Middle age is typically a difficult passage for many professionals. It is a developmental phase involving the mourning of lost opportunities and the acceptance of one’s limits. One also reflects on his or her identity, takes note of regrets, and reevaluates how one will apportion time in the future.—Glen Gabbard, MD¹

Hospital medicine is a relatively young specialty, but we are growing up, with many hospitalists now firmly in the middle phase of their careers. In 1999, 15% of our peers had been hospitalists for more than five years; by 2010, that number had grown to 50%.² As the ranks of hospitalists grow older, we are faced with questions reflecting a life station marked by a little more wisdom, a few more gray hairs, and an occasional reflection on the legacy we will leave.

Drybye and colleagues recently released further analysis on a survey that had been previously reported, shedding new light on mid-career physician satisfaction and burnout and revealing important implications for hospital medicine.³ The study looked at responses to the Maslach Burnout Inventory for physicians from a range of specialties who had been in practice 10 years or less (early career), 11 to 20 years (mid-career), and 21 years or more (late career).

The study demonstrated that while early and late career have their challenges, middle career is a particularly difficult time for physicians. Mid-career physicians had the lowest satisfaction with their specialty choice and their work-life balance and the highest rates of emotional exhaustion and burnout. Strikingly, mid-career physicians were more than twice as likely as those in early and late career to plan to leave the practice of medicine for reasons other than retirement in the next 24 months.

What does this mean for hospital medicine? Because the survey findings are drawn from multiple specialties, we must use caution in extrapolating the results to hospitalists; however, if hospitalists are leaving the specialty mid-career, a more pressing problem may exist for hospital medicine than for other specialties. Why? First, the specialty has grown so rapidly over the last 15 years that it has been difficult to generate a sufficient supply of physicians to meet the demand. If a large number of mid-career hospitalists leave the specialty, our field may be stuck in a state of “arrested development” without the sufficient presence of mature clinicians. Second, effective hospitalists possess “system” skills that are learned on the job, so seasoned hospitalists often play an integrative and problem-solving role within the hospital. Third, there could be a downward spiral of career satisfaction in the specialty if onlookers like trainees and stakeholders in the healthcare ecosystem see hospitalists as dissatisfied and disengaged. Will the promise of hospital medicine be fulfilled?

In an accompanying editorial, Spinelli suggests three principles for physician well-being, which hospitalist programs would do well to consider:⁴

1. Elevate well-being metrics to the same level of importance as financial, quality, and patient satisfaction metrics. (Place such metrics on the organizational dashboard.)
2. Design system and care processes that include intentional plans for physician and staff wellness. (Redesign of care models and workflows should consider physician and staff wellness.)
3. Adopt a robust set of self-care strategies for those experiencing burnout.

SHM’s Role

SHM has taken up the issue of hospitalist career satisfaction on a number of occasions over the years, initially engendered by field observations of the stressful nature of hospitalist work and a 2001 study reporting that 25% of hospitalists were “at risk” of burnout and 13% were “burned out.”⁵ Subsequently, SHM released a white paper with a number of specific recommendations organized around a career satisfaction framework consisting of autonomy, reward/recognition, occupational solidarity, and connection with one’s professional and broader community.⁶

 

Recently, the SHM Practice Management Committee has once again taken up the issue of “physician engagement.” Over the next few months, the committee plans to:

1. Create a repository of related resources on the SHM website, including physician engagement profiles for some hospitalist practices;
2. Initiate a dialogue on the topic of physician engagement on HMX (connect.hospitalmedicine.org), SHM’s social networking platform; and
3. Publish a “public domain” survey questionnaire that hospitalist practices can use. This is a crucial matter that remains a central concern for our specialty and for the safety and well-being of our patients.

Conclusion

The Institute for Healthcare Improvement advanced the idea of the Triple Aim (better care, better health, lower costs) several years ago as a guiding principle in the transformation of healthcare. More recently, a growing number of voices suggest that physician satisfaction is a crucial foundation of the Triple Aim.⁴ I submit that for hospitalists to fulfill their potential as healthcare change agents, we will need to build a professional experience that enables them to traverse mid-career challenges and make it to the professional finish line as engaged and well-adjusted members of the healthcare community.

---

Dr. Whitcomb is Chief Medical Officer of Remedy Partners. He is co-founder and past president of SHM. Email him at [email protected].

References

1. Gabbard GO. Medicine and its discontents. Mayo Clin Proc. 2013;88(12):1347-1349.
2. Hinami K, Whelan CT, Wolosin RJ, Miller JA, Wetterneck TB. Worklife and satisfaction of hospitalists: Toward flourishing careers. J Gen Intern Med. 2012;27(1):28-36.
3. Drybye LN, Varkey P, Boone SL, Satele DV, Sloan JA, Shanafelt TD. Physician satisfaction and burnout at different career stages. Mayo Clin Proc. 2013;88(12):1358-1367.
4. Spinelli WM. The phantom limb of the triple aim. Mayo Clin Proc. 2013;88(12):1356-1357.
5. Hoff TH, Whitcomb WF, Williams K, Nelson JR, Cheesman RA. Characteristics and work experiences of hospitalists in the United States. Arch Intern Med. 2001;161(6):851-858.
6. Society of Hospital Medicine. A challenge for a new specialty: a white paper on hospitalist career satisfaction. Available at: http://www.hospitalmedicine.org/Content/NavigationMenu/Publications/WhitePapers/White_Papers.htm. Accessed January 4, 2014.

Middle age is typically a difficult passage for many professionals. It is a developmental phase involving the mourning of lost opportunities and the acceptance of one’s limits. One also reflects on his or her identity, takes note of regrets, and reevaluates how one will apportion time in the future.—Glen Gabbard, MD¹

Hospital medicine is a relatively young specialty, but we are growing up, with many hospitalists now firmly in the middle phase of their careers. In 1999, 15% of our peers had been hospitalists for more than five years; by 2010, that number had grown to 50%.² As the ranks of hospitalists grow older, we are faced with questions reflecting a life station marked by a little more wisdom, a few more gray hairs, and an occasional reflection on the legacy we will leave.

Drybye and colleagues recently released further analysis on a survey that had been previously reported, shedding new light on mid-career physician satisfaction and burnout and revealing important implications for hospital medicine.³ The study looked at responses to the Maslach Burnout Inventory for physicians from a range of specialties who had been in practice 10 years or less (early career), 11 to 20 years (mid-career), and 21 years or more (late career).

The study demonstrated that while early and late career have their challenges, middle career is a particularly difficult time for physicians. Mid-career physicians had the lowest satisfaction with their specialty choice and their work-life balance and the highest rates of emotional exhaustion and burnout. Strikingly, mid-career physicians were more than twice as likely as those in early and late career to plan to leave the practice of medicine for reasons other than retirement in the next 24 months.

What does this mean for hospital medicine? Because the survey findings are drawn from multiple specialties, we must use caution in extrapolating the results to hospitalists; however, if hospitalists are leaving the specialty mid-career, a more pressing problem may exist for hospital medicine than for other specialties. Why? First, the specialty has grown so rapidly over the last 15 years that it has been difficult to generate a sufficient supply of physicians to meet the demand. If a large number of mid-career hospitalists leave the specialty, our field may be stuck in a state of “arrested development” without the sufficient presence of mature clinicians. Second, effective hospitalists possess “system” skills that are learned on the job, so seasoned hospitalists often play an integrative and problem-solving role within the hospital. Third, there could be a downward spiral of career satisfaction in the specialty if onlookers like trainees and stakeholders in the healthcare ecosystem see hospitalists as dissatisfied and disengaged. Will the promise of hospital medicine be fulfilled?

In an accompanying editorial, Spinelli suggests three principles for physician well-being, which hospitalist programs would do well to consider:⁴

1. Elevate well-being metrics to the same level of importance as financial, quality, and patient satisfaction metrics. (Place such metrics on the organizational dashboard.)
2. Design system and care processes that include intentional plans for physician and staff wellness. (Redesign of care models and workflows should consider physician and staff wellness.)
3. Adopt a robust set of self-care strategies for those experiencing burnout.

