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Welcome to Annual Meeting Day 2
Day 1 has already raised the bar for the SHM Annual Meeting. Day 2, Wednesday, will set a whole new standard with courses, speakers, content, and perspective.
Leading off the day will be the presentation of the best of Research and Innovations. This year, we had hundreds of submissions, and the kickoff of Day 2 will showcase the very best of the best! Following immediately, we will recognize the winners of the SHM Awards of Excellence.
Then, off to the main meeting!
This year, we anticipated that some sessions would be so hot that we would have to hold them twice to meet the demand. These sessions are labeled with their own track and include my own personal favorite – and ironically named – series at SHM, “Things We Do for No Reason.” So if you missed this or any of the other talks – heart failure, pulmonary embolism, infectious diseases, delirium, and syncope – here’s your second chance!
But wait – there’s more! This year, for the first time, we have Maintenance of Certification credit available for attendees of the MOC-Clinical Updates sessions and the Rapid Fire Sessions. So, go right ahead and get the MOC credits while you catch up on the latest evidence.
Every year, hospitalists, residents, and students from all over submit hundreds of insightful clinical vignettes posters. Lunch and learn in the Exhibit Hall and peruse the great cases while the judges debate over the absolute best. Afterward is the can’t- miss feature at every Annual Meeting: the Update in Hospital Medicine – this year being delivered by a pair of hospitalist leaders from the heartland, Rachel Thompson, MD, MPH, SFHM and Chad Miller, MD, FHM. Come for Rachel and Chad’s interpretation of the most important and relevant recent literature in adult hospital medicine.
Resident or medical student? You’re in good company at HM17. We have more trainees here than ever before. At 5:30 p.m., we’re holding a special session for you: A skills workshop on “Mastering the Job Interview.” We don’t learn these things in medical or residency – learn them at HM17!
A few other key sessions close out Day 2: Ron Greeno, MD, FCCP, MHM, and Nasim Afsar, MD, SFHM, present on the role hospitalists can (and must) play in the rollout and management of Alternative Payment Models. Then, there’s the mysteriously titled “Myths, Misunderstandings, Medicare & Money: PA/NP and Physician Teams in Hospital Medicine.”
Finally, wind down and see what’s new in the pediatrics world with the Pediatric Hospital Medicine Update with Akshata Hopkins, MD, and Amit Singh, MD.
If yesterday set the tone and tomorrow is the wrap up, Day 2 – today – is the middle act of HM17 and is sure to be educational, provocative, exciting, and an exceptional learning experience. Be sure to take time to walk through the exhibit hall. Please also stop by the SHM Booth to meet the hardworking SHM staff who have made this meeting a great success and introduce yourself to members of the Board who will be present in the booth during the course of the meeting!
Dr. Harte is outgoing president of SHM and president of Cleveland Clinic Akron General and Southern Region.
Day 1 has already raised the bar for the SHM Annual Meeting. Day 2, Wednesday, will set a whole new standard with courses, speakers, content, and perspective.
Leading off the day will be the presentation of the best of Research and Innovations. This year, we had hundreds of submissions, and the kickoff of Day 2 will showcase the very best of the best! Following immediately, we will recognize the winners of the SHM Awards of Excellence.
Then, off to the main meeting!
This year, we anticipated that some sessions would be so hot that we would have to hold them twice to meet the demand. These sessions are labeled with their own track and include my own personal favorite – and ironically named – series at SHM, “Things We Do for No Reason.” So if you missed this or any of the other talks – heart failure, pulmonary embolism, infectious diseases, delirium, and syncope – here’s your second chance!
But wait – there’s more! This year, for the first time, we have Maintenance of Certification credit available for attendees of the MOC-Clinical Updates sessions and the Rapid Fire Sessions. So, go right ahead and get the MOC credits while you catch up on the latest evidence.
Every year, hospitalists, residents, and students from all over submit hundreds of insightful clinical vignettes posters. Lunch and learn in the Exhibit Hall and peruse the great cases while the judges debate over the absolute best. Afterward is the can’t- miss feature at every Annual Meeting: the Update in Hospital Medicine – this year being delivered by a pair of hospitalist leaders from the heartland, Rachel Thompson, MD, MPH, SFHM and Chad Miller, MD, FHM. Come for Rachel and Chad’s interpretation of the most important and relevant recent literature in adult hospital medicine.
