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.

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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.

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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.

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.

BOOST Makes a Difference

Want to make a real difference in your hospital’s readmission rates? Now is the time to start compiling applications for SHM’s Project BOOST. Applications are due Aug. 30.

For more info, visit www.hospitalmedicine.org/boost.

BOOST Makes a Difference

Want to make a real difference in your hospital’s readmission rates? Now is the time to start compiling applications for SHM’s Project BOOST. Applications are due Aug. 30.

For more info, visit www.hospitalmedicine.org/boost.

BOOST Makes a Difference

Want to make a real difference in your hospital’s readmission rates? Now is the time to start compiling applications for SHM’s Project BOOST. Applications are due Aug. 30.

For more info, visit www.hospitalmedicine.org/boost.

Academic Hospitalists and Program Directors: There Is Still Time to Register for the Quality and Safety Educators Academy

Make sure your hospital is ready to meet the ACGME’s requirements that residency programs integrate quality and safety into their curriculum. The Quality and Safety Educators Academy (QSEA) is May 1-3 at the Tempe Mission Palms in Arizona.

For more info, visit www.hospitalmedicine.org/qsea.

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.

BOOST Makes a Difference

Want to make a real difference in your hospital’s readmission rates? Now is the time to start compiling applications for SHM’s Project BOOST. Applications are due Aug. 30.

For more info, visit www.hospitalmedicine.org/boost.

Academic Hospitalists and Program Directors: There Is Still Time to Register for the Quality and Safety Educators Academy

Make sure your hospital is ready to meet the ACGME’s requirements that residency programs integrate quality and safety into their curriculum. The Quality and Safety Educators Academy (QSEA) is May 1-3 at the Tempe Mission Palms in Arizona.

For more info, visit www.hospitalmedicine.org/qsea.

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.

BOOST Makes a Difference

Want to make a real difference in your hospital’s readmission rates? Now is the time to start compiling applications for SHM’s Project BOOST. Applications are due Aug. 30.

For more info, visit www.hospitalmedicine.org/boost.

Academic Hospitalists and Program Directors: There Is Still Time to Register for the Quality and Safety Educators Academy

Make sure your hospital is ready to meet the ACGME’s requirements that residency programs integrate quality and safety into their curriculum. The Quality and Safety Educators Academy (QSEA) is May 1-3 at the Tempe Mission Palms in Arizona.

For more info, visit www.hospitalmedicine.org/qsea.

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.

BOOST Makes a Difference

Want to make a real difference in your hospital’s readmission rates? Now is the time to start compiling applications for SHM’s Project BOOST. Applications are due Aug. 30.

For more info, visit www.hospitalmedicine.org/boost.

Disney&#039;s Yacht Club Resort, Lake Buena Vista: Florida Resorts

Mark Your Calendar for Pediatric Hospital Medicine 2014, July 24-27

Pediatric hospitalists: It’s not too early to register for the only national conference dedicated to pediatric hospital medicine.

The PHM14 theme, “Keep Moving Forward,” focuses on the future of pediatric hospital medicine and improving the care provided to children. The largest meeting of pediatric hospitalists of the year, the conference is co-sponsored by the Society of Hospital Medicine (SHM), the American Academy of Pediatrics (AAP), the AAP Section on Hospital Medicine (SOHM), and the Academic Pediatric Association (APA).

PHM14 is July 24-27, and this year’s setting—Disney’s Yacht and Beach Club Resorts in Lake Buena Vista, Fla.—makes it the perfect destination for a family vacation. Make plans now to meet with the best in pediatric hospital medicine—and bring the family.

For more information, visit www.hospitalmedicine.org/phm14.

Disney&#039;s Yacht Club Resort, Lake Buena Vista: Florida Resorts

Mark Your Calendar for Pediatric Hospital Medicine 2014, July 24-27

Pediatric hospitalists: It’s not too early to register for the only national conference dedicated to pediatric hospital medicine.

The PHM14 theme, “Keep Moving Forward,” focuses on the future of pediatric hospital medicine and improving the care provided to children. The largest meeting of pediatric hospitalists of the year, the conference is co-sponsored by the Society of Hospital Medicine (SHM), the American Academy of Pediatrics (AAP), the AAP Section on Hospital Medicine (SOHM), and the Academic Pediatric Association (APA).

PHM14 is July 24-27, and this year’s setting—Disney’s Yacht and Beach Club Resorts in Lake Buena Vista, Fla.—makes it the perfect destination for a family vacation. Make plans now to meet with the best in pediatric hospital medicine—and bring the family.

For more information, visit www.hospitalmedicine.org/phm14.

Disney&#039;s Yacht Club Resort, Lake Buena Vista: Florida Resorts

Mark Your Calendar for Pediatric Hospital Medicine 2014, July 24-27

Pediatric hospitalists: It’s not too early to register for the only national conference dedicated to pediatric hospital medicine.

The PHM14 theme, “Keep Moving Forward,” focuses on the future of pediatric hospital medicine and improving the care provided to children. The largest meeting of pediatric hospitalists of the year, the conference is co-sponsored by the Society of Hospital Medicine (SHM), the American Academy of Pediatrics (AAP), the AAP Section on Hospital Medicine (SOHM), and the Academic Pediatric Association (APA).

PHM14 is July 24-27, and this year’s setting—Disney’s Yacht and Beach Club Resorts in Lake Buena Vista, Fla.—makes it the perfect destination for a family vacation. Make plans now to meet with the best in pediatric hospital medicine—and bring the family.

For more information, visit www.hospitalmedicine.org/phm14.