SHM’s Role

SHM has taken up the issue of hospitalist career satisfaction on a number of occasions over the years, initially engendered by field observations of the stressful nature of hospitalist work and a 2001 study reporting that 25% of hospitalists were “at risk” of burnout and 13% were “burned out.”⁵ Subsequently, SHM released a white paper with a number of specific recommendations organized around a career satisfaction framework consisting of autonomy, reward/recognition, occupational solidarity, and connection with one’s professional and broader community.⁶

 

Recently, the SHM Practice Management Committee has once again taken up the issue of “physician engagement.” Over the next few months, the committee plans to:

1. Create a repository of related resources on the SHM website, including physician engagement profiles for some hospitalist practices;
2. Initiate a dialogue on the topic of physician engagement on HMX (connect.hospitalmedicine.org), SHM’s social networking platform; and
3. Publish a “public domain” survey questionnaire that hospitalist practices can use. This is a crucial matter that remains a central concern for our specialty and for the safety and well-being of our patients.

Conclusion

The Institute for Healthcare Improvement advanced the idea of the Triple Aim (better care, better health, lower costs) several years ago as a guiding principle in the transformation of healthcare. More recently, a growing number of voices suggest that physician satisfaction is a crucial foundation of the Triple Aim.⁴ I submit that for hospitalists to fulfill their potential as healthcare change agents, we will need to build a professional experience that enables them to traverse mid-career challenges and make it to the professional finish line as engaged and well-adjusted members of the healthcare community.

---

Dr. Whitcomb is Chief Medical Officer of Remedy Partners. He is co-founder and past president of SHM. Email him at [email protected].

References

1. Gabbard GO. Medicine and its discontents. Mayo Clin Proc. 2013;88(12):1347-1349.
2. Hinami K, Whelan CT, Wolosin RJ, Miller JA, Wetterneck TB. Worklife and satisfaction of hospitalists: Toward flourishing careers. J Gen Intern Med. 2012;27(1):28-36.
3. Drybye LN, Varkey P, Boone SL, Satele DV, Sloan JA, Shanafelt TD. Physician satisfaction and burnout at different career stages. Mayo Clin Proc. 2013;88(12):1358-1367.
4. Spinelli WM. The phantom limb of the triple aim. Mayo Clin Proc. 2013;88(12):1356-1357.
5. Hoff TH, Whitcomb WF, Williams K, Nelson JR, Cheesman RA. Characteristics and work experiences of hospitalists in the United States. Arch Intern Med. 2001;161(6):851-858.
6. Society of Hospital Medicine. A challenge for a new specialty: a white paper on hospitalist career satisfaction. Available at: http://www.hospitalmedicine.org/Content/NavigationMenu/Publications/WhitePapers/White_Papers.htm. Accessed January 4, 2014.

Middle age is typically a difficult passage for many professionals. It is a developmental phase involving the mourning of lost opportunities and the acceptance of one’s limits. One also reflects on his or her identity, takes note of regrets, and reevaluates how one will apportion time in the future.—Glen Gabbard, MD¹

Hospital medicine is a relatively young specialty, but we are growing up, with many hospitalists now firmly in the middle phase of their careers. In 1999, 15% of our peers had been hospitalists for more than five years; by 2010, that number had grown to 50%.² As the ranks of hospitalists grow older, we are faced with questions reflecting a life station marked by a little more wisdom, a few more gray hairs, and an occasional reflection on the legacy we will leave.

Drybye and colleagues recently released further analysis on a survey that had been previously reported, shedding new light on mid-career physician satisfaction and burnout and revealing important implications for hospital medicine.³ The study looked at responses to the Maslach Burnout Inventory for physicians from a range of specialties who had been in practice 10 years or less (early career), 11 to 20 years (mid-career), and 21 years or more (late career).

The study demonstrated that while early and late career have their challenges, middle career is a particularly difficult time for physicians. Mid-career physicians had the lowest satisfaction with their specialty choice and their work-life balance and the highest rates of emotional exhaustion and burnout. Strikingly, mid-career physicians were more than twice as likely as those in early and late career to plan to leave the practice of medicine for reasons other than retirement in the next 24 months.

What does this mean for hospital medicine? Because the survey findings are drawn from multiple specialties, we must use caution in extrapolating the results to hospitalists; however, if hospitalists are leaving the specialty mid-career, a more pressing problem may exist for hospital medicine than for other specialties. Why? First, the specialty has grown so rapidly over the last 15 years that it has been difficult to generate a sufficient supply of physicians to meet the demand. If a large number of mid-career hospitalists leave the specialty, our field may be stuck in a state of “arrested development” without the sufficient presence of mature clinicians. Second, effective hospitalists possess “system” skills that are learned on the job, so seasoned hospitalists often play an integrative and problem-solving role within the hospital. Third, there could be a downward spiral of career satisfaction in the specialty if onlookers like trainees and stakeholders in the healthcare ecosystem see hospitalists as dissatisfied and disengaged. Will the promise of hospital medicine be fulfilled?

In an accompanying editorial, Spinelli suggests three principles for physician well-being, which hospitalist programs would do well to consider:⁴

1. Elevate well-being metrics to the same level of importance as financial, quality, and patient satisfaction metrics. (Place such metrics on the organizational dashboard.)
2. Design system and care processes that include intentional plans for physician and staff wellness. (Redesign of care models and workflows should consider physician and staff wellness.)
3. Adopt a robust set of self-care strategies for those experiencing burnout.

SHM’s Role

SHM has taken up the issue of hospitalist career satisfaction on a number of occasions over the years, initially engendered by field observations of the stressful nature of hospitalist work and a 2001 study reporting that 25% of hospitalists were “at risk” of burnout and 13% were “burned out.”⁵ Subsequently, SHM released a white paper with a number of specific recommendations organized around a career satisfaction framework consisting of autonomy, reward/recognition, occupational solidarity, and connection with one’s professional and broader community.⁶

 

Recently, the SHM Practice Management Committee has once again taken up the issue of “physician engagement.” Over the next few months, the committee plans to:

1. Create a repository of related resources on the SHM website, including physician engagement profiles for some hospitalist practices;
2. Initiate a dialogue on the topic of physician engagement on HMX (connect.hospitalmedicine.org), SHM’s social networking platform; and
3. Publish a “public domain” survey questionnaire that hospitalist practices can use. This is a crucial matter that remains a central concern for our specialty and for the safety and well-being of our patients.

Conclusion

The Institute for Healthcare Improvement advanced the idea of the Triple Aim (better care, better health, lower costs) several years ago as a guiding principle in the transformation of healthcare. More recently, a growing number of voices suggest that physician satisfaction is a crucial foundation of the Triple Aim.⁴ I submit that for hospitalists to fulfill their potential as healthcare change agents, we will need to build a professional experience that enables them to traverse mid-career challenges and make it to the professional finish line as engaged and well-adjusted members of the healthcare community.

---

Dr. Whitcomb is Chief Medical Officer of Remedy Partners. He is co-founder and past president of SHM. Email him at [email protected].

References

1. Gabbard GO. Medicine and its discontents. Mayo Clin Proc. 2013;88(12):1347-1349.
2. Hinami K, Whelan CT, Wolosin RJ, Miller JA, Wetterneck TB. Worklife and satisfaction of hospitalists: Toward flourishing careers. J Gen Intern Med. 2012;27(1):28-36.
3. Drybye LN, Varkey P, Boone SL, Satele DV, Sloan JA, Shanafelt TD. Physician satisfaction and burnout at different career stages. Mayo Clin Proc. 2013;88(12):1358-1367.
4. Spinelli WM. The phantom limb of the triple aim. Mayo Clin Proc. 2013;88(12):1356-1357.
5. Hoff TH, Whitcomb WF, Williams K, Nelson JR, Cheesman RA. Characteristics and work experiences of hospitalists in the United States. Arch Intern Med. 2001;161(6):851-858.
6. Society of Hospital Medicine. A challenge for a new specialty: a white paper on hospitalist career satisfaction. Available at: http://www.hospitalmedicine.org/Content/NavigationMenu/Publications/WhitePapers/White_Papers.htm. Accessed January 4, 2014.