Resident or medical student? You’re in good company at HM17. We have more trainees here than ever before. At 5:30 p.m., we’re holding a special session for you: A skills workshop on “Mastering the Job Interview.” We don’t learn these things in medical or residency – learn them at HM17!
A few other key sessions close out Day 2: Ron Greeno, MD, FCCP, MHM, and Nasim Afsar, MD, SFHM, present on the role hospitalists can (and must) play in the rollout and management of Alternative Payment Models. Then, there’s the mysteriously titled “Myths, Misunderstandings, Medicare & Money: PA/NP and Physician Teams in Hospital Medicine.”
Finally, wind down and see what’s new in the pediatrics world with the Pediatric Hospital Medicine Update with Akshata Hopkins, MD, and Amit Singh, MD.
If yesterday set the tone and tomorrow is the wrap up, Day 2 – today – is the middle act of HM17 and is sure to be educational, provocative, exciting, and an exceptional learning experience. Be sure to take time to walk through the exhibit hall. Please also stop by the SHM Booth to meet the hardworking SHM staff who have made this meeting a great success and introduce yourself to members of the Board who will be present in the booth during the course of the meeting!
Dr. Harte is outgoing president of SHM and president of Cleveland Clinic Akron General and Southern Region.
Day 1 has already raised the bar for the SHM Annual Meeting. Day 2, Wednesday, will set a whole new standard with courses, speakers, content, and perspective.
Leading off the day will be the presentation of the best of Research and Innovations. This year, we had hundreds of submissions, and the kickoff of Day 2 will showcase the very best of the best! Following immediately, we will recognize the winners of the SHM Awards of Excellence.
Then, off to the main meeting!
This year, we anticipated that some sessions would be so hot that we would have to hold them twice to meet the demand. These sessions are labeled with their own track and include my own personal favorite – and ironically named – series at SHM, “Things We Do for No Reason.” So if you missed this or any of the other talks – heart failure, pulmonary embolism, infectious diseases, delirium, and syncope – here’s your second chance!
But wait – there’s more! This year, for the first time, we have Maintenance of Certification credit available for attendees of the MOC-Clinical Updates sessions and the Rapid Fire Sessions. So, go right ahead and get the MOC credits while you catch up on the latest evidence.
Every year, hospitalists, residents, and students from all over submit hundreds of insightful clinical vignettes posters. Lunch and learn in the Exhibit Hall and peruse the great cases while the judges debate over the absolute best. Afterward is the can’t- miss feature at every Annual Meeting: the Update in Hospital Medicine – this year being delivered by a pair of hospitalist leaders from the heartland, Rachel Thompson, MD, MPH, SFHM and Chad Miller, MD, FHM. Come for Rachel and Chad’s interpretation of the most important and relevant recent literature in adult hospital medicine.
Resident or medical student? You’re in good company at HM17. We have more trainees here than ever before. At 5:30 p.m., we’re holding a special session for you: A skills workshop on “Mastering the Job Interview.” We don’t learn these things in medical or residency – learn them at HM17!
A few other key sessions close out Day 2: Ron Greeno, MD, FCCP, MHM, and Nasim Afsar, MD, SFHM, present on the role hospitalists can (and must) play in the rollout and management of Alternative Payment Models. Then, there’s the mysteriously titled “Myths, Misunderstandings, Medicare & Money: PA/NP and Physician Teams in Hospital Medicine.”
Finally, wind down and see what’s new in the pediatrics world with the Pediatric Hospital Medicine Update with Akshata Hopkins, MD, and Amit Singh, MD.
If yesterday set the tone and tomorrow is the wrap up, Day 2 – today – is the middle act of HM17 and is sure to be educational, provocative, exciting, and an exceptional learning experience. Be sure to take time to walk through the exhibit hall. Please also stop by the SHM Booth to meet the hardworking SHM staff who have made this meeting a great success and introduce yourself to members of the Board who will be present in the booth during the course of the meeting!
Dr. Harte is outgoing president of SHM and president of Cleveland Clinic Akron General and Southern Region.