Should I check out “Attending 101” or the session on clinical problem solving? Wait, are they even at the same time? OK, great, they’re not, but I’ll just have to remember to get to both—and the session on medication reconciliation. I don’t have the presentations for them, so I’ll have to print them out beforehand for my notes and pack them.

That was life three years ago, before SHM launched its groundbreaking annual meeting mobile app. And, this month, the HM14 mobile app will pack even more power into hospitalists’ hands.

Now available at www.hm14athand.org, the HM14 At Hand mobile app is designed for all smartphones and tablets with wi-fi or wireless data access. It launches more than a month ahead of the meeting, allowing HM14 attendees to download the app at home and plan their meeting before they depart for Las Vegas—or on the plane en route.

The app includes all of the features hospitalists have come to expect, with some new surprises:

• Full program schedule, with the ability to schedule and set reminders for selected sessions;
• Options for presenters and conference-goers to provide contact information to other attendees;
• Presentation notes from speakers;
• The “Scan-to-Win” prize game, with even more locations to scan;
• Real-time program alerts for breaking news about the conference;
• Links to other resources for hospitalists;
• NEW: Integration with social media to help you connect with other conference bloggers, tweeters, and posters; and
• NEW: A section for job seekers and career networkers to connect with recruiters.

SHM has said farewell to the antiquated bulletin board that connected hospitalists and recruiters and replaced it with a mobile job board for hospitalists exploring new career opportunities at the conference. The mobile job board, available in the HM14 At Hand app, will include contact information for recruiters, so candidates and recruiters can connect virtually and then meet up in real life in a matter of minutes.

---

Brendon Shank is SHM’s associate vice president of communications.

Should I check out “Attending 101” or the session on clinical problem solving? Wait, are they even at the same time? OK, great, they’re not, but I’ll just have to remember to get to both—and the session on medication reconciliation. I don’t have the presentations for them, so I’ll have to print them out beforehand for my notes and pack them.

That was life three years ago, before SHM launched its groundbreaking annual meeting mobile app. And, this month, the HM14 mobile app will pack even more power into hospitalists’ hands.

Now available at www.hm14athand.org, the HM14 At Hand mobile app is designed for all smartphones and tablets with wi-fi or wireless data access. It launches more than a month ahead of the meeting, allowing HM14 attendees to download the app at home and plan their meeting before they depart for Las Vegas—or on the plane en route.

The app includes all of the features hospitalists have come to expect, with some new surprises:

• Full program schedule, with the ability to schedule and set reminders for selected sessions;
• Options for presenters and conference-goers to provide contact information to other attendees;
• Presentation notes from speakers;
• The “Scan-to-Win” prize game, with even more locations to scan;
• Real-time program alerts for breaking news about the conference;
• Links to other resources for hospitalists;
• NEW: Integration with social media to help you connect with other conference bloggers, tweeters, and posters; and
• NEW: A section for job seekers and career networkers to connect with recruiters.

SHM has said farewell to the antiquated bulletin board that connected hospitalists and recruiters and replaced it with a mobile job board for hospitalists exploring new career opportunities at the conference. The mobile job board, available in the HM14 At Hand app, will include contact information for recruiters, so candidates and recruiters can connect virtually and then meet up in real life in a matter of minutes.

---

Brendon Shank is SHM’s associate vice president of communications.

Should I check out “Attending 101” or the session on clinical problem solving? Wait, are they even at the same time? OK, great, they’re not, but I’ll just have to remember to get to both—and the session on medication reconciliation. I don’t have the presentations for them, so I’ll have to print them out beforehand for my notes and pack them.

That was life three years ago, before SHM launched its groundbreaking annual meeting mobile app. And, this month, the HM14 mobile app will pack even more power into hospitalists’ hands.

Now available at www.hm14athand.org, the HM14 At Hand mobile app is designed for all smartphones and tablets with wi-fi or wireless data access. It launches more than a month ahead of the meeting, allowing HM14 attendees to download the app at home and plan their meeting before they depart for Las Vegas—or on the plane en route.

The app includes all of the features hospitalists have come to expect, with some new surprises:

• Full program schedule, with the ability to schedule and set reminders for selected sessions;
• Options for presenters and conference-goers to provide contact information to other attendees;
• Presentation notes from speakers;
• The “Scan-to-Win” prize game, with even more locations to scan;
• Real-time program alerts for breaking news about the conference;
• Links to other resources for hospitalists;
• NEW: Integration with social media to help you connect with other conference bloggers, tweeters, and posters; and
• NEW: A section for job seekers and career networkers to connect with recruiters.

SHM has said farewell to the antiquated bulletin board that connected hospitalists and recruiters and replaced it with a mobile job board for hospitalists exploring new career opportunities at the conference. The mobile job board, available in the HM14 At Hand app, will include contact information for recruiters, so candidates and recruiters can connect virtually and then meet up in real life in a matter of minutes.

---

Brendon Shank is SHM’s associate vice president of communications.

Dr. Howell

If only there were a place where young hospitalists, mid-career hospitalists, and veteran hospitalists in a new position could go to proverbially pick the brains of those who came before them in an informal setting that practically begs for crowd-sourced learning.

Wait, there is.

Sure, the roughly 3,000 hospitalists who descend upon SHM’s annual meeting at Mandalay Bay Resort and Casino will be there for HM14’s slate of educational offerings, keynote addresses, and clinical updates. But for guys like Darren Swenson, MD, a regional medical advisor for IPC The Hospitalist Co. in Las Vegas, it’s also a chance to catch up with long-lost colleagues and med-school buddies while making new friends and gleaning tips from a who’s who of industry leaders.