Increase in the number of “top performer” hospitals in 2012 accreditation surveys conducted by the Joint Commission. Those 1,099 hospitals making the list had to receive a composite score of 95% or above for selected accountability measures.

Increase in the number of “top performer” hospitals in 2012 accreditation surveys conducted by the Joint Commission. Those 1,099 hospitals making the list had to receive a composite score of 95% or above for selected accountability measures.

Increase in the number of “top performer” hospitals in 2012 accreditation surveys conducted by the Joint Commission. Those 1,099 hospitals making the list had to receive a composite score of 95% or above for selected accountability measures.

Basic Principles for Pediatric Hospital Medicine Published A recent policy statement from the American Academy of Pediatrics (AAP), published online in Pediatrics, urges recognition of the expanded roles and responsibilities of pediatric hospitalists and offers basic principles for pediatric hospital medicine (PHM) programs, including focusing on the unique culture of each program within its parent institution and the importance of coordinated, patient-centered care.⁴

The article outlines settings available for PHM programs, optimal processes for care transitions, and the need for leadership and goal setting.

“It is implicit in all the aforementioned recommendations that the overarching goal is always to provide the best possible care for children and protect the safety of children in the hospital setting,” the authors note.

AAP’s Section on Hospital Medicine supports a policy of voluntary referrals to pediatric hospital medicine programs.

Basic Principles for Pediatric Hospital Medicine Published A recent policy statement from the American Academy of Pediatrics (AAP), published online in Pediatrics, urges recognition of the expanded roles and responsibilities of pediatric hospitalists and offers basic principles for pediatric hospital medicine (PHM) programs, including focusing on the unique culture of each program within its parent institution and the importance of coordinated, patient-centered care.⁴

The article outlines settings available for PHM programs, optimal processes for care transitions, and the need for leadership and goal setting.

“It is implicit in all the aforementioned recommendations that the overarching goal is always to provide the best possible care for children and protect the safety of children in the hospital setting,” the authors note.

AAP’s Section on Hospital Medicine supports a policy of voluntary referrals to pediatric hospital medicine programs.

Basic Principles for Pediatric Hospital Medicine Published A recent policy statement from the American Academy of Pediatrics (AAP), published online in Pediatrics, urges recognition of the expanded roles and responsibilities of pediatric hospitalists and offers basic principles for pediatric hospital medicine (PHM) programs, including focusing on the unique culture of each program within its parent institution and the importance of coordinated, patient-centered care.⁴

The article outlines settings available for PHM programs, optimal processes for care transitions, and the need for leadership and goal setting.

“It is implicit in all the aforementioned recommendations that the overarching goal is always to provide the best possible care for children and protect the safety of children in the hospital setting,” the authors note.

AAP’s Section on Hospital Medicine supports a policy of voluntary referrals to pediatric hospital medicine programs.

Study Suggests Medical Trainees Need More Manners

Researchers at Johns Hopkins Hospital and the University of Maryland Medical Center, both in Baltimore, identified an overall lack of “common courtesy” shown by internal medicine trainees in their interactions with patients.³ Such behavior can lead to lower patient satisfaction and worse medical outcomes, note the authors of the study, which included hospitalist Leonard Feldman, MD, FACP, FAAP, SFHM, an assistant professor of medicine at Hopkins.

The study, published in the November issue of the Journal of Hospital Medicine, followed 29 interns on rounds for three weeks and looked for five key strategies of etiquette-based communication. Researchers found that while the interns asked open-ended questions 75% of the time, they explained their role to the patient only 37% of the time and sat down to talk eye to eye during an encounter only 9% of the time.

The interns performed all five recommended behaviors only 4% of the time.

“These are things that matter to patients and are relatively easy to do,” Dr. Feldman said in a prepared statement. “They’re not being done to the extent they should be.”

---

Larry Beresford is a freelance writer in Alameda, Calif.

References

1. Rizk D, Calabrese R, Page C, Bookbinder M, Flores S, Portenoy R. A unique hospitalist/pain management collaboration to improve pain outcomes [abstract]. Available at: http://www.shmabstracts.com/abstract.asp?MeetingID=793&id=104310. Accessed November 29, 2013.
2. American Society for Parenteral and Enteral Nutrition. A.S.P.E.N. supports major medical device changes for improved patient safety. Available at: http://www.nutritioncare.org/Press_Room/Press_Releases/A_S_P_E_N__Supports_Major_Medical_Device_Changes_for_Improved_Patient_Safety/. Accessed November 29, 2013.
3. Block LB, Hutzler L, Habicht R, Wu AW, et al. Do internal medicine interns practice etiquette-based communication? A critical look at the inpatient encounter. J Hosp Med. 2013;8(11):631-634.
4. Mirkinson LJ, Section on Hospital Medicine. Guiding principles for pediatric hospital medicine programs. Pediatrics. 2013;132(4):782-786.

Study Suggests Medical Trainees Need More Manners

Researchers at Johns Hopkins Hospital and the University of Maryland Medical Center, both in Baltimore, identified an overall lack of “common courtesy” shown by internal medicine trainees in their interactions with patients.³ Such behavior can lead to lower patient satisfaction and worse medical outcomes, note the authors of the study, which included hospitalist Leonard Feldman, MD, FACP, FAAP, SFHM, an assistant professor of medicine at Hopkins.

The study, published in the November issue of the Journal of Hospital Medicine, followed 29 interns on rounds for three weeks and looked for five key strategies of etiquette-based communication. Researchers found that while the interns asked open-ended questions 75% of the time, they explained their role to the patient only 37% of the time and sat down to talk eye to eye during an encounter only 9% of the time.

The interns performed all five recommended behaviors only 4% of the time.

“These are things that matter to patients and are relatively easy to do,” Dr. Feldman said in a prepared statement. “They’re not being done to the extent they should be.”

---

Larry Beresford is a freelance writer in Alameda, Calif.

References

1. Rizk D, Calabrese R, Page C, Bookbinder M, Flores S, Portenoy R. A unique hospitalist/pain management collaboration to improve pain outcomes [abstract]. Available at: http://www.shmabstracts.com/abstract.asp?MeetingID=793&id=104310. Accessed November 29, 2013.
2. American Society for Parenteral and Enteral Nutrition. A.S.P.E.N. supports major medical device changes for improved patient safety. Available at: http://www.nutritioncare.org/Press_Room/Press_Releases/A_S_P_E_N__Supports_Major_Medical_Device_Changes_for_Improved_Patient_Safety/. Accessed November 29, 2013.
3. Block LB, Hutzler L, Habicht R, Wu AW, et al. Do internal medicine interns practice etiquette-based communication? A critical look at the inpatient encounter. J Hosp Med. 2013;8(11):631-634.
4. Mirkinson LJ, Section on Hospital Medicine. Guiding principles for pediatric hospital medicine programs. Pediatrics. 2013;132(4):782-786.

Study Suggests Medical Trainees Need More Manners

Researchers at Johns Hopkins Hospital and the University of Maryland Medical Center, both in Baltimore, identified an overall lack of “common courtesy” shown by internal medicine trainees in their interactions with patients.³ Such behavior can lead to lower patient satisfaction and worse medical outcomes, note the authors of the study, which included hospitalist Leonard Feldman, MD, FACP, FAAP, SFHM, an assistant professor of medicine at Hopkins.

The study, published in the November issue of the Journal of Hospital Medicine, followed 29 interns on rounds for three weeks and looked for five key strategies of etiquette-based communication. Researchers found that while the interns asked open-ended questions 75% of the time, they explained their role to the patient only 37% of the time and sat down to talk eye to eye during an encounter only 9% of the time.

The interns performed all five recommended behaviors only 4% of the time.

“These are things that matter to patients and are relatively easy to do,” Dr. Feldman said in a prepared statement. “They’re not being done to the extent they should be.”

---

Larry Beresford is a freelance writer in Alameda, Calif.

