced over 5 years of observation. Future research should examine whether accreditation actually promotes improved performance or is a marker for other hospital characteristics associated with such performance. Journal of Hospital Medicine 2011;6:458–465. © 2011 Society of Hospital Medicine (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5311973 Sat, 01 Oct 2011 04:00:00 +0100 5311973 http://www.medworm.com/index.php?rid=5311971&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.919 CONCLUSIONS:Residents depended on interprofessional supervision when making decisions regarding medications in the ICU. Improving interprofessional supervision, which thus far has been underrecognized and underemphasized in graduate medical education, can potentially improve medication safety in high‐risk settings. Journal of Hospital Medicine 2011;6:448–456. © 2011 Society of Hospital Medicine (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5311971 Sat, 01 Oct 2011 04:00:00 +0100 5311971 http://www.medworm.com/index.php?rid=5311970&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.916 CONCLUSIONS:Hospitalized patients are experiencing less continuity than 10 years ago. The hospitalist model of care does not appear to play a role in this discontinuity. Journal of Hospital Medicine 2011;6:441–447. © 2011 Society of Hospital Medicine. (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5311970 Sat, 01 Oct 2011 04:00:00 +0100 5311970 http://www.medworm.com/index.php?rid=5311968&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.966 (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5311968 Sat, 01 Oct 2011 04:00:00 +0100 5311968 http://www.medworm.com/index.php?rid=5311967&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.960 (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5311967 Sat, 01 Oct 2011 04:00:00 +0100 5311967 http://www.medworm.com/index.php?rid=5311963&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.943 CONCLUSIONS:Methylnaltrexone was generally well tolerated and was active in inducing laxation in this study of patients experiencing acute OIC following orthopedic surgery. Journal of Hospital Medicine 2011. © 2011 Society of Hospital Medicine. (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5311963 Sat, 01 Oct 2011 04:00:00 +0100 5311963 http://www.medworm.com/index.php?rid=5282553&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.915 CONCLUSIONS:This curriculum showed that students could acquire the needed skills to prepare quality discharge summaries and communicate well with patients at discharge, as well as improve their overall knowledge surrounding care transitions. Journal of Hospital Medicine 2011. © 2011 Society of Hospital Medicine (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5282553 Thu, 01 Sep 2011 04:00:00 +0100 5282553 http://www.medworm.com/index.php?rid=5270536&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.930 CONCLUSIONS:There is no evidence that AD discussions or documentation result in increased mortality. In regards to the current national debate about the merits of advance care planning, this study suggests that honoring patients' wishes to engage in AD discussions and documentation does not lead to harm. Journal of Hospital Medicine 2011. © 2011 Society of Hospital Medicine (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5270536 Thu, 01 Sep 2011 04:00:00 +0100 5270536 http://www.medworm.com/index.php?rid=5257987&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.926 CONCLUSIONS:Restructuring the admission system to achieve constant daily admissions to each care team resulted in a smoothing of daily discharge rates and improved operational efficiency with shorter lengths of stay. Journal of Hospital Medicine 2011;. © 2011 Society of Hospital Medicine. (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5257987 Thu, 01 Sep 2011 04:00:00 +0100 5257987 http://www.medworm.com/index.php?rid=5220131&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.879 CONCLUSIONS:We found incorporating OSTEs into a FCR faculty development program to be an effective strategy for improving faculty teaching behavior. Additional study is needed to determine if this strategy results in sustained improvements in conducting FCRs in real inpatient settings. Journal of Hospital Medicine 2011. © 2011 Society of Hospital Medicine (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5220131 Thu, 01 Sep 2011 04:00:00 +0100 5220131 http://www.medworm.com/index.php?rid=5220130&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.974 (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5220130 Thu, 01 Sep 2011 04:00:00 +0100 5220130 http://www.medworm.com/index.php?rid=5220129&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.894 CONCLUSIONS:Successful promotion in academic hospital medicine depends on accomplishment in traditional academic domains, raising potential concerns for academic hospitalists with less traditional roles. This study may provide guidance for early‐career academic hospitalists and program leaders. Journal of Hospital Medicine 2011. © 2011 Society of Hospital Medicine (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5220129 Thu, 01 Sep 2011 04:00:00 +0100 5220129 