“Whether you’re early in your career, or eight, 10, 12 years into your career, healthcare is changing so rapidly now, getting access to leadership skills is essential,” he says.

HM14 course director Daniel Brotman, MD, FACP, SFHM, says it’s impossible to overstate the value of networking at the annual meeting.

“Many of these folks I see once a year, and I look forward to seeing them,” says Dr. Brotman, who practices at John Hopkins Hospital in Baltimore, Md. “For me, as a director of a hospitalist program, to network with other people who direct programs and are trying to navigate very similar challenges is great, because it gives me ideas for how I might do something different, and I can return the favor.”

There’s the flipside, too, where commiseration helps soothe the soul. But mostly, conversations with other physicians who struggle the same issues that you see can be the meeting’s most important takeaway.

“There’s so much commonality in what we’re dealing with on a day-to-day basis to run a hospitalist program successfully,” Dr. Brotman adds. “Ultimately, good ideas are good ideas.

“There is so much innovation going on in this field that’s it’s almost impossible not to attend this meeting and come away with so many new ideas.”

In particular, Dr. Brotman sees great opportunities for early-career hospitalists to meet, greet, and build relationships.

“One of the things that marks our specialty is recognizing that the future of hospital medicine is the young hospitalists who are attending these meetings and getting fired up about it,” he adds.

SHM President Eric Howell, MD, SFHM, chief of hospital medicine at Johns Hopkins Bayview Medical Center in Baltimore, sees another, less heralded benefit to networking: pride.

“You can really brag about your program’s success and your individual successes,” he says. “That can’t be underestimated in terms of value.”

Dr. Howell encourages junior faculty to attend in order to meet and interact with as many people as possible, through the poster contests or impromptu post-meeting beverages. Such discussion, whether it involves bragging or the aforementioned commiserating, tends to invigorate and energize staffers, he says.

“It’s therapeutic to be able to discuss these things,” Dr. Howell adds. “Networking is also peer-to-peer mentoring. You can tell them things you can’t tell your boss or the people you oversee. It allows you a fairly open conversation with a peer on how to advance your program and your career.”

 

---

Richard Quinn is a freelance writer in New Jersey.

Dr. Howell

If only there were a place where young hospitalists, mid-career hospitalists, and veteran hospitalists in a new position could go to proverbially pick the brains of those who came before them in an informal setting that practically begs for crowd-sourced learning.

Wait, there is.

Sure, the roughly 3,000 hospitalists who descend upon SHM’s annual meeting at Mandalay Bay Resort and Casino will be there for HM14’s slate of educational offerings, keynote addresses, and clinical updates. But for guys like Darren Swenson, MD, a regional medical advisor for IPC The Hospitalist Co. in Las Vegas, it’s also a chance to catch up with long-lost colleagues and med-school buddies while making new friends and gleaning tips from a who’s who of industry leaders.

“Whether you’re early in your career, or eight, 10, 12 years into your career, healthcare is changing so rapidly now, getting access to leadership skills is essential,” he says.

HM14 course director Daniel Brotman, MD, FACP, SFHM, says it’s impossible to overstate the value of networking at the annual meeting.

“Many of these folks I see once a year, and I look forward to seeing them,” says Dr. Brotman, who practices at John Hopkins Hospital in Baltimore, Md. “For me, as a director of a hospitalist program, to network with other people who direct programs and are trying to navigate very similar challenges is great, because it gives me ideas for how I might do something different, and I can return the favor.”

There’s the flipside, too, where commiseration helps soothe the soul. But mostly, conversations with other physicians who struggle the same issues that you see can be the meeting’s most important takeaway.

“There’s so much commonality in what we’re dealing with on a day-to-day basis to run a hospitalist program successfully,” Dr. Brotman adds. “Ultimately, good ideas are good ideas.

“There is so much innovation going on in this field that’s it’s almost impossible not to attend this meeting and come away with so many new ideas.”

In particular, Dr. Brotman sees great opportunities for early-career hospitalists to meet, greet, and build relationships.

“One of the things that marks our specialty is recognizing that the future of hospital medicine is the young hospitalists who are attending these meetings and getting fired up about it,” he adds.

SHM President Eric Howell, MD, SFHM, chief of hospital medicine at Johns Hopkins Bayview Medical Center in Baltimore, sees another, less heralded benefit to networking: pride.

“You can really brag about your program’s success and your individual successes,” he says. “That can’t be underestimated in terms of value.”

Dr. Howell encourages junior faculty to attend in order to meet and interact with as many people as possible, through the poster contests or impromptu post-meeting beverages. Such discussion, whether it involves bragging or the aforementioned commiserating, tends to invigorate and energize staffers, he says.

“It’s therapeutic to be able to discuss these things,” Dr. Howell adds. “Networking is also peer-to-peer mentoring. You can tell them things you can’t tell your boss or the people you oversee. It allows you a fairly open conversation with a peer on how to advance your program and your career.”

 

---

Richard Quinn is a freelance writer in New Jersey.

Dr. Howell

If only there were a place where young hospitalists, mid-career hospitalists, and veteran hospitalists in a new position could go to proverbially pick the brains of those who came before them in an informal setting that practically begs for crowd-sourced learning.

Wait, there is.

Sure, the roughly 3,000 hospitalists who descend upon SHM’s annual meeting at Mandalay Bay Resort and Casino will be there for HM14’s slate of educational offerings, keynote addresses, and clinical updates. But for guys like Darren Swenson, MD, a regional medical advisor for IPC The Hospitalist Co. in Las Vegas, it’s also a chance to catch up with long-lost colleagues and med-school buddies while making new friends and gleaning tips from a who’s who of industry leaders.