References

1. Rizk D, Calabrese R, Page C, Bookbinder M, Flores S, Portenoy R. A unique hospitalist/pain management collaboration to improve pain outcomes [abstract]. Available at: http://www.shmabstracts.com/abstract.asp?MeetingID=793&id=104310. Accessed November 29, 2013.
2. American Society for Parenteral and Enteral Nutrition. A.S.P.E.N. supports major medical device changes for improved patient safety. Available at: http://www.nutritioncare.org/Press_Room/Press_Releases/A_S_P_E_N__Supports_Major_Medical_Device_Changes_for_Improved_Patient_Safety/. Accessed November 29, 2013.
3. Block LB, Hutzler L, Habicht R, Wu AW, et al. Do internal medicine interns practice etiquette-based communication? A critical look at the inpatient encounter. J Hosp Med. 2013;8(11):631-634.
4. Mirkinson LJ, Section on Hospital Medicine. Guiding principles for pediatric hospital medicine programs. Pediatrics. 2013;132(4):782-786.

The American Society for Parenteral and Enteral Nutrition (ASPEN), the Global Enteral Device Supplier Association (GEDSA) and a number of other quality-oriented groups, including the FDA, Centers for Medicare & Medicaid Services (CMS), and the Joint Commission, are working to address tubing misconnections for medical device small-bore connectors—used for enteral, luer, neuro-cranial, respiratory, and other medical tubing equipment.²

Misconnections, although rare, can be harmful or even fatal to patients. The task force conducted a panel discussion Oct. 22 in Washington, D.C., focused on redesign issues, and is collaborating with the International Standards Organization to develop new small-bore connector standards.

GEDSA’s “Stay Connected” is an education campaign to inform and prepare the healthcare community for impending changes in standards for small-bore connectors. For more information, visit www.stayconnected2014.org.

The American Society for Parenteral and Enteral Nutrition (ASPEN), the Global Enteral Device Supplier Association (GEDSA) and a number of other quality-oriented groups, including the FDA, Centers for Medicare & Medicaid Services (CMS), and the Joint Commission, are working to address tubing misconnections for medical device small-bore connectors—used for enteral, luer, neuro-cranial, respiratory, and other medical tubing equipment.²

Misconnections, although rare, can be harmful or even fatal to patients. The task force conducted a panel discussion Oct. 22 in Washington, D.C., focused on redesign issues, and is collaborating with the International Standards Organization to develop new small-bore connector standards.

GEDSA’s “Stay Connected” is an education campaign to inform and prepare the healthcare community for impending changes in standards for small-bore connectors. For more information, visit www.stayconnected2014.org.

The American Society for Parenteral and Enteral Nutrition (ASPEN), the Global Enteral Device Supplier Association (GEDSA) and a number of other quality-oriented groups, including the FDA, Centers for Medicare & Medicaid Services (CMS), and the Joint Commission, are working to address tubing misconnections for medical device small-bore connectors—used for enteral, luer, neuro-cranial, respiratory, and other medical tubing equipment.²

Misconnections, although rare, can be harmful or even fatal to patients. The task force conducted a panel discussion Oct. 22 in Washington, D.C., focused on redesign issues, and is collaborating with the International Standards Organization to develop new small-bore connector standards.

GEDSA’s “Stay Connected” is an education campaign to inform and prepare the healthcare community for impending changes in standards for small-bore connectors. For more information, visit www.stayconnected2014.org.

A collaboration between hospitalists and the pain department at Beth Israel Medical Center in New York City is helping hospitalists address moderate to severe pain and complicating factors in their patients.

“The idea was to impart knowledge from a small group of experts to the hospitalists who manage pain in the majority of hospitalized patients,” says Dahlia Rizk, DO, chief of hospital medicine at Beth Israel and lead author on a poster that described the program and was presented at HM13 in Washington, D.C.¹

Dr. Rizk first approached Russell Portenoy, MD, internationally recognized chair of the Department of Pain Management and Palliative Care at Beth Israel, to draw upon his specialized knowledge. Grant funding supported protected time for two hospitalist champions and a nurse practitioner; they reviewed charts on participating units and conducted focus groups with hospitalists to identify barriers to effective pain management. Barriers were compiled into a 56-item menu and shaped the curriculum for weekly training sessions presented by the pain service.

Dr. Portenoy and the project team also established a metric for “high sustained pain,” patients reporting three or more days of three or more episodes of moderate to severe pain, according to the hospital’s standardized pain assessment scale. The information was captured in a computerized, tablet-based “Live View” tool that shows all of the patients on a unit and their incidences of high sustained pain over a week. The tool is used for rounding on patients and identifying those needing an immediate interdisciplinary focus.

Project results, Dr. Rizk reported, include improvements in high sustained pain scores on six of seven participating units and average reductions in the number of identified barriers to pain. Hospitalists reported increased comfort with adjusting pain therapies, while patient satisfaction scores with pain management also increased.

“Not everyone has access to an expert like Dr. Portenoy, but we’ve now done the root cause analysis and barriers list,” Dr. Rizk says. “I also think this approach could be applied more widely to other problem areas. We plan to try something similar with geriatrics.”

For more information about the collaborative and its pain problem list, contact Dr. Rizk at [email protected].

A collaboration between hospitalists and the pain department at Beth Israel Medical Center in New York City is helping hospitalists address moderate to severe pain and complicating factors in their patients.

“The idea was to impart knowledge from a small group of experts to the hospitalists who manage pain in the majority of hospitalized patients,” says Dahlia Rizk, DO, chief of hospital medicine at Beth Israel and lead author on a poster that described the program and was presented at HM13 in Washington, D.C.¹

Dr. Rizk first approached Russell Portenoy, MD, internationally recognized chair of the Department of Pain Management and Palliative Care at Beth Israel, to draw upon his specialized knowledge. Grant funding supported protected time for two hospitalist champions and a nurse practitioner; they reviewed charts on participating units and conducted focus groups with hospitalists to identify barriers to effective pain management. Barriers were compiled into a 56-item menu and shaped the curriculum for weekly training sessions presented by the pain service.

Dr. Portenoy and the project team also established a metric for “high sustained pain,” patients reporting three or more days of three or more episodes of moderate to severe pain, according to the hospital’s standardized pain assessment scale. The information was captured in a computerized, tablet-based “Live View” tool that shows all of the patients on a unit and their incidences of high sustained pain over a week. The tool is used for rounding on patients and identifying those needing an immediate interdisciplinary focus.

Project results, Dr. Rizk reported, include improvements in high sustained pain scores on six of seven participating units and average reductions in the number of identified barriers to pain. Hospitalists reported increased comfort with adjusting pain therapies, while patient satisfaction scores with pain management also increased.

“Not everyone has access to an expert like Dr. Portenoy, but we’ve now done the root cause analysis and barriers list,” Dr. Rizk says. “I also think this approach could be applied more widely to other problem areas. We plan to try something similar with geriatrics.”

For more information about the collaborative and its pain problem list, contact Dr. Rizk at [email protected].

A collaboration between hospitalists and the pain department at Beth Israel Medical Center in New York City is helping hospitalists address moderate to severe pain and complicating factors in their patients.

“The idea was to impart knowledge from a small group of experts to the hospitalists who manage pain in the majority of hospitalized patients,” says Dahlia Rizk, DO, chief of hospital medicine at Beth Israel and lead author on a poster that described the program and was presented at HM13 in Washington, D.C.¹

Dr. Rizk first approached Russell Portenoy, MD, internationally recognized chair of the Department of Pain Management and Palliative Care at Beth Israel, to draw upon his specialized knowledge. Grant funding supported protected time for two hospitalist champions and a nurse practitioner; they reviewed charts on participating units and conducted focus groups with hospitalists to identify barriers to effective pain management. Barriers were compiled into a 56-item menu and shaped the curriculum for weekly training sessions presented by the pain service.