http://www.medworm.com/index.php?rid=5220128&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.899 CONCLUSIONS:In severe sepsis attributed to Gram‐negative bacteremia, initial treatment with an antibiotic regimen to which the causative pathogen is resistant was associated with increased hospital mortality. This finding suggests that rapid determination of bacterial susceptibility could influence treatment choices in patients with severe sepsis potentially improving their clinical outcomes. Journal of Hospital Medicine 2011. © 2011 Society of Hospital Medicine (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5220128 Thu, 01 Sep 2011 04:00:00 +0100 5220128 http://www.medworm.com/index.php?rid=5220127&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.914 CONCLUSIONS:Preferences and experiences about provider roles are not uniform under comanagement, and conflicting preferences exist around decision‐making processes. Providers generally agreed that comanaging hospitalists should participate broadly in management decisions. Journal of Hospital Medicine 2011. © 2011 Society of Hospital Medicine (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5220127 Thu, 01 Sep 2011 04:00:00 +0100 5220127 http://www.medworm.com/index.php?rid=5220126&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.892 CONCLUSIONS:Analysis of resident‐selected ICD‐9 codes might serve as a method to attempt to define resident clinical experience, and may be useful in the development of innovative experiential learning‐based residency curricula. This might also be used to assess gaps in experiential learning at the program or resident level, and may serve to identify topics that require additional teaching supplementation. Journal of Hospital Medicine 2011. © 2011 Society of Hospital Medicine (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5220126 Thu, 01 Sep 2011 04:00:00 +0100 5220126 http://www.medworm.com/index.php?rid=5220125&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.917 CONCLUSION:At our hospital, we found no association between the arrival of new house‐staff and the adjusted risk of death in hospital. These data, along with the results of the vast majority of previous studies in this field, make the existence of the “July Phenomenon” for inpatient mortality extremely unlikely. Journal of Hospital Medicine 2011. © 2011 Society of Hospital Medicine (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5220125 Thu, 01 Sep 2011 04:00:00 +0100 5220125 http://www.medworm.com/index.php?rid=5220124&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.909 CONCLUSIONS:The study points to the multifactorial nature of interventions needed to prevent readmissions, the tradeoffs between hospital length of stay and readmission, and the importance of fostering a culture of optimism and engagement to outpatient components of the health system to reduce hospital readmissions. Journal of Hospital Medicine 2011. © 2011 Society of Hospital Medicine (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5220124 Thu, 01 Sep 2011 04:00:00 +0100 5220124 http://www.medworm.com/index.php?rid=5220123&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.896 CONCLUSIONS:The hospitalist system has higher efficiency than the internist‐run general wards under the NHI system in terms of costs and length of hospitalization. It may serve as an alternative model to address rising admissions and staff shortages. Journal of Hospital Medicine 2011. © 2011 Society of Hospital Medicine. (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5220123 Thu, 01 Sep 2011 04:00:00 +0100 5220123 http://www.medworm.com/index.php?rid=5220122&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.967 (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5220122 Thu, 01 Sep 2011 04:00:00 +0100 5220122 http://www.medworm.com/index.php?rid=5220121&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.961 (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5220121 Thu, 01 Sep 2011 04:00:00 +0100 5220121 http://www.medworm.com/index.php?rid=5157125&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.886 CONCLUSIONS:Clinical judgment regarding patient stability can be reliably quantified in a simple score with the potential for efficiently conveying complex assessments of at‐risk patients during handoffs between healthcare members. Journal of Hospital Medicine 2011;. © 2011 Society of Hospital Medicine (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5157125 Thu, 30 Jun 2011 23:00:00 +0100 5157125 http://www.medworm.com/index.php?rid=5118181&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.908 (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5118181 Thu, 30 Jun 2011 23:00:00 +0100 5118181 http://www.medworm.com/index.php?rid=5118180&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.782 (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5118180 Thu, 30 Jun 2011 23:00:00 +0100 5118180 http://www.medworm.com/index.php?rid=5118179&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.885 (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5118179 Thu, 30 Jun 2011 23:00:00 +0100 5118179 http://www.medworm.com/index.php?rid=5118178&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.878 CONCLUSIONS:A mobile ACE service may result in reduced