“Whether you’re early in your career, or eight, 10, 12 years into your career, healthcare is changing so rapidly now, getting access to leadership skills is essential,” he says.

HM14 course director Daniel Brotman, MD, FACP, SFHM, says it’s impossible to overstate the value of networking at the annual meeting.

“Many of these folks I see once a year, and I look forward to seeing them,” says Dr. Brotman, who practices at John Hopkins Hospital in Baltimore, Md. “For me, as a director of a hospitalist program, to network with other people who direct programs and are trying to navigate very similar challenges is great, because it gives me ideas for how I might do something different, and I can return the favor.”

There’s the flipside, too, where commiseration helps soothe the soul. But mostly, conversations with other physicians who struggle the same issues that you see can be the meeting’s most important takeaway.

“There’s so much commonality in what we’re dealing with on a day-to-day basis to run a hospitalist program successfully,” Dr. Brotman adds. “Ultimately, good ideas are good ideas.

“There is so much innovation going on in this field that’s it’s almost impossible not to attend this meeting and come away with so many new ideas.”

In particular, Dr. Brotman sees great opportunities for early-career hospitalists to meet, greet, and build relationships.

“One of the things that marks our specialty is recognizing that the future of hospital medicine is the young hospitalists who are attending these meetings and getting fired up about it,” he adds.

SHM President Eric Howell, MD, SFHM, chief of hospital medicine at Johns Hopkins Bayview Medical Center in Baltimore, sees another, less heralded benefit to networking: pride.

“You can really brag about your program’s success and your individual successes,” he says. “That can’t be underestimated in terms of value.”

Dr. Howell encourages junior faculty to attend in order to meet and interact with as many people as possible, through the poster contests or impromptu post-meeting beverages. Such discussion, whether it involves bragging or the aforementioned commiserating, tends to invigorate and energize staffers, he says.

“It’s therapeutic to be able to discuss these things,” Dr. Howell adds. “Networking is also peer-to-peer mentoring. You can tell them things you can’t tell your boss or the people you oversee. It allows you a fairly open conversation with a peer on how to advance your program and your career.”

 

---

Richard Quinn is a freelance writer in New Jersey.

HM14 offers something for every hospitalist, from procedures training to special interest forums to practice management pearls. The four-day annual meeting, coming up March 24-27 at the Mandalay Bay in Las Vegas, caters to young, old, and every doctor in between.

So how will you get the most value out of the conference?

“The highest-yield content is going to depend on what your background is and how to spend that time in a way that augments your knowledge, your perspective, or your exposure to like-minded colleagues in a very individual way,” says HM14 course director Daniel Brotman, MD, FACP, SFHM, director of the hospitalist program at Johns Hopkins Hospital in Baltimore. “One of the things that’s so cool about hospital medicine is its diversity.”

But don’t take Dr. Brotman’s well-educated word for it. Here’s a list of recommendations from Team Hospitalist, the only reader-involvement group of its kind in HM, on events they would not miss this year.

Team Hospitalist contributors: Danielle Scheurer, MD, MSCR, SFHM, hospitalist, chief quality officer, Medical University of South Carolina; Edward Ma, MD, hospitalist, Coatesville (Pa.) VA Medical Center; Nick Fitterman, MD, FACP, SFHM, vice chair of hospital medicine, Hofstra North Shore-LIJ School of Medicine, Manhasset, N.Y.; James O’Callaghan, MD, FHM, clinical assistant professor of pediatrics, Seattle Children’s Hospital, University of Washington, and EvergreenHealth, Kirkland, Wash.; Klaus Suehler, MD, FHM, Mercy Hospital, Allina Health, Minneapolis, Minn.

1 “When Time is Brain (or Cord): Neurological Emergencies for the Hospitalist”

Tuesday, March 25

10:35-11:15 am

Dr. Suehler: As hospitalists, we often are the first ones to see patients with such neurological emergencies, and it is crucial to know when to get the neurologist or neurosurgeon involved. These are opportunities with a brief window of time to save or restore a patient’s neurological function.

2 “The ACA at 4: Impact on Costs, Quality, Lifestyle, and Payment”

Tuesday, March 25

10:35-11:50 am

Dr. Scheurer: This will be a packed session and will discuss all angles of the Affordable Care Act: how it will play out in hospitals around the country and, particularly, what it will mean to hospitalists. The complexity of the ACA is dizzying, so it will be time well spent to hear from several leaders in the field on how the major components of the ACA can and will impact us.

Dr. Ma: The ACA is nearly four years old, so I’m looking forward to a review on what precisely has been accomplished in medicine thus far and what can we anticipate down the road. The lawyers bantered about the constitutionality of the policy for the first two years. Politicians have been ranting about death panels, repeals, and amendments [for] the past four years. The public endured the latter part of 2013 reading about (or experiencing firsthand) the disastrous rollout of the healthcare.gov website. I want a clearer idea, beyond the fear and loathing, beyond the inane rhetoric, of the real impact that ACA has had and will have on the two most important components of healthcare: physicians and patients.

3 “Rate, Rhythm, Rivaroxaban, Ablation: Update in Atrial Fibrillation”

Tuesday, March 25

11:20 am-Noon

Dr. Suehler: This is a standard situation for hospitalists. We often admit patients with atrial fibrillation or get consulted when patients who are hospitalized for other reasons develop atrial fibrillation. It is very important for hospitalists to provide optimal care and counseling to patients with this arrhythmia, whether or not cardiologists get involved down the road.