Dr. Portenoy and the project team also established a metric for “high sustained pain,” patients reporting three or more days of three or more episodes of moderate to severe pain, according to the hospital’s standardized pain assessment scale. The information was captured in a computerized, tablet-based “Live View” tool that shows all of the patients on a unit and their incidences of high sustained pain over a week. The tool is used for rounding on patients and identifying those needing an immediate interdisciplinary focus.

Project results, Dr. Rizk reported, include improvements in high sustained pain scores on six of seven participating units and average reductions in the number of identified barriers to pain. Hospitalists reported increased comfort with adjusting pain therapies, while patient satisfaction scores with pain management also increased.

“Not everyone has access to an expert like Dr. Portenoy, but we’ve now done the root cause analysis and barriers list,” Dr. Rizk says. “I also think this approach could be applied more widely to other problem areas. We plan to try something similar with geriatrics.”

For more information about the collaborative and its pain problem list, contact Dr. Rizk at [email protected].

Clinical question: What is the appropriate length of hospitalization necessary for infants <30 days admitted for fever without source?

Background: Infants ≤30 days old are routinely hospitalized for fever without source (FWS). From 1988-2006, 2.5 million infants younger than three months old were admitted for sepsis, according to National Hospital Discharge Survey data. Term infants <7 days of age accounted for 33% of these hospitalizations. Current national guidelines recommend observation in the hospital for 48-72 hours after cultures of blood, urine, and cerebrospinal fluid (CSF) are initiated. Whether this length of hospitalization is appropriate for well-appearing infants in this age group is not clear, based on current data.

Study design: Single-center, retrospective, cohort study.

Setting: 574-bed tertiary medical center with a 30-bed general pediatric inpatient unit.

Synopsis: Researchers identified infants ≤30 days old who had blood and/or CSF cultures performed from 1999 to 2010. After excluding infants with cultures from the NICU and PICU, infants hospitalized with FWS were identified by chart review. A pediatric infectious disease specialist reviewed positive cultures from blood and CSF to exclude skin contaminants. Time to notification was defined as the time between sample collection and medical staff notification. Blood cultures were monitored continuously for growth at this institution, with staff being notified of positive results immediately during the day but not until 8 a.m. if this occurred overnight. Microbiology laboratory staff reviewed CSF cultures once daily. Of the 408 confirmed FWS hospitalizations, 26 resulted in positive cultures of blood and/or CSF. Time to notification of >24 hours occurred in six of these hospitalizations. Overall, of the 388 FWS hospitalizations with no positive blood or CSF cultures at 24 hours, six went on to develop positive cultures after 24 hours, a rate of 1.5%. All six had at least one high-risk characteristic (WBC <5,000 or >15,000 per µL, a band count >1,500 per per µL, or abnormal urinalysis). However, five patients with no high-risk characteristics and a normal urinalysis on admission were diagnosed with a UTI after 24 hours.

Bottom line: Infants ≤30 days old with no high-risk characteristics for sepsis may not need a full 48 hours of hospitalization for FWS, although this approach could lead rarely to a diagnosis of UTI after discharge.

Citation: Fielding-Singh V, Hong DK, Harris SJ, et al. Ruling out bacteremia and bacterial meningitis in infants less than one month of age: is 48 hours of hospitalization necessary? Hosp Pediatrics. 2013;3(4):355-361.

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Reviewed by Pediatric Editor Weijen Chang, MD, SFHM, FAAP, associate clinical professor of medicine and pediatrics at the University of California at San Diego School of Medicine, and a hospitalist at both UCSD Medical Center and Rady Children’s Hospital.

Clinical question: What is the appropriate length of hospitalization necessary for infants <30 days admitted for fever without source?

Background: Infants ≤30 days old are routinely hospitalized for fever without source (FWS). From 1988-2006, 2.5 million infants younger than three months old were admitted for sepsis, according to National Hospital Discharge Survey data. Term infants <7 days of age accounted for 33% of these hospitalizations. Current national guidelines recommend observation in the hospital for 48-72 hours after cultures of blood, urine, and cerebrospinal fluid (CSF) are initiated. Whether this length of hospitalization is appropriate for well-appearing infants in this age group is not clear, based on current data.

Study design: Single-center, retrospective, cohort study.

Setting: 574-bed tertiary medical center with a 30-bed general pediatric inpatient unit.

Synopsis: Researchers identified infants ≤30 days old who had blood and/or CSF cultures performed from 1999 to 2010. After excluding infants with cultures from the NICU and PICU, infants hospitalized with FWS were identified by chart review. A pediatric infectious disease specialist reviewed positive cultures from blood and CSF to exclude skin contaminants. Time to notification was defined as the time between sample collection and medical staff notification. Blood cultures were monitored continuously for growth at this institution, with staff being notified of positive results immediately during the day but not until 8 a.m. if this occurred overnight. Microbiology laboratory staff reviewed CSF cultures once daily. Of the 408 confirmed FWS hospitalizations, 26 resulted in positive cultures of blood and/or CSF. Time to notification of >24 hours occurred in six of these hospitalizations. Overall, of the 388 FWS hospitalizations with no positive blood or CSF cultures at 24 hours, six went on to develop positive cultures after 24 hours, a rate of 1.5%. All six had at least one high-risk characteristic (WBC <5,000 or >15,000 per µL, a band count >1,500 per per µL, or abnormal urinalysis). However, five patients with no high-risk characteristics and a normal urinalysis on admission were diagnosed with a UTI after 24 hours.

Bottom line: Infants ≤30 days old with no high-risk characteristics for sepsis may not need a full 48 hours of hospitalization for FWS, although this approach could lead rarely to a diagnosis of UTI after discharge.

Citation: Fielding-Singh V, Hong DK, Harris SJ, et al. Ruling out bacteremia and bacterial meningitis in infants less than one month of age: is 48 hours of hospitalization necessary? Hosp Pediatrics. 2013;3(4):355-361.

---

Reviewed by Pediatric Editor Weijen Chang, MD, SFHM, FAAP, associate clinical professor of medicine and pediatrics at the University of California at San Diego School of Medicine, and a hospitalist at both UCSD Medical Center and Rady Children’s Hospital.

Clinical question: What is the appropriate length of hospitalization necessary for infants <30 days admitted for fever without source?

Background: Infants ≤30 days old are routinely hospitalized for fever without source (FWS). From 1988-2006, 2.5 million infants younger than three months old were admitted for sepsis, according to National Hospital Discharge Survey data. Term infants <7 days of age accounted for 33% of these hospitalizations. Current national guidelines recommend observation in the hospital for 48-72 hours after cultures of blood, urine, and cerebrospinal fluid (CSF) are initiated. Whether this length of hospitalization is appropriate for well-appearing infants in this age group is not clear, based on current data.

Study design: Single-center, retrospective, cohort study.

Setting: 574-bed tertiary medical center with a 30-bed general pediatric inpatient unit.

Synopsis: Researchers identified infants ≤30 days old who had blood and/or CSF cultures performed from 1999 to 2010. After excluding infants with cultures from the NICU and PICU, infants hospitalized with FWS were identified by chart review. A pediatric infectious disease specialist reviewed positive cultures from blood and CSF to exclude skin contaminants. Time to notification was defined as the time between sample collection and medical staff notification. Blood cultures were monitored continuously for growth at this institution, with staff being notified of positive results immediately during the day but not until 8 a.m. if this occurred overnight. Microbiology laboratory staff reviewed CSF cultures once daily. Of the 408 confirmed FWS hospitalizations, 26 resulted in positive cultures of blood and/or CSF. Time to notification of >24 hours occurred in six of these hospitalizations. Overall, of the 388 FWS hospitalizations with no positive blood or CSF cultures at 24 hours, six went on to develop positive cultures after 24 hours, a rate of 1.5%. All six had at least one high-risk characteristic (WBC <5,000 or >15,000 per µL, a band count >1,500 per per µL, or abnormal urinalysis). However, five patients with no high-risk characteristics and a normal urinalysis on admission were diagnosed with a UTI after 24 hours.

Bottom line: Infants ≤30 days old with no high-risk characteristics for sepsis may not need a full 48 hours of hospitalization for FWS, although this approach could lead rarely to a diagnosis of UTI after discharge.