Hospitalists can do better at end-of-life care, expert says
As a 99-year-old friend neared the end of her life, she offered a lesson for the health care world, said Deborah Korenstein, MD, chief of general internal medicine and director of clinical effectiveness at Memorial Sloan Kettering Cancer Center, N.Y., in the Tuesday session “Finding High Value Inpatient Care at the End of Life.”
The woman, nicknamed “Mitch,” had bluntly made her preference clear, Dr. Korenstein said: “She wanted to live independently as long as she could, and then, she wanted to be dead.”
But when a pathology report showed urothelial cancer, that preference didn’t stop an oncology urologist from suggesting that Mitch enter a clinical trial on an unproven therapy. Worse, Mitch initially said “yes” to this idea, seemingly because she thought that’s what she was expected to say.
It was only when Dr. Korenstein spoke with her that she changed her mind, entered inpatient hospice care, and died peacefully.
“I think it’s a cautionary tale about when a patient is crystal clear about their wishes,” she said. “The wave of the medical system kind of pushes them along in a particular direction that may go against their wishes.”
Dr. Korenstein said U.S. health care system does fairly well in some areas – for instance, research shows that about 60% of people die in their preferred location, whether at home or somewhere else. But it does not do so well in others – a 2013 Journal of General Internal Medicine study found that, during 2002-2008, Medicare beneficiaries typically spent $39,000 out of pocket on their medical care, and in 25% of cases, what they spent exceeded the total value of their assets.
As far as individual preferences, these tend to correlate poorly with the care that people actually get, Dr. Korenstein said. Patients often don’t express their wishes, doctors are poor judges of what matters to individual people, and care is largely driven by physician preferences and by the care setting involved, she said.
Given those problems, she said, “we cannot possibly be providing high-value individualized care.”
Hospitalists are well positioned to help patients’ preferences align with care, she added. Sometimes, a sustained relationship with a patient, while generally a positive thing, might lead a provider to become invested in their care in “ways that are not always rational.” So a hospitalist can have a helpful vantage point.
As a 99-year-old friend neared the end of her life, she offered a lesson for the health care world, said Deborah Korenstein, MD, chief of general internal medicine and director of clinical effectiveness at Memorial Sloan Kettering Cancer Center, N.Y., in the Tuesday session “Finding High Value Inpatient Care at the End of Life.”
The woman, nicknamed “Mitch,” had bluntly made her preference clear, Dr. Korenstein said: “She wanted to live independently as long as she could, and then, she wanted to be dead.”
But when a pathology report showed urothelial cancer, that preference didn’t stop an oncology urologist from suggesting that Mitch enter a clinical trial on an unproven therapy. Worse, Mitch initially said “yes” to this idea, seemingly because she thought that’s what she was expected to say.
It was only when Dr. Korenstein spoke with her that she changed her mind, entered inpatient hospice care, and died peacefully.
“I think it’s a cautionary tale about when a patient is crystal clear about their wishes,” she said. “The wave of the medical system kind of pushes them along in a particular direction that may go against their wishes.”
Dr. Korenstein said U.S. health care system does fairly well in some areas – for instance, research shows that about 60% of people die in their preferred location, whether at home or somewhere else. But it does not do so well in others – a 2013 Journal of General Internal Medicine study found that, during 2002-2008, Medicare beneficiaries typically spent $39,000 out of pocket on their medical care, and in 25% of cases, what they spent exceeded the total value of their assets.
As far as individual preferences, these tend to correlate poorly with the care that people actually get, Dr. Korenstein said. Patients often don’t express their wishes, doctors are poor judges of what matters to individual people, and care is largely driven by physician preferences and by the care setting involved, she said.
Given those problems, she said, “we cannot possibly be providing high-value individualized care.”
Hospitalists are well positioned to help patients’ preferences align with care, she added. Sometimes, a sustained relationship with a patient, while generally a positive thing, might lead a provider to become invested in their care in “ways that are not always rational.” So a hospitalist can have a helpful vantage point.
As a 99-year-old friend neared the end of her life, she offered a lesson for the health care world, said Deborah Korenstein, MD, chief of general internal medicine and director of clinical effectiveness at Memorial Sloan Kettering Cancer Center, N.Y., in the Tuesday session “Finding High Value Inpatient Care at the End of Life.”