4 “How ICD-10 Will Affect Hospitalists”

 

Tuesday, March 25

1:10-2:25 pm

Dr. Scheurer: Whether we like it or not, ICD-10 is right around the corner. This session will give an overview of what impact ICD-10 will have on our medical record documentation and coding, including how it can and will affect reimbursement. The more you know now, the better off you will be when your hospital implements it.

5 “Controversies in Perioperative Medicine”

Wednesday, March 26

11 am-Noon

Dr. Scheurer: We all know how much our surgeons depend on us to give them sound and evidence-based advice on how to manage surgical patients in the perioperative period. This session will review some controversial topics, from [the perspective of] two of the leaders in the field of perioperative medicine.

6 “Is It OK if I Sit Down?: Improving Patient Communication and Satisfaction at the Bedside”

Wednesday, March 26

11:45 am-12:25 pm

Dr. Fitterman: Any hospitalist or HM program leader struggling to raise patient satisfaction scores must attend this session. Recognizing that 30% of the value-based incentive pool for hospitals is directly linked to these scores, we all have “skin in the game.” Most hospitalists have part of their salary tied to patient satisfaction; however, many still lack the desired improvement in rankings despite multiple initiatives to address this issue. Four of the top five drivers of the patient experience are related to nursing, making our responsibility to impact this quite challenging. There is a correlation between the hospitals with the best satisfaction scores and lower patient mortality, so this is not just about the “chocolate on the pillow” but about filling gaps in care. I anticipate the discussion leaders will help us navigate this challenge with tips to bring back to our programs.

7 “Ending the Benevolent Dictatorship: Shared Decision-Making in the Hospital”

Wednesday, March 26

2:50-3:30 pm

Dr. Fitterman: This is a must attend for anyone interested in the “next blockbuster drug.” That is how patient activation and shared decision-making are being referred to (Health Affairs, February 2013). Where this has been implemented, patients have recognized better health outcomes, and there has been less decisional conflict (which likely equates to better satisfaction)—and all at lower costs. Sounds like a blockbuster drug, doesn’t it? The challenges I hope to see answered in this breakout session: First, most evidence wrapped around this topic is in the outpatient arena. Second, how do we overcome a lack of training in this field? Finally, how can we fit this into our busy workflows? Save me a seat.

8 “What Keeps Your CFO Awake at Night”

Wednesday, March 26

2:50-4:05 pm

Dr. Scheurer: The complexity of hospital finances can confuse even the brightest of hospitalists. This session will focus on the basics of what hospitalists should know and care about, as it relates to hospital finances. You won’t want to miss the concise opportunity to get informed.

9 “Different Generation/Different Concerns: Managing Boomers, Gen-Xers, and Gen Ys”

Thursday, March 27

8:45-9:40 am

Dr. Ma: This will likely be a contentious yet humorous session. The generational differences in attitude toward the practice of medicine can be very pronounced at times and certainly can lead to conflict in the workplace between the older and younger physicians. It’s important to recognize these differences without passing judgment and understand how they impact a practice.

10 “Effective, Efficient, and Prudent Syncope Evaluation”

Thursday, March 27

10:30-11:10 am

Dr. Suehler: Syncope is a frequent admission diagnosis for hospitalists. There is a wide spectrum of how hospitalists manage such patients (how long to monitor on telemetry, what additional tests to order). Hospitalists need to know how to provide a rational and cost-effective evaluation of patients with syncope and be able to identify patients who have a serious or life-threatening cause for their syncope.

 

11 “The Leadership Imperative: Building a Culture of Engagement and Ownership”

Thursday, March 27

10:55-11:50 am

Dr. O’Callaghan: Hospital practices, and the systems to which they belong, are complex organizations with their own culture. Producing long-term, sustainable change and improvement usually means changing this culture. Practices and their leaders need to develop hospitalists who think about improving the system of care, not just the patients in front of them. Successful practices are able to provide physicians with the freedom and responsibility to develop an ownership-mindset toward the practice. This lecture will help leaders develop the skills needed to support the development and maintenance of a culture of ownership.

12 “HFNC in Bronchiolitis: Best Thing Since Sliced Bread?”

Thursday, March 25

1:10-2:25 pm

Dr. O’Callaghan: Shawn Ralston, MD, is well known in pediatric hospital medicine for having both expertise and passion around the diagnosis of bronchiolitis. In the past year, she was lead author of a multi-site voluntary QI collaborative study that demonstrated that benchmarking decreased utilization of bronchodilators and chest physiotherapy in bronchiolitis (J Hosp Med. 2013;8:25-30). In addition, she was one of the authors of SHM’s Choosing Wisely Pediatric Hospital Medicine Recommendations (J Hosp Med. 2013;8(9):479-485). Dr. Ralston is a strong proponent of “doing more by doing less,” with regard to bronchiolitis, which is a self-limiting disease in pediatrics; however, along comes a potential new therapy—high flow nasal cannula therapy. I am very excited to see Dr. Ralston explore this new treatment. Will she have a debate with herself, and if so, which Ralston wins—doing-less Ralston or doing-more Ralston? I anticipate this session to be both highly informative and highly entertaining.

---

Richard Quinn is a freelance writer in New Jersey.

HM14 offers something for every hospitalist, from procedures training to special interest forums to practice management pearls. The four-day annual meeting, coming up March 24-27 at the Mandalay Bay in Las Vegas, caters to young, old, and every doctor in between.

So how will you get the most value out of the conference?