Citation: Fielding-Singh V, Hong DK, Harris SJ, et al. Ruling out bacteremia and bacterial meningitis in infants less than one month of age: is 48 hours of hospitalization necessary? Hosp Pediatrics. 2013;3(4):355-361.

---

Reviewed by Pediatric Editor Weijen Chang, MD, SFHM, FAAP, associate clinical professor of medicine and pediatrics at the University of California at San Diego School of Medicine, and a hospitalist at both UCSD Medical Center and Rady Children’s Hospital.

HM MOVERS AND SHAKERS

Sereen Sharp, MD, has been named director of the hospital medicine program at Fairview Range Medical Center (FRMC) in Hibbing, Minn. Dr. Sharp has been a practicing hospitalist at FRMC since the program launched in 2010.

James Matsuda, MD, PhD, has been hired as a pediatric hospitalist and director of pediatrics at Mercy Medical Center in Cedar Rapids, Iowa. Dr. Matsuda comes to Mercy from St. Luke’s Hospital in Cedar Rapids, where he served as director of the pediatric hospitalist program and pediatric intensive care unit.

 

 

Robert Maloney, MD, chief hospitalist at Sault Area Hospital (SAH) in Sault Ste. Marie, Ontario, Canada, was awarded the Canadian Society of Hospital Medicine’s 2013 clinical excellence award. Dr. Maloney was recognized for his excellent patient care, professionalism, and leadership. He is credited with helping to launch SAH’s hospitalist program, which has improved inpatient healthcare for the community since its 2004 introduction. Dr. Maloney is also an assistant professor of family medicine at the Northern Ontario School of Medicine.

 

Sanin Syed, MD, has been named medical director of the newly founded hospitalist program at Lawrence Hospital Center in Bronxville, N.Y. Dr. Syed previously served as a hospitalist at Mt. Sinai Hospital in New York City.

Business Moves

Tacoma, Wash.-based Sound Physicians has agreed to provide hospitalist services at Wyckoff Heights Medical Center in Brooklyn, N.Y., and Covenant Medical Center in Lubbock, Texas. Sound also has acquired hospitalist-related assets of Inpatient Care United, Inc., a private hospitalist staffing company in northeast Ohio, which already provides hospitalist services to Akron General Medical Center and Summa Akron City Hospital in Akron, Ohio.

Ob Hospitalist Group (OBHG), based in Mauldin, S.C., has been named one of the best places to work in South Carolina by the South Carolina Chamber of Commerce, the Best Companies Group, and the publishers of SCBIZ News. The private OB-GYN hospitalist staffing company was ranked 5th among South Carolina companies in the same size category. Additionally, OBHG was recognized as one of Inc.’s 500/5000 list of fastest-growing private companies, as well as one of South Carolina’s 25 fastest-growing companies. OBHG has been staffing private OB hospitalists at hospitals throughout the country since 2006.

North Hollywood, Calif.-based IPC The Hospitalist Company recently acquired the following hospitalist practices:

Greater Orlando Hospitalists (GOH), P.A., in Orlando, Fla.

The Hospitalist Group (THG) in Mission, Texas, consisting of three affiliated hospitalist practices: THG The Hospitalist Group, LP; The Hospitalist Management Group, LLC; and MD @ Home Ltd., all serving the greater Rio Grande Valley area of Southwest Texas.

Naples, Fla.-based Neapolitan Inpatient Care, LLC , and Venetian Hospitalist Services, LLC, headquartered in Venice, Fla.

Hospitalist-related assets of Metropolitan Pulmonary and Hospital Medicine, P.C., based in Kansas City, Mo.

IPC has signed definitive agreements to acquire Park Avenue Health Care Management, LLC; Park Avenue Medical Associates, P.C.; Park Avenue Medical Associates, LLC; and Geriatric Services, P.C., collectively known as Park Avenue and headquartered in White Plains, N.Y.

TeamHealth Hospital Medicine has acquired Marshall Physician Services, LLC, also known as MESA Medical Group, in Lexington, Ky. MESA already oversees hospitalist and emergency medicine services at 24 different hospitals throughout Indiana, Ohio, West Virginia, and Kentucky. TeamHealth now operates specialty hospital medicine programs in more than 850 acute and post-acute care centers throughout the U.S.

The Children’s Hospital of San Antonio and Baylor College of Medicine have collaborated to initiate a pediatric hospitalist program at the facility in San Antonio, Texas. The new program will staff 10 pediatric hospitalists and will be led by professor Ricardo Quiñonez, who comes to San Antonio from Texas Children’s Hospital in Houston, Texas.

 

Methodist Hospital in Henderson, Ky.,has partnered with the Dallas, Texas-based Eagle Hospital Physicians to provide hospitalist services at the privately owned facility. Eagle provides hospitalist and emergency medicine services to hospitals in 17 states.

HM MOVERS AND SHAKERS

Sereen Sharp, MD, has been named director of the hospital medicine program at Fairview Range Medical Center (FRMC) in Hibbing, Minn. Dr. Sharp has been a practicing hospitalist at FRMC since the program launched in 2010.

James Matsuda, MD, PhD, has been hired as a pediatric hospitalist and director of pediatrics at Mercy Medical Center in Cedar Rapids, Iowa. Dr. Matsuda comes to Mercy from St. Luke’s Hospital in Cedar Rapids, where he served as director of the pediatric hospitalist program and pediatric intensive care unit.

 

 

Robert Maloney, MD, chief hospitalist at Sault Area Hospital (SAH) in Sault Ste. Marie, Ontario, Canada, was awarded the Canadian Society of Hospital Medicine’s 2013 clinical excellence award. Dr. Maloney was recognized for his excellent patient care, professionalism, and leadership. He is credited with helping to launch SAH’s hospitalist program, which has improved inpatient healthcare for the community since its 2004 introduction. Dr. Maloney is also an assistant professor of family medicine at the Northern Ontario School of Medicine.

 

Sanin Syed, MD, has been named medical director of the newly founded hospitalist program at Lawrence Hospital Center in Bronxville, N.Y. Dr. Syed previously served as a hospitalist at Mt. Sinai Hospital in New York City.

Business Moves

Tacoma, Wash.-based Sound Physicians has agreed to provide hospitalist services at Wyckoff Heights Medical Center in Brooklyn, N.Y., and Covenant Medical Center in Lubbock, Texas. Sound also has acquired hospitalist-related assets of Inpatient Care United, Inc., a private hospitalist staffing company in northeast Ohio, which already provides hospitalist services to Akron General Medical Center and Summa Akron City Hospital in Akron, Ohio.

Ob Hospitalist Group (OBHG), based in Mauldin, S.C., has been named one of the best places to work in South Carolina by the South Carolina Chamber of Commerce, the Best Companies Group, and the publishers of SCBIZ News. The private OB-GYN hospitalist staffing company was ranked 5th among South Carolina companies in the same size category. Additionally, OBHG was recognized as one of Inc.’s 500/5000 list of fastest-growing private companies, as well as one of South Carolina’s 25 fastest-growing companies. OBHG has been staffing private OB hospitalists at hospitals throughout the country since 2006.

North Hollywood, Calif.-based IPC The Hospitalist Company recently acquired the following hospitalist practices:

Greater Orlando Hospitalists (GOH), P.A., in Orlando, Fla.

The Hospitalist Group (THG) in Mission, Texas, consisting of three affiliated hospitalist practices: THG The Hospitalist Group, LP; The Hospitalist Management Group, LLC; and MD @ Home Ltd., all serving the greater Rio Grande Valley area of Southwest Texas.

Naples, Fla.-based Neapolitan Inpatient Care, LLC , and Venetian Hospitalist Services, LLC, headquartered in Venice, Fla.

Hospitalist-related assets of Metropolitan Pulmonary and Hospital Medicine, P.C., based in Kansas City, Mo.

IPC has signed definitive agreements to acquire Park Avenue Health Care Management, LLC; Park Avenue Medical Associates, P.C.; Park Avenue Medical Associates, LLC; and Geriatric Services, P.C., collectively known as Park Avenue and headquartered in White Plains, N.Y.