LOS and lower costs with no change in in‐hospital mortality or 7‐ or 30‐day readmission rates when compared with standard medical service and a traditional unit‐based ACE service. Journal of Hospital Medicine 2011;6:358–363. © 2011 Society of Hospital Medicine (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5118178 Thu, 30 Jun 2011 23:00:00 +0100 5118178 http://www.medworm.com/index.php?rid=5118177&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.900 This article addresses these issues with 10 evidence‐based pearls developed to help hospitalists provide optimal care for this expanding population. Journal of Hospital Medicine 2011;6:351–357. © 2011 Society of Hospital Medicine (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5118177 Thu, 30 Jun 2011 23:00:00 +0100 5118177 http://www.medworm.com/index.php?rid=5118176&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.965 (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5118176 Thu, 30 Jun 2011 23:00:00 +0100 5118176 http://www.medworm.com/index.php?rid=5118175&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.877 CONCLUSIONS:After controlling for severity of illness and multiple comorbidities only fluoroquinolone resistance, cirrhosis, and cardiac dysfunction independently predicted mortality in patients with E coli bacteremia. Journal of Hospital Medicine 2011;6:344–349. © 2011 Society of Hospital Medicine (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5118175 Thu, 30 Jun 2011 23:00:00 +0100 5118175 http://www.medworm.com/index.php?rid=5118174&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.889 CONCLUSIONS:Our data suggest that younger patients and those cared for by surgical specialty services may receive the most benefit from palliative care consultation, a finding that needs to be corroborated in other centers. Journal of Hospital Medicine 2011;6:336–343. © 2011 Society of Hospital Medicine (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5118174 Thu, 30 Jun 2011 23:00:00 +0100 5118174 http://www.medworm.com/index.php?rid=5118173&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.891 CONCLUSION:Key barriers to medication reconciliation are unreliable sources of medication information and tasks that compete for providers' time and attention that they consider higher priority. Addressing these barriers while increasing providers' self‐efficacy might improve medication reconciliation and its outcomes. Journal of Hospital Medicine 2011;6:329–337. © 2011 Society of Hospital Medicine (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5118173 Thu, 30 Jun 2011 23:00:00 +0100 5118173 http://www.medworm.com/index.php?rid=5118172&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.910 CONCLUSIONS:Implementation of a PDAS provides a net improvement in quality of care for the patient taking warfarin in the inpatient setting. Journal of Hospital Medicine 2011;6:322–328. © 2011 Society of Hospital Medicine (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5118172 Thu, 30 Jun 2011 23:00:00 +0100 5118172 http://www.medworm.com/index.php?rid=5118171&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.906 CONCLUSIONS:A Hospitalist‐ACE service may improve care processes without significantly increasing resource consumption. No impact on key clinical outcomes was observed. Journal of Hospital Medicine 2011;6:313–321. © 2011 Society of Hospital Medicine (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=5118171 Thu, 30 Jun 2011 23:00:00 +0100 5118171 http://www.medworm.com/index.php?rid=4920673&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.883 (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=4920673 Sat, 30 Apr 2011 23:00:00 +0100 4920673 http://www.medworm.com/index.php?rid=4920672&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.933 AbstractPain is the predominant medical presentation to hospitalists for patients with sickle cell disease (SCD). Dramatic treatment gains of SCD in childhood have resulted in more adults now requiring hospitalization than children. This has created new challenges to improve the quality of hospital care for SCD. The evidence base for pain management in SCD is lacking. We therefore offer some evidence and our informed opinion to answer frequently asked questions (FAQs) about pain management by hospitalists caring for adults with SCD. The most common questions center around defining a crisis; selecting and managing opioids; distinguishing between opioid tolerance, physical dependence, and addiction or misuse; determining appropriateness of discharge; and avoiding lengthy or recurrent hospita... Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=4920672 Sat, 30 Apr 2011 23:00:00 +0100 4920672 http://www.medworm.com/index.php?rid=4920671&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.895 CONCLUSIONS:Many microbiology results return postdischarge and some necessitate a change in treatment. These results arise from many specialties, suggesting the need for a hospital‐wide system to ensure effective communication of these results. Journal of Hospital Medicine 2011. © 2011 Society of Hospital Medicine (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=4920671 Sat, 30 Apr 2011 23:00:00 +0100 4920671 http://www.medworm.com/index.php?rid=4920670&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.940 (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=4920670 Sat, 30 Apr 2011 23:00:00 +0100 4920670 http://www.medworm.com/index.php?rid=4920669&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.868 CONCLUSIONS:ECG score correlates with the severity of PE in hemodynamically stable patients. It is potentially useful for risk‐stratification strategies in this setting. Journal of Hospital Medicine 2011. © 2011 Society of Hospital Medicine (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=4920669 Sat, 30 Apr 2011 23:00:00 +0100 4920669 http://www.medworm.com/index.php?rid=4920668&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.866 CONCLUSIONS:An aspart insulin protocol safely lowers BG levels in the ED without prolonging LOS. During hospitalization, a detemir‐aspart protocol achieves significantly better glycemic control compared with guideline‐driven use of NPH‐aspart or glargine/detemir‐aspart (usual care) without increasing hypoglycemia. Standardization of insulin protocols in the ED and hospital settings leads to improvement in overall glycemic control with greater safety and efficacy than usual care. Journal of Hospital Medicine 2011. © 2011 Society of Hospital Medicine (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=4920668 Sat, 30 Apr 2011 23:00:00 +0100 4920668 http://www.medworm.com/index.php?rid=4920667&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.903 CONCLUSIONS:There are important differences between infants with bronchiolitis having short and prolonged hospital stays, including several clinical markers identifiable on hospital day 2. This model may be a useful prediction tool for targeting early interventions for high‐risk infants. Journal of Hospital Medicine 2011. © 2011 Society of Hospital Medicine (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=4920667 Sat, 30 Apr 2011 23:00:00 +0100 4920667 http://www.medworm.com/index.php?rid=4920666&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.850 CONCLUSIONS:Overall, high utilization was difficult to predict, as was its course. The diagnoses most associated with high utilization indicated more severe sickle cell disease. Septicemia deserves further investigation as a preventable cause for high utilization, as do mood disorders. Journal of Hospital Medicine 2011. © 2011 Society of Hospital Medicine (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=4920666 Sat, 30 Apr 2011 23:00:00 +0100 4920666 http://www.medworm.com/index.php?rid=4920665&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.935 (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=4920665 Sat, 30 Apr 2011 23:00:00 +0100 4920665 http://www.medworm.com/index.php?rid=4861896&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.904 CONCLUSION:Hospitals do have substantial unused capacity, and smoothing occupancy over the course of a week could be a useful strategy that hospitals can use to reduce crowding and protect patients from crowded conditions. Journal of Hospital Medicine 2011;. © 2011 Society of Hospital Medicine. (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=4861896 Thu, 31 Mar 2011 23:00:00 +0100 4861896 http://www.medworm.com/index.php?rid=4683685&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.923 (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=4683685 Thu, 31 Mar 2011 23:00:00 +0100 4683685 http://www.medworm.com/index.php?rid=4683684&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.855 (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=4683684 Thu, 31 Mar 2011 23:00:00 +0100 4683684 http://www.medworm.com/index.php?rid=4683683&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.876 (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=4683683 Thu, 31 Mar 2011 23:00:00 +0100 4683683 http://www.medworm.com/index.php?rid=4683682&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.884 We present a case of serum sickness‐like reaction to clarithromycin, a commonly prescribed drug for the treatment of respiratory tract infections. The patient had been taking this drug for 3 days when she experienced generalized body aches, rash, arthralgia, and shortness of breath, prompting presentation to the emergency department. Laboratory studies showed decreased C4 and total complement with a slightly elevated sedimentation rate. After exclusion of other possible causes, the diagnosis of serum sickness‐like reaction was made. The patient responded well to nonsteroidal antiinflammatory medication, antihistamines, and a short, tapering dose of steroids. To our knowledge, serum sickness‐like reaction to clarithromycin has never been reported previously. This case emphasizes the n... Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=4683682 Thu, 31 Mar 2011 23:00:00 +0100 4683682 http://www.medworm.com/index.php?rid=4683681&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.853 CONCLUSIONS:Communication tools designed to reduce the likelihood of patient harm remain a focus of patient safety efforts. Critical Conversations are an innovative communication tool, intervention, and policy that potentially limits communication failures at critical junctures to ensure high quality and safe patient care. Journal of Hospital Medicine 2011. © 2011 Society of Hospital Medicine. (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=4683681 Thu, 31 Mar 2011 23:00:00 +0100 4683681 http://www.medworm.com/index.php?rid=4683680&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.856 CONCLUSIONS:Patients are highly satisfied with procedure performance by supervised trainees, and many patients were reassured by physician communication during the procedure. These results suggest that patient experience and teaching can be preserved with a hospitalist‐supervised procedure service. Journal of Hospital Medicine 2011. © 2011 Society of Hospital Medicine. (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=4683680 Thu, 31 Mar 2011 23:00:00 +0100 4683680 http://www.medworm.com/index.php?rid=4683679&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.922 (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=4683679 Thu, 31 Mar 2011 23:00:00 +0100 4683679 http://www.medworm.com/index.php?rid=4683678&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.888 CONCLUSIONS:The risk of symptomatic VTE in general medical patients is low. A risk factor model can identify those at sufficient risk to warrant pharmacologic prophylaxis. Journal of Hospital Medicine 2011. © 2011 Society of Hospital Medicine. (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=4683678 Thu, 31 Mar 2011 23:00:00 +0100 4683678 http://www.medworm.com/index.php?rid=4683677&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.860 CONCLUSIONS:We determined that, following brief instructions early in the academic year, a point‐based VTE risk assessment tool has only fair to moderate inter‐rater reliability, with suboptimal adherence to the protocol. Both might lead to underutilization of VTE prevention strategies. Journal of Hospital Medicine 2011. © 2011 Society of Hospital Medicine. (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=4683677 Thu, 31 Mar 2011 23:00:00 +0100 4683677 http://www.medworm.com/index.php?rid=4683676&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.827 CONCLUSIONS:The prevalence of PE in hospitalized patients receiving prophylactic heparin is lower than in cohorts from which the Wells prediction criteria were derived and validated. A modified Wells score <4 safely excludes PE in such patients and reduces the need for CT. D‐dimer testing adds nothing to the evaluation. Journal of Hospital Medicine 2011;. © 2011 Society of Hospital Medicine. (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=4683676 Thu, 31 Mar 2011 23:00:00 +0100 4683676 http://www.medworm.com/index.php?rid=4683675&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.846 CONCLUSIONS:Audit and feedback of aggregated patient‐level urinary catheter duration determined from electronic documentation may prove effective in improving urinary catheter management for surgical patients. Journal of Hospital Medicine 2010;. © 2010 Society of Hospital Medicine. (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=4683675 Thu, 31 Mar 2011 23:00:00 +0100 4683675 http://www.medworm.com/index.php?rid=4683674&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.913 (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=4683674 Thu, 31 Mar 2011 23:00:00 +0100 4683674 http://www.medworm.com/index.php?rid=4544649&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.872 CONCLUSION:There is variability in the treatment and outcomes of children with complicated pneumonia. Outcomes were similar in patients undergoing initial chest tube placement with or without fibrinolysis. Those undergoing VATS received fewer additional drainage procedures but had no differences in LOS compared with other strategies. Journal of Hospital Medicine 2011;. © 2011 Society of Hospital Medicine (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=4544649 Thu, 03 Mar 2011 00:00:00 +0100 4544649 http://www.medworm.com/index.php?rid=4559840&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.874 (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=4559840 Tue, 01 Mar 2011 00:00:00 +0100 4559840 http://www.medworm.com/index.php?rid=4559839&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.852 (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=4559839 Tue, 01 Mar 2011 00:00:00 +0100 4559839 http://www.medworm.com/index.php?rid=4559838&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.875 (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=4559838 Tue, 01 Mar 2011 00:00:00 +0100 4559838 http://www.medworm.com/index.php?rid=4559837&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.845 Conclusion:Building FD programs can be effective to foster the development and satisfaction of new faculty while also creating a shared commitment towards an academic mission. Journal of Hospital Medicine 2011. © 2011 Society of Hospital Medicine. (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=4559837 Tue, 01 Mar 2011 00:00:00 +0100 4559837 http://www.medworm.com/index.php?rid=4559836&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.912 (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=4559836 Tue, 01 Mar 2011 00:00:00 +0100 4559836 http://www.medworm.com/index.php?rid=4559835&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.834 Conclusions:A