“The highest-yield content is going to depend on what your background is and how to spend that time in a way that augments your knowledge, your perspective, or your exposure to like-minded colleagues in a very individual way,” says HM14 course director Daniel Brotman, MD, FACP, SFHM, director of the hospitalist program at Johns Hopkins Hospital in Baltimore. “One of the things that’s so cool about hospital medicine is its diversity.”

But don’t take Dr. Brotman’s well-educated word for it. Here’s a list of recommendations from Team Hospitalist, the only reader-involvement group of its kind in HM, on events they would not miss this year.

Team Hospitalist contributors: Danielle Scheurer, MD, MSCR, SFHM, hospitalist, chief quality officer, Medical University of South Carolina; Edward Ma, MD, hospitalist, Coatesville (Pa.) VA Medical Center; Nick Fitterman, MD, FACP, SFHM, vice chair of hospital medicine, Hofstra North Shore-LIJ School of Medicine, Manhasset, N.Y.; James O’Callaghan, MD, FHM, clinical assistant professor of pediatrics, Seattle Children’s Hospital, University of Washington, and EvergreenHealth, Kirkland, Wash.; Klaus Suehler, MD, FHM, Mercy Hospital, Allina Health, Minneapolis, Minn.

1 “When Time is Brain (or Cord): Neurological Emergencies for the Hospitalist”

Tuesday, March 25

10:35-11:15 am

Dr. Suehler: As hospitalists, we often are the first ones to see patients with such neurological emergencies, and it is crucial to know when to get the neurologist or neurosurgeon involved. These are opportunities with a brief window of time to save or restore a patient’s neurological function.

2 “The ACA at 4: Impact on Costs, Quality, Lifestyle, and Payment”

Tuesday, March 25

10:35-11:50 am

Dr. Scheurer: This will be a packed session and will discuss all angles of the Affordable Care Act: how it will play out in hospitals around the country and, particularly, what it will mean to hospitalists. The complexity of the ACA is dizzying, so it will be time well spent to hear from several leaders in the field on how the major components of the ACA can and will impact us.

Dr. Ma: The ACA is nearly four years old, so I’m looking forward to a review on what precisely has been accomplished in medicine thus far and what can we anticipate down the road. The lawyers bantered about the constitutionality of the policy for the first two years. Politicians have been ranting about death panels, repeals, and amendments [for] the past four years. The public endured the latter part of 2013 reading about (or experiencing firsthand) the disastrous rollout of the healthcare.gov website. I want a clearer idea, beyond the fear and loathing, beyond the inane rhetoric, of the real impact that ACA has had and will have on the two most important components of healthcare: physicians and patients.

3 “Rate, Rhythm, Rivaroxaban, Ablation: Update in Atrial Fibrillation”

Tuesday, March 25

11:20 am-Noon

Dr. Suehler: This is a standard situation for hospitalists. We often admit patients with atrial fibrillation or get consulted when patients who are hospitalized for other reasons develop atrial fibrillation. It is very important for hospitalists to provide optimal care and counseling to patients with this arrhythmia, whether or not cardiologists get involved down the road.

4 “How ICD-10 Will Affect Hospitalists”

 

Tuesday, March 25

1:10-2:25 pm

Dr. Scheurer: Whether we like it or not, ICD-10 is right around the corner. This session will give an overview of what impact ICD-10 will have on our medical record documentation and coding, including how it can and will affect reimbursement. The more you know now, the better off you will be when your hospital implements it.

5 “Controversies in Perioperative Medicine”

Wednesday, March 26

11 am-Noon

Dr. Scheurer: We all know how much our surgeons depend on us to give them sound and evidence-based advice on how to manage surgical patients in the perioperative period. This session will review some controversial topics, from [the perspective of] two of the leaders in the field of perioperative medicine.

6 “Is It OK if I Sit Down?: Improving Patient Communication and Satisfaction at the Bedside”

Wednesday, March 26

11:45 am-12:25 pm

Dr. Fitterman: Any hospitalist or HM program leader struggling to raise patient satisfaction scores must attend this session. Recognizing that 30% of the value-based incentive pool for hospitals is directly linked to these scores, we all have “skin in the game.” Most hospitalists have part of their salary tied to patient satisfaction; however, many still lack the desired improvement in rankings despite multiple initiatives to address this issue. Four of the top five drivers of the patient experience are related to nursing, making our responsibility to impact this quite challenging. There is a correlation between the hospitals with the best satisfaction scores and lower patient mortality, so this is not just about the “chocolate on the pillow” but about filling gaps in care. I anticipate the discussion leaders will help us navigate this challenge with tips to bring back to our programs.

7 “Ending the Benevolent Dictatorship: Shared Decision-Making in the Hospital”

Wednesday, March 26

2:50-3:30 pm

Dr. Fitterman: This is a must attend for anyone interested in the “next blockbuster drug.” That is how patient activation and shared decision-making are being referred to (Health Affairs, February 2013). Where this has been implemented, patients have recognized better health outcomes, and there has been less decisional conflict (which likely equates to better satisfaction)—and all at lower costs. Sounds like a blockbuster drug, doesn’t it? The challenges I hope to see answered in this breakout session: First, most evidence wrapped around this topic is in the outpatient arena. Second, how do we overcome a lack of training in this field? Finally, how can we fit this into our busy workflows? Save me a seat.

8 “What Keeps Your CFO Awake at Night”

Wednesday, March 26

2:50-4:05 pm

Dr. Scheurer: The complexity of hospital finances can confuse even the brightest of hospitalists. This session will focus on the basics of what hospitalists should know and care about, as it relates to hospital finances. You won’t want to miss the concise opportunity to get informed.