TeamHealth Hospital Medicine has acquired Marshall Physician Services, LLC, also known as MESA Medical Group, in Lexington, Ky. MESA already oversees hospitalist and emergency medicine services at 24 different hospitals throughout Indiana, Ohio, West Virginia, and Kentucky. TeamHealth now operates specialty hospital medicine programs in more than 850 acute and post-acute care centers throughout the U.S.

The Children’s Hospital of San Antonio and Baylor College of Medicine have collaborated to initiate a pediatric hospitalist program at the facility in San Antonio, Texas. The new program will staff 10 pediatric hospitalists and will be led by professor Ricardo Quiñonez, who comes to San Antonio from Texas Children’s Hospital in Houston, Texas.

 

Methodist Hospital in Henderson, Ky.,has partnered with the Dallas, Texas-based Eagle Hospital Physicians to provide hospitalist services at the privately owned facility. Eagle provides hospitalist and emergency medicine services to hospitals in 17 states.

HM MOVERS AND SHAKERS

Sereen Sharp, MD, has been named director of the hospital medicine program at Fairview Range Medical Center (FRMC) in Hibbing, Minn. Dr. Sharp has been a practicing hospitalist at FRMC since the program launched in 2010.

James Matsuda, MD, PhD, has been hired as a pediatric hospitalist and director of pediatrics at Mercy Medical Center in Cedar Rapids, Iowa. Dr. Matsuda comes to Mercy from St. Luke’s Hospital in Cedar Rapids, where he served as director of the pediatric hospitalist program and pediatric intensive care unit.

 

 

Robert Maloney, MD, chief hospitalist at Sault Area Hospital (SAH) in Sault Ste. Marie, Ontario, Canada, was awarded the Canadian Society of Hospital Medicine’s 2013 clinical excellence award. Dr. Maloney was recognized for his excellent patient care, professionalism, and leadership. He is credited with helping to launch SAH’s hospitalist program, which has improved inpatient healthcare for the community since its 2004 introduction. Dr. Maloney is also an assistant professor of family medicine at the Northern Ontario School of Medicine.

 

Sanin Syed, MD, has been named medical director of the newly founded hospitalist program at Lawrence Hospital Center in Bronxville, N.Y. Dr. Syed previously served as a hospitalist at Mt. Sinai Hospital in New York City.

Business Moves

Tacoma, Wash.-based Sound Physicians has agreed to provide hospitalist services at Wyckoff Heights Medical Center in Brooklyn, N.Y., and Covenant Medical Center in Lubbock, Texas. Sound also has acquired hospitalist-related assets of Inpatient Care United, Inc., a private hospitalist staffing company in northeast Ohio, which already provides hospitalist services to Akron General Medical Center and Summa Akron City Hospital in Akron, Ohio.

Ob Hospitalist Group (OBHG), based in Mauldin, S.C., has been named one of the best places to work in South Carolina by the South Carolina Chamber of Commerce, the Best Companies Group, and the publishers of SCBIZ News. The private OB-GYN hospitalist staffing company was ranked 5th among South Carolina companies in the same size category. Additionally, OBHG was recognized as one of Inc.’s 500/5000 list of fastest-growing private companies, as well as one of South Carolina’s 25 fastest-growing companies. OBHG has been staffing private OB hospitalists at hospitals throughout the country since 2006.

North Hollywood, Calif.-based IPC The Hospitalist Company recently acquired the following hospitalist practices:

Greater Orlando Hospitalists (GOH), P.A., in Orlando, Fla.

The Hospitalist Group (THG) in Mission, Texas, consisting of three affiliated hospitalist practices: THG The Hospitalist Group, LP; The Hospitalist Management Group, LLC; and MD @ Home Ltd., all serving the greater Rio Grande Valley area of Southwest Texas.

Naples, Fla.-based Neapolitan Inpatient Care, LLC , and Venetian Hospitalist Services, LLC, headquartered in Venice, Fla.

Hospitalist-related assets of Metropolitan Pulmonary and Hospital Medicine, P.C., based in Kansas City, Mo.

IPC has signed definitive agreements to acquire Park Avenue Health Care Management, LLC; Park Avenue Medical Associates, P.C.; Park Avenue Medical Associates, LLC; and Geriatric Services, P.C., collectively known as Park Avenue and headquartered in White Plains, N.Y.

TeamHealth Hospital Medicine has acquired Marshall Physician Services, LLC, also known as MESA Medical Group, in Lexington, Ky. MESA already oversees hospitalist and emergency medicine services at 24 different hospitals throughout Indiana, Ohio, West Virginia, and Kentucky. TeamHealth now operates specialty hospital medicine programs in more than 850 acute and post-acute care centers throughout the U.S.

The Children’s Hospital of San Antonio and Baylor College of Medicine have collaborated to initiate a pediatric hospitalist program at the facility in San Antonio, Texas. The new program will staff 10 pediatric hospitalists and will be led by professor Ricardo Quiñonez, who comes to San Antonio from Texas Children’s Hospital in Houston, Texas.

 

Methodist Hospital in Henderson, Ky.,has partnered with the Dallas, Texas-based Eagle Hospital Physicians to provide hospitalist services at the privately owned facility. Eagle provides hospitalist and emergency medicine services to hospitals in 17 states.

The 2014 State of Hospital Medicine survey is under way.

Participate now at www.hospitalmedicine.org/survey.

Each year, we look forward to receiving the Society of Hospital Medicine’s State of Hospital Medicine survey results. Over the years we have refined the way we use the information for our practices, which include HM services at the five hospitals of WellStar Health System in Northwest Atlanta. Historically, the report had been used merely to look at the industry trends, and, at times, to cover the scope of service, compensation, and other data points. The information was not widely shared with either the hospitalist team or health system administration.

Our approach to the survey changed when we set our sights on becoming a destination of choice for hospitalists in the Southeast Region. This stated goal made it clear we needed to take a more active approach to benchmarking ourselves against our peers in the field. The State of Hospital Medicine report, with its abundance of data, was the perfect tool. We set up an annual review of our HM practices (54 physicians and 21 advanced practice professionals spread among five hospitals) that enumerated individual provider performance in key measures: total compensation, total wRVUs, compensation per wRVU, and professional collections per wRVU. We then benchmarked the data against the survey data, highlighting the percentile achievement in each category. This allowed us to identify pockets of opportunities and make adjustments to compensation model and productivity targets, thus positioning ourselves competitively in the local and regional market.

Not only did this process aid in demonstrating our performance as compared to industry peers, but it also highlighted the differences in practice patterns within our health system. In turn, we reduced variation and promoted best practices among the five WellStar hospitals—standard workflow, scope of services, transfer policies, and collaboration with advanced practice professionals, to name a few.

In addition, transparent discussion of external and internal benchmarking findings dramatically improved provider engagement; individuals were eager to learn how other practices were able to achieve success. As a result, the clinical footprint of HM services expanded tremendously, ultimately benefiting patients, referring and consulting physicians, and hospitals.

The report also helped us to reiterate the value of WellStar Hospital Medicine to our administrative partners. Complementary to our balanced scorecard, which tracks quality, efficiency, and patient satisfaction measures, the external benchmarking validated a very strong return on the investment that WellStar Health System is making in its hospitalist programs.

The State of Hospital Medicine survey can be a tremendous resource to your practice, as it has been to ours. We recommend setting a mission and vision statement for your practice and then formulating a plan around the best way to share and utilize the data from the report to pursue your mission. As we experienced, a meaningful review, along with follow through on identified opportunities, can be positively transformative.

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Dr. Akopov is vice president and chief of hospital medicine operations at WellStar Health System in Atlanta, Ga. Ms. Papetti is assistant vice president of WellStar Medical Group in Atlanta, and a member of SHM’s Practice Analysis Committee.

The 2014 State of Hospital Medicine survey is under way.

Participate now at www.hospitalmedicine.org/survey.