possible direct dose response relationship between SPS and the reduction in serum potassium concentration was found and should be evaluated prospectively. Journal of Hospital Medicine 2011. © 2011 Society of Hospital Medicine. (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=4559835 Tue, 01 Mar 2011 00:00:00 +0100 4559835 http://www.medworm.com/index.php?rid=4559834&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.826 CONCLUSIONS:H‐PA team‐based GM inpatient care was associated with a higher LOS but similar charges, readmission rates, and inpatient mortality to traditional resident‐based teams, a finding that persisted in sensitivity analyses. Journal of Hospital Medicine 2011. © 2011 Society of Hospital Medicine. (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=4559834 Tue, 01 Mar 2011 00:00:00 +0100 4559834 http://www.medworm.com/index.php?rid=4559833&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.821 CONCLUSION:The family medicine hospitalist model was associated with reductions in hospital LOS and cost of care without adversely affecting mortality or 30‐day all‐cause readmission rate. These findings suggest that the hospitalist care model can be adapted for health systems outside North America and may produce similar beneficial effects in care efficiency and cost savings. Journal of Hospital Medicine 2011. © 2011 Society of Hospital Medicine. (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=4559833 Tue, 01 Mar 2011 00:00:00 +0100 4559833 http://www.medworm.com/index.php?rid=4459564&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.864 CONCLUSIONS:Bacterial contamination occurs within hours after donning newly laundered short‐sleeved uniforms. After 8 hours of wear, no difference was observed in the degree of contamination of uniforms versus infrequently laundered white coats. Our data do not support discarding long‐sleeved white coats for short‐sleeved uniforms that are changed on a daily basis. Journal of Hospital Medicine 2011. © 2011 Society of Hospital Medicine. (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=4459564 Thu, 10 Feb 2011 00:00:00 +0100 4459564 http://www.medworm.com/index.php?rid=4544648&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.859 AbstractThe use of triple therapy (warfarin plus dual antiplatelet therapy) has increased in recent years due to an aging population with a higher risk for atrial fibrillation, as well as the increased use of coronary stents for acute coronary syndromes. Triple therapy confers a higher bleeding risk than either warfarin or dual antiplatelet therapy alone. However, warfarin alone is inadequate for patients with indications for triple therapy because of an unacceptable risk of stent thrombosis, and dual antiplatelet therapy is inferior to warfarin for the prevention of ischemic strokes in patients with atrial fibrillation, mechanical valves, or intraventricular thrombosis. Hospitalists face the challenge of balancing the aforementioned risks; the optimal management of these patients requires... Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=4544648 Tue, 01 Feb 2011 00:00:00 +0100 4544648 http://www.medworm.com/index.php?rid=4459563&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.873 CONCLUSION:The intensive collaborative approach outpaced the simpler toolkit approach in changing processes of care, but neither approach improved outcomes. Incorporating quality improvement methods, such as ICU checklists, into routine care processes is complex, highly context‐dependent, and may take longer than 18 months to achieve. © Society of Hospital Medicine Journal of Hospital Medicine 2011 (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=4459563 Tue, 01 Feb 2011 00:00:00 +0100 4459563 http://www.medworm.com/index.php?rid=4428742&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.844 (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=4428742 Tue, 01 Feb 2011 00:00:00 +0100 4428742 http://www.medworm.com/index.php?rid=4428741&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.701 (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=4428741 Tue, 01 Feb 2011 00:00:00 +0100 4428741 http://www.medworm.com/index.php?rid=4428740&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.862 (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=4428740 Tue, 01 Feb 2011 00:00:00 +0100 4428740 http://www.medworm.com/index.php?rid=4428739&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.823 CONCLUSION:A demonstrative case is provided, followed by key concepts for practice and for educating trainees. Journal of Hospital Medicine 2011;6:94–97. © 2011 Society of Hospital Medicine. (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=4428739 Tue, 01 Feb 2011 00:00:00 +0100 4428739 http://www.medworm.com/index.php?rid=4428738&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.907 (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=4428738 Tue, 01 Feb 2011 00:00:00 +0100 4428738 http://www.medworm.com/index.php?rid=4428737&cid=s_33649_148_f&fid=33649&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fjhm.901 (Source: Journal of Hospital Medicine) Journal of Hospital Medicine journals http://www.medworm.com/rss/comments.php?id=4428737 Tue, 01 Feb 2011 00:00:00 +0100 4428737