9 “Different Generation/Different Concerns: Managing Boomers, Gen-Xers, and Gen Ys”

Thursday, March 27

8:45-9:40 am

Dr. Ma: This will likely be a contentious yet humorous session. The generational differences in attitude toward the practice of medicine can be very pronounced at times and certainly can lead to conflict in the workplace between the older and younger physicians. It’s important to recognize these differences without passing judgment and understand how they impact a practice.

10 “Effective, Efficient, and Prudent Syncope Evaluation”

Thursday, March 27

10:30-11:10 am

Dr. Suehler: Syncope is a frequent admission diagnosis for hospitalists. There is a wide spectrum of how hospitalists manage such patients (how long to monitor on telemetry, what additional tests to order). Hospitalists need to know how to provide a rational and cost-effective evaluation of patients with syncope and be able to identify patients who have a serious or life-threatening cause for their syncope.

 

11 “The Leadership Imperative: Building a Culture of Engagement and Ownership”

Thursday, March 27

10:55-11:50 am

Dr. O’Callaghan: Hospital practices, and the systems to which they belong, are complex organizations with their own culture. Producing long-term, sustainable change and improvement usually means changing this culture. Practices and their leaders need to develop hospitalists who think about improving the system of care, not just the patients in front of them. Successful practices are able to provide physicians with the freedom and responsibility to develop an ownership-mindset toward the practice. This lecture will help leaders develop the skills needed to support the development and maintenance of a culture of ownership.

12 “HFNC in Bronchiolitis: Best Thing Since Sliced Bread?”

Thursday, March 25

1:10-2:25 pm

Dr. O’Callaghan: Shawn Ralston, MD, is well known in pediatric hospital medicine for having both expertise and passion around the diagnosis of bronchiolitis. In the past year, she was lead author of a multi-site voluntary QI collaborative study that demonstrated that benchmarking decreased utilization of bronchodilators and chest physiotherapy in bronchiolitis (J Hosp Med. 2013;8:25-30). In addition, she was one of the authors of SHM’s Choosing Wisely Pediatric Hospital Medicine Recommendations (J Hosp Med. 2013;8(9):479-485). Dr. Ralston is a strong proponent of “doing more by doing less,” with regard to bronchiolitis, which is a self-limiting disease in pediatrics; however, along comes a potential new therapy—high flow nasal cannula therapy. I am very excited to see Dr. Ralston explore this new treatment. Will she have a debate with herself, and if so, which Ralston wins—doing-less Ralston or doing-more Ralston? I anticipate this session to be both highly informative and highly entertaining.

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Richard Quinn is a freelance writer in New Jersey.

HM14 offers something for every hospitalist, from procedures training to special interest forums to practice management pearls. The four-day annual meeting, coming up March 24-27 at the Mandalay Bay in Las Vegas, caters to young, old, and every doctor in between.

So how will you get the most value out of the conference?

“The highest-yield content is going to depend on what your background is and how to spend that time in a way that augments your knowledge, your perspective, or your exposure to like-minded colleagues in a very individual way,” says HM14 course director Daniel Brotman, MD, FACP, SFHM, director of the hospitalist program at Johns Hopkins Hospital in Baltimore. “One of the things that’s so cool about hospital medicine is its diversity.”

But don’t take Dr. Brotman’s well-educated word for it. Here’s a list of recommendations from Team Hospitalist, the only reader-involvement group of its kind in HM, on events they would not miss this year.

Team Hospitalist contributors: Danielle Scheurer, MD, MSCR, SFHM, hospitalist, chief quality officer, Medical University of South Carolina; Edward Ma, MD, hospitalist, Coatesville (Pa.) VA Medical Center; Nick Fitterman, MD, FACP, SFHM, vice chair of hospital medicine, Hofstra North Shore-LIJ School of Medicine, Manhasset, N.Y.; James O’Callaghan, MD, FHM, clinical assistant professor of pediatrics, Seattle Children’s Hospital, University of Washington, and EvergreenHealth, Kirkland, Wash.; Klaus Suehler, MD, FHM, Mercy Hospital, Allina Health, Minneapolis, Minn.

1 “When Time is Brain (or Cord): Neurological Emergencies for the Hospitalist”

Tuesday, March 25

10:35-11:15 am

Dr. Suehler: As hospitalists, we often are the first ones to see patients with such neurological emergencies, and it is crucial to know when to get the neurologist or neurosurgeon involved. These are opportunities with a brief window of time to save or restore a patient’s neurological function.

2 “The ACA at 4: Impact on Costs, Quality, Lifestyle, and Payment”

Tuesday, March 25

10:35-11:50 am

Dr. Scheurer: This will be a packed session and will discuss all angles of the Affordable Care Act: how it will play out in hospitals around the country and, particularly, what it will mean to hospitalists. The complexity of the ACA is dizzying, so it will be time well spent to hear from several leaders in the field on how the major components of the ACA can and will impact us.

Dr. Ma: The ACA is nearly four years old, so I’m looking forward to a review on what precisely has been accomplished in medicine thus far and what can we anticipate down the road. The lawyers bantered about the constitutionality of the policy for the first two years. Politicians have been ranting about death panels, repeals, and amendments [for] the past four years. The public endured the latter part of 2013 reading about (or experiencing firsthand) the disastrous rollout of the healthcare.gov website. I want a clearer idea, beyond the fear and loathing, beyond the inane rhetoric, of the real impact that ACA has had and will have on the two most important components of healthcare: physicians and patients.