Each year, we look forward to receiving the Society of Hospital Medicine’s State of Hospital Medicine survey results. Over the years we have refined the way we use the information for our practices, which include HM services at the five hospitals of WellStar Health System in Northwest Atlanta. Historically, the report had been used merely to look at the industry trends, and, at times, to cover the scope of service, compensation, and other data points. The information was not widely shared with either the hospitalist team or health system administration.

Our approach to the survey changed when we set our sights on becoming a destination of choice for hospitalists in the Southeast Region. This stated goal made it clear we needed to take a more active approach to benchmarking ourselves against our peers in the field. The State of Hospital Medicine report, with its abundance of data, was the perfect tool. We set up an annual review of our HM practices (54 physicians and 21 advanced practice professionals spread among five hospitals) that enumerated individual provider performance in key measures: total compensation, total wRVUs, compensation per wRVU, and professional collections per wRVU. We then benchmarked the data against the survey data, highlighting the percentile achievement in each category. This allowed us to identify pockets of opportunities and make adjustments to compensation model and productivity targets, thus positioning ourselves competitively in the local and regional market.

Not only did this process aid in demonstrating our performance as compared to industry peers, but it also highlighted the differences in practice patterns within our health system. In turn, we reduced variation and promoted best practices among the five WellStar hospitals—standard workflow, scope of services, transfer policies, and collaboration with advanced practice professionals, to name a few.

In addition, transparent discussion of external and internal benchmarking findings dramatically improved provider engagement; individuals were eager to learn how other practices were able to achieve success. As a result, the clinical footprint of HM services expanded tremendously, ultimately benefiting patients, referring and consulting physicians, and hospitals.

The report also helped us to reiterate the value of WellStar Hospital Medicine to our administrative partners. Complementary to our balanced scorecard, which tracks quality, efficiency, and patient satisfaction measures, the external benchmarking validated a very strong return on the investment that WellStar Health System is making in its hospitalist programs.

The State of Hospital Medicine survey can be a tremendous resource to your practice, as it has been to ours. We recommend setting a mission and vision statement for your practice and then formulating a plan around the best way to share and utilize the data from the report to pursue your mission. As we experienced, a meaningful review, along with follow through on identified opportunities, can be positively transformative.

---

Dr. Akopov is vice president and chief of hospital medicine operations at WellStar Health System in Atlanta, Ga. Ms. Papetti is assistant vice president of WellStar Medical Group in Atlanta, and a member of SHM’s Practice Analysis Committee.

The 2014 State of Hospital Medicine survey is under way.

Participate now at www.hospitalmedicine.org/survey.

Each year, we look forward to receiving the Society of Hospital Medicine’s State of Hospital Medicine survey results. Over the years we have refined the way we use the information for our practices, which include HM services at the five hospitals of WellStar Health System in Northwest Atlanta. Historically, the report had been used merely to look at the industry trends, and, at times, to cover the scope of service, compensation, and other data points. The information was not widely shared with either the hospitalist team or health system administration.

Our approach to the survey changed when we set our sights on becoming a destination of choice for hospitalists in the Southeast Region. This stated goal made it clear we needed to take a more active approach to benchmarking ourselves against our peers in the field. The State of Hospital Medicine report, with its abundance of data, was the perfect tool. We set up an annual review of our HM practices (54 physicians and 21 advanced practice professionals spread among five hospitals) that enumerated individual provider performance in key measures: total compensation, total wRVUs, compensation per wRVU, and professional collections per wRVU. We then benchmarked the data against the survey data, highlighting the percentile achievement in each category. This allowed us to identify pockets of opportunities and make adjustments to compensation model and productivity targets, thus positioning ourselves competitively in the local and regional market.

Not only did this process aid in demonstrating our performance as compared to industry peers, but it also highlighted the differences in practice patterns within our health system. In turn, we reduced variation and promoted best practices among the five WellStar hospitals—standard workflow, scope of services, transfer policies, and collaboration with advanced practice professionals, to name a few.

In addition, transparent discussion of external and internal benchmarking findings dramatically improved provider engagement; individuals were eager to learn how other practices were able to achieve success. As a result, the clinical footprint of HM services expanded tremendously, ultimately benefiting patients, referring and consulting physicians, and hospitals.

The report also helped us to reiterate the value of WellStar Hospital Medicine to our administrative partners. Complementary to our balanced scorecard, which tracks quality, efficiency, and patient satisfaction measures, the external benchmarking validated a very strong return on the investment that WellStar Health System is making in its hospitalist programs.

The State of Hospital Medicine survey can be a tremendous resource to your practice, as it has been to ours. We recommend setting a mission and vision statement for your practice and then formulating a plan around the best way to share and utilize the data from the report to pursue your mission. As we experienced, a meaningful review, along with follow through on identified opportunities, can be positively transformative.

---

Dr. Akopov is vice president and chief of hospital medicine operations at WellStar Health System in Atlanta, Ga. Ms. Papetti is assistant vice president of WellStar Medical Group in Atlanta, and a member of SHM’s Practice Analysis Committee.

Use SHM’s CODE-H Interactive to Avoid Coding Issues

Coding is a part of every hospitalist’s life, but tips from the experts can make that life easier, more efficient, and more compliant. That’s why SHM’s CODE-H program teaches hospitalists and hospitalist group managers and administrators how to stay up to date with the latest in the best

practices of coding and documentation.

On March 20, coding expert Barbara Pierce, CCS-P, ACS-EM, will present an online session on some of the most important coding topics for hospitalists, including:

• Critical care;
• Prolonged services;
• Documentation when working with NPs and PAs;
• Teaching physician rules; and
• Tips to avoid billing issues and potential denials.

This session is the third in a series of seven that cover the full range of coding topics, from developing a compliance plan and internal auditing process to ICD-10, PQRS, and Medicare’s Physician Value-Based Payment Modifier.

CME credits are offered through post-tests following each webinar, and each participant is eligible for up to seven credits throughout the series. Up to 10 individuals in a group can sign up through a single registration.

For more information, visit www.hospitalmedicine.org/codeh.

Use SHM’s CODE-H Interactive to Avoid Coding Issues

Coding is a part of every hospitalist’s life, but tips from the experts can make that life easier, more efficient, and more compliant. That’s why SHM’s CODE-H program teaches hospitalists and hospitalist group managers and administrators how to stay up to date with the latest in the best

practices of coding and documentation.

On March 20, coding expert Barbara Pierce, CCS-P, ACS-EM, will present an online session on some of the most important coding topics for hospitalists, including:

• Critical care;
• Prolonged services;
• Documentation when working with NPs and PAs;
• Teaching physician rules; and
• Tips to avoid billing issues and potential denials.

This session is the third in a series of seven that cover the full range of coding topics, from developing a compliance plan and internal auditing process to ICD-10, PQRS, and Medicare’s Physician Value-Based Payment Modifier.

CME credits are offered through post-tests following each webinar, and each participant is eligible for up to seven credits throughout the series. Up to 10 individuals in a group can sign up through a single registration.

For more information, visit www.hospitalmedicine.org/codeh.

Use SHM’s CODE-H Interactive to Avoid Coding Issues

Coding is a part of every hospitalist’s life, but tips from the experts can make that life easier, more efficient, and more compliant. That’s why SHM’s CODE-H program teaches hospitalists and hospitalist group managers and administrators how to stay up to date with the latest in the best

practices of coding and documentation.

On March 20, coding expert Barbara Pierce, CCS-P, ACS-EM, will present an online session on some of the most important coding topics for hospitalists, including:

• Critical care;
• Prolonged services;
• Documentation when working with NPs and PAs;
• Teaching physician rules; and
• Tips to avoid billing issues and potential denials.

This session is the third in a series of seven that cover the full range of coding topics, from developing a compliance plan and internal auditing process to ICD-10, PQRS, and Medicare’s Physician Value-Based Payment Modifier.

CME credits are offered through post-tests following each webinar, and each participant is eligible for up to seven credits throughout the series. Up to 10 individuals in a group can sign up through a single registration.

For more information, visit www.hospitalmedicine.org/codeh.