The woman, nicknamed “Mitch,” had bluntly made her preference clear, Dr. Korenstein said: “She wanted to live independently as long as she could, and then, she wanted to be dead.”
But when a pathology report showed urothelial cancer, that preference didn’t stop an oncology urologist from suggesting that Mitch enter a clinical trial on an unproven therapy. Worse, Mitch initially said “yes” to this idea, seemingly because she thought that’s what she was expected to say.
It was only when Dr. Korenstein spoke with her that she changed her mind, entered inpatient hospice care, and died peacefully.
“I think it’s a cautionary tale about when a patient is crystal clear about their wishes,” she said. “The wave of the medical system kind of pushes them along in a particular direction that may go against their wishes.”
Dr. Korenstein said U.S. health care system does fairly well in some areas – for instance, research shows that about 60% of people die in their preferred location, whether at home or somewhere else. But it does not do so well in others – a 2013 Journal of General Internal Medicine study found that, during 2002-2008, Medicare beneficiaries typically spent $39,000 out of pocket on their medical care, and in 25% of cases, what they spent exceeded the total value of their assets.
As far as individual preferences, these tend to correlate poorly with the care that people actually get, Dr. Korenstein said. Patients often don’t express their wishes, doctors are poor judges of what matters to individual people, and care is largely driven by physician preferences and by the care setting involved, she said.
Given those problems, she said, “we cannot possibly be providing high-value individualized care.”
Hospitalists are well positioned to help patients’ preferences align with care, she added. Sometimes, a sustained relationship with a patient, while generally a positive thing, might lead a provider to become invested in their care in “ways that are not always rational.” So a hospitalist can have a helpful vantage point.
VIDEO: Policy-focused SHM president thinks hospitalists can impact global, systems change
An original member of the Society of Hospital Medicine, new SHM Board President Ron Greeno, MD, MHM, is excited about helping to guide hospitalists into a new era of health system transformation.
The former chair of SHM’s Public Policy Committee, Dr. Greeno believes payment reforms like MACRA will have a “huge impact” on both hospitalists and the hospitals/health systems they work in. He expects hospital medicine, as a field, is well positioned for such changes and can play a vital role in systems change at the global level.
“In order to impact those things, hospitalists have to be ready to help change systems,” he said after his plenary address Tuesday at HM17.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
An original member of the Society of Hospital Medicine, new SHM Board President Ron Greeno, MD, MHM, is excited about helping to guide hospitalists into a new era of health system transformation.
The former chair of SHM’s Public Policy Committee, Dr. Greeno believes payment reforms like MACRA will have a “huge impact” on both hospitalists and the hospitals/health systems they work in. He expects hospital medicine, as a field, is well positioned for such changes and can play a vital role in systems change at the global level.
“In order to impact those things, hospitalists have to be ready to help change systems,” he said after his plenary address Tuesday at HM17.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
An original member of the Society of Hospital Medicine, new SHM Board President Ron Greeno, MD, MHM, is excited about helping to guide hospitalists into a new era of health system transformation.
The former chair of SHM’s Public Policy Committee, Dr. Greeno believes payment reforms like MACRA will have a “huge impact” on both hospitalists and the hospitals/health systems they work in. He expects hospital medicine, as a field, is well positioned for such changes and can play a vital role in systems change at the global level.
“In order to impact those things, hospitalists have to be ready to help change systems,” he said after his plenary address Tuesday at HM17.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
DeSalvo: HM needs holistic approach to health care
LAS VEGAS – To deliver her message of inclusion Tuesday morning, former acting assistant secretary for health in the U.S. Department of Health and Human Services (HHS) Karen DeSalvo, MD, MPH, MSc, could think of “no finer group” than those assembled before her at HM17.
The thousands of hospitalists gathered to hear her keynote address, “Rethinking Health: The Vital Role of Hospitals and the Hospitalist,” listened as she talked about including more than just the best medical care in HM’s scope of practice. The job must evolve to include a focus on such social issues as economic stability, neighborhood and physical environment, education, and access to healthy options for food.
In other words, Dr. DeSalvo wondered aloud, what good is treating a grandmother’s heart failure over and over if she’s always going to return to the hospital because her home, her neighborhood, or her finances mean she is unable to prevent recurring health issues? [[{"fid":"195561","view_mode":"medstat_image_flush_left","attributes":{"alt":"Dr. Brian Harte conducts an interveiw with Dr. Karen DeSalvo duing the opening plenary Tuesday at HM17.","height":"147","width":"220","class":"media-element file-medstat-image-flush-left","data-delta":"1"},"fields":{"format":"medstat_image_flush_left","field_file_image_caption[und][0][value]":"Dr. Brian Harte conducts an interview with Dr. Karen DeSalvo during the opening plenary Tuesday at HM17.","field_file_image_credit[und][0][value]":"Darnell Scott","field_file_image_caption[und][0][format]":"plain_text","field_file_image_credit[und][0][format]":"plain_text"},"type":"media","field_deltas":{"1":{"format":"medstat_image_flush_left","field_file_image_caption[und][0][value]":"Dr. Brian Harte conducts an interview with Dr. Karen DeSalvo during the opening plenary Tuesday at HM17.","field_file_image_credit[und][0][value]":"Darnell Scott"}}}]]
Hospitalists “have been at the center of change, not only in building a new field and showing us that medicine doesn’t have to always be the way it always was,” she said. “You have been at the forefront of seeing that we’re getting better value out of our health care system and, though that work must continue, you must also begin to broaden our thinking and understand that the drivers of health are much more than [just] health care. There are social determinants, social factors.”
Dr. DeSalvo, an internist by training, understands that dealing with social issues may seem like a role for others, but she said that the implications of those factors directly impact hospitalists and their institutions via issues such as readmissions.
“These things … don’t just matter conceptually,” she said. “They [have] direct relationships with mortality and morbidity and cost. They are literally affecting people’s lives in this country every day. When we begin to adjust them, to impact them, you can see that it also affects the health care system.”
On the front lines, Dr. DeSalvo said that hospitalists and others can work to take advantage of their hospital’s existing tools to link their patients to available resources, partner with local public health offices, and push to make their hospitals “anchor institutions to build community capacity to address these social determinants.”
Dr. DeSalvo also praised HM as a field that has already embraced value-based payment (VBP) models. She said that ability to anticipate and adapt to health care’s changing needs positions the field well as the Medicare Access and CHIP Reauthorization Act (MACRA) moves health care from fee-for-service to payment models that seek to manage risk and penalize mistakes.
LAS VEGAS – To deliver her message of inclusion Tuesday morning, former acting assistant secretary for health in the U.S. Department of Health and Human Services (HHS) Karen DeSalvo, MD, MPH, MSc, could think of “no finer group” than those assembled before her at HM17.
The thousands of hospitalists gathered to hear her keynote address, “Rethinking Health: The Vital Role of Hospitals and the Hospitalist,” listened as she talked about including more than just the best medical care in HM’s scope of practice. The job must evolve to include a focus on such social issues as economic stability, neighborhood and physical environment, education, and access to healthy options for food.
In other words, Dr. DeSalvo wondered aloud, what good is treating a grandmother’s heart failure over and over if she’s always going to return to the hospital because her home, her neighborhood, or her finances mean she is unable to prevent recurring health issues? [[{"fid":"195561","view_mode":"medstat_image_flush_left","attributes":{"alt":"Dr. Brian Harte conducts an interveiw with Dr. Karen DeSalvo duing the opening plenary Tuesday at HM17.","height":"147","width":"220","class":"media-element file-medstat-image-flush-left","data-delta":"1"},"fields":{"format":"medstat_image_flush_left","field_file_image_caption[und][0][value]":"Dr. Brian Harte conducts an interview with Dr. Karen DeSalvo during the opening plenary Tuesday at HM17.","field_file_image_credit[und][0][value]":"Darnell Scott","field_file_image_caption[und][0][format]":"plain_text","field_file_image_credit[und][0][format]":"plain_text"},"type":"media","field_deltas":{"1":{"format":"medstat_image_flush_left","field_file_image_caption[und][0][value]":"Dr. Brian Harte conducts an interview with Dr. Karen DeSalvo during the opening plenary Tuesday at HM17.","field_file_image_credit[und][0][value]":"Darnell Scott"}}}]]
Hospitalists “have been at the center of change, not only in building a new field and showing us that medicine doesn’t have to always be the way it always was,” she said. “You have been at the forefront of seeing that we’re getting better value out of our health care system and, though that work must continue, you must also begin to broaden our thinking and understand that the drivers of health are much more than [just] health care. There are social determinants, social factors.”
Dr. DeSalvo, an internist by training, understands that dealing with social issues may seem like a role for others, but she said that the implications of those factors directly impact hospitalists and their institutions via issues such as readmissions.
“These things … don’t just matter conceptually,” she said. “They [have] direct relationships with mortality and morbidity and cost. They are literally affecting people’s lives in this country every day. When we begin to adjust them, to impact them, you can see that it also affects the health care system.”
On the front lines, Dr. DeSalvo said that hospitalists and others can work to take advantage of their hospital’s existing tools to link their patients to available resources, partner with local public health offices, and push to make their hospitals “anchor institutions to build community capacity to address these social determinants.”
Dr. DeSalvo also praised HM as a field that has already embraced value-based payment (VBP) models. She said that ability to anticipate and adapt to health care’s changing needs positions the field well as the Medicare Access and CHIP Reauthorization Act (MACRA) moves health care from fee-for-service to payment models that seek to manage risk and penalize mistakes.
LAS VEGAS – To deliver her message of inclusion Tuesday morning, former acting assistant secretary for health in the U.S. Department of Health and Human Services (HHS) Karen DeSalvo, MD, MPH, MSc, could think of “no finer group” than those assembled before her at HM17.
The thousands of hospitalists gathered to hear her keynote address, “Rethinking Health: The Vital Role of Hospitals and the Hospitalist,” listened as she talked about including more than just the best medical care in HM’s scope of practice. The job must evolve to include a focus on such social issues as economic stability, neighborhood and physical environment, education, and access to healthy options for food.
In other words, Dr. DeSalvo wondered aloud, what good is treating a grandmother’s heart failure over and over if she’s always going to return to the hospital because her home, her neighborhood, or her finances mean she is unable to prevent recurring health issues? [[{"fid":"195561","view_mode":"medstat_image_flush_left","attributes":{"alt":"Dr. Brian Harte conducts an interveiw with Dr. Karen DeSalvo duing the opening plenary Tuesday at HM17.","height":"147","width":"220","class":"media-element file-medstat-image-flush-left","data-delta":"1"},"fields":{"format":"medstat_image_flush_left","field_file_image_caption[und][0][value]":"Dr. Brian Harte conducts an interview with Dr. Karen DeSalvo during the opening plenary Tuesday at HM17.","field_file_image_credit[und][0][value]":"Darnell Scott","field_file_image_caption[und][0][format]":"plain_text","field_file_image_credit[und][0][format]":"plain_text"},"type":"media","field_deltas":{"1":{"format":"medstat_image_flush_left","field_file_image_caption[und][0][value]":"Dr. Brian Harte conducts an interview with Dr. Karen DeSalvo during the opening plenary Tuesday at HM17.","field_file_image_credit[und][0][value]":"Darnell Scott"}}}]]
Hospitalists “have been at the center of change, not only in building a new field and showing us that medicine doesn’t have to always be the way it always was,” she said. “You have been at the forefront of seeing that we’re getting better value out of our health care system and, though that work must continue, you must also begin to broaden our thinking and understand that the drivers of health are much more than [just] health care. There are social determinants, social factors.”
Dr. DeSalvo, an internist by training, understands that dealing with social issues may seem like a role for others, but she said that the implications of those factors directly impact hospitalists and their institutions via issues such as readmissions.
“These things … don’t just matter conceptually,” she said. “They [have] direct relationships with mortality and morbidity and cost. They are literally affecting people’s lives in this country every day. When we begin to adjust them, to impact them, you can see that it also affects the health care system.”
On the front lines, Dr. DeSalvo said that hospitalists and others can work to take advantage of their hospital’s existing tools to link their patients to available resources, partner with local public health offices, and push to make their hospitals “anchor institutions to build community capacity to address these social determinants.”
Dr. DeSalvo also praised HM as a field that has already embraced value-based payment (VBP) models. She said that ability to anticipate and adapt to health care’s changing needs positions the field well as the Medicare Access and CHIP Reauthorization Act (MACRA) moves health care from fee-for-service to payment models that seek to manage risk and penalize mistakes.
Rapid-fire session troubleshoots mechanical ventilation
Troubleshooting problems with mechanical ventilation starts with assessing how much control one has over specific variables, according to an expert at HM17.
“You want to be in charge of everything when you’re dealing with a ventilator, but you have to acknowledge that you only get to be in charge of some stuff,” said Peter Clardy, MD, an assistant professor of medicine at Harvard University in Cambridge, Mass., and its affiliate, Mount Auburn Hospital. He made his remarks during a rapid-fire science session at HM17.
Since successful algorithms for acute mechanical ventilation require control over many independent variables, knowing what is most stable and going from there can allow the physician to develop a workable plan of action, according to Dr. Clardy.
“It’s really good to be explicit about what is dependent and what is independent,” he said. Independent variables might be those specific to the ventilator, but will always include the positive end-expiratory pressure and the fraction of inspired oxygen. Other independent variables will depend on the mode of ventilation – either fully assisted, partially assisted, or noninvasive.
“If you’re in charge of volume, you have to worry about pressure,” he noted. “If you’re in charge of pressure you have to worry about volume.”
Dependent variables also can vary by mode of ventilation. Once the independent and dependent variables are mapped, it is easier to glean more information about the respiratory mechanics of the situation and the physiologic processes, such as the metabolic cost of breathing and whether it can be reduced, what can be done to prevent ventilator-induced lung injury, and how gas exchange can be supported.
Understanding the independent/dependent variable ratio can also help provide valuable clinical information, such as whether reversing hypoxemia and/or hypercarbia is necessary, or if there are signs of respiratory distress or dyspnea. Other clinical indications might include whether there is a need to prevent or reverse atelectasis, or reduce ventilatory muscle fatigue. Additionally, it will be easier to know whether sedation is possible, or if a neuromuscular blockade should be used. Such information can help determine whether to protect the airway.
“Respiratory distress in a patient who is already ventilated is quite common, so having a routinized way to assess these patients and their stability can help you think about what your moves are right there while you’re in the room,” Dr. Clardy explained. “All of that can be incredibly helpful.”
Dr. Clardy had no relevant financial disclosures.
Troubleshooting problems with mechanical ventilation starts with assessing how much control one has over specific variables, according to an expert at HM17.
“You want to be in charge of everything when you’re dealing with a ventilator, but you have to acknowledge that you only get to be in charge of some stuff,” said Peter Clardy, MD, an assistant professor of medicine at Harvard University in Cambridge, Mass., and its affiliate, Mount Auburn Hospital. He made his remarks during a rapid-fire science session at HM17.
Since successful algorithms for acute mechanical ventilation require control over many independent variables, knowing what is most stable and going from there can allow the physician to develop a workable plan of action, according to Dr. Clardy.
“It’s really good to be explicit about what is dependent and what is independent,” he said. Independent variables might be those specific to the ventilator, but will always include the positive end-expiratory pressure and the fraction of inspired oxygen. Other independent variables will depend on the mode of ventilation – either fully assisted, partially assisted, or noninvasive.
“If you’re in charge of volume, you have to worry about pressure,” he noted. “If you’re in charge of pressure you have to worry about volume.”
Dependent variables also can vary by mode of ventilation. Once the independent and dependent variables are mapped, it is easier to glean more information about the respiratory mechanics of the situation and the physiologic processes, such as the metabolic cost of breathing and whether it can be reduced, what can be done to prevent ventilator-induced lung injury, and how gas exchange can be supported.
Understanding the independent/dependent variable ratio can also help provide valuable clinical information, such as whether reversing hypoxemia and/or hypercarbia is necessary, or if there are signs of respiratory distress or dyspnea. Other clinical indications might include whether there is a need to prevent or reverse atelectasis, or reduce ventilatory muscle fatigue. Additionally, it will be easier to know whether sedation is possible, or if a neuromuscular blockade should be used. Such information can help determine whether to protect the airway.
“Respiratory distress in a patient who is already ventilated is quite common, so having a routinized way to assess these patients and their stability can help you think about what your moves are right there while you