3 “Rate, Rhythm, Rivaroxaban, Ablation: Update in Atrial Fibrillation”

Tuesday, March 25

11:20 am-Noon

Dr. Suehler: This is a standard situation for hospitalists. We often admit patients with atrial fibrillation or get consulted when patients who are hospitalized for other reasons develop atrial fibrillation. It is very important for hospitalists to provide optimal care and counseling to patients with this arrhythmia, whether or not cardiologists get involved down the road.

4 “How ICD-10 Will Affect Hospitalists”

 

Tuesday, March 25

1:10-2:25 pm

Dr. Scheurer: Whether we like it or not, ICD-10 is right around the corner. This session will give an overview of what impact ICD-10 will have on our medical record documentation and coding, including how it can and will affect reimbursement. The more you know now, the better off you will be when your hospital implements it.

5 “Controversies in Perioperative Medicine”

Wednesday, March 26

11 am-Noon

Dr. Scheurer: We all know how much our surgeons depend on us to give them sound and evidence-based advice on how to manage surgical patients in the perioperative period. This session will review some controversial topics, from [the perspective of] two of the leaders in the field of perioperative medicine.

6 “Is It OK if I Sit Down?: Improving Patient Communication and Satisfaction at the Bedside”

Wednesday, March 26

11:45 am-12:25 pm

Dr. Fitterman: Any hospitalist or HM program leader struggling to raise patient satisfaction scores must attend this session. Recognizing that 30% of the value-based incentive pool for hospitals is directly linked to these scores, we all have “skin in the game.” Most hospitalists have part of their salary tied to patient satisfaction; however, many still lack the desired improvement in rankings despite multiple initiatives to address this issue. Four of the top five drivers of the patient experience are related to nursing, making our responsibility to impact this quite challenging. There is a correlation between the hospitals with the best satisfaction scores and lower patient mortality, so this is not just about the “chocolate on the pillow” but about filling gaps in care. I anticipate the discussion leaders will help us navigate this challenge with tips to bring back to our programs.

7 “Ending the Benevolent Dictatorship: Shared Decision-Making in the Hospital”

Wednesday, March 26

2:50-3:30 pm

Dr. Fitterman: This is a must attend for anyone interested in the “next blockbuster drug.” That is how patient activation and shared decision-making are being referred to (Health Affairs, February 2013). Where this has been implemented, patients have recognized better health outcomes, and there has been less decisional conflict (which likely equates to better satisfaction)—and all at lower costs. Sounds like a blockbuster drug, doesn’t it? The challenges I hope to see answered in this breakout session: First, most evidence wrapped around this topic is in the outpatient arena. Second, how do we overcome a lack of training in this field? Finally, how can we fit this into our busy workflows? Save me a seat.

8 “What Keeps Your CFO Awake at Night”

Wednesday, March 26

2:50-4:05 pm

Dr. Scheurer: The complexity of hospital finances can confuse even the brightest of hospitalists. This session will focus on the basics of what hospitalists should know and care about, as it relates to hospital finances. You won’t want to miss the concise opportunity to get informed.

9 “Different Generation/Different Concerns: Managing Boomers, Gen-Xers, and Gen Ys”

Thursday, March 27

8:45-9:40 am

Dr. Ma: This will likely be a contentious yet humorous session. The generational differences in attitude toward the practice of medicine can be very pronounced at times and certainly can lead to conflict in the workplace between the older and younger physicians. It’s important to recognize these differences without passing judgment and understand how they impact a practice.

10 “Effective, Efficient, and Prudent Syncope Evaluation”

Thursday, March 27

10:30-11:10 am

Dr. Suehler: Syncope is a frequent admission diagnosis for hospitalists. There is a wide spectrum of how hospitalists manage such patients (how long to monitor on telemetry, what additional tests to order). Hospitalists need to know how to provide a rational and cost-effective evaluation of patients with syncope and be able to identify patients who have a serious or life-threatening cause for their syncope.

 

11 “The Leadership Imperative: Building a Culture of Engagement and Ownership”

Thursday, March 27

10:55-11:50 am

Dr. O’Callaghan: Hospital practices, and the systems to which they belong, are complex organizations with their own culture. Producing long-term, sustainable change and improvement usually means changing this culture. Practices and their leaders need to develop hospitalists who think about improving the system of care, not just the patients in front of them. Successful practices are able to provide physicians with the freedom and responsibility to develop an ownership-mindset toward the practice. This lecture will help leaders develop the skills needed to support the development and maintenance of a culture of ownership.

12 “HFNC in Bronchiolitis: Best Thing Since Sliced Bread?”

Thursday, March 25

1:10-2:25 pm

Dr. O’Callaghan: Shawn Ralston, MD, is well known in pediatric hospital medicine for having both expertise and passion around the diagnosis of bronchiolitis. In the past year, she was lead author of a multi-site voluntary QI collaborative study that demonstrated that benchmarking decreased utilization of bronchodilators and chest physiotherapy in bronchiolitis (J Hosp Med. 2013;8:25-30). In addition, she was one of the authors of SHM’s Choosing Wisely Pediatric Hospital Medicine Recommendations (J Hosp Med. 2013;8(9):479-485). Dr. Ralston is a strong proponent of “doing more by doing less,” with regard to bronchiolitis, which is a self-limiting disease in pediatrics; however, along comes a potential new therapy—high flow nasal cannula therapy. I am very excited to see Dr. Ralston explore this new treatment. Will she have a debate with herself, and if so, which Ralston wins—doing-less Ralston or doing-more Ralston? I anticipate this session to be both highly informative and highly entertaining.

---

Richard Quinn is a freelance writer in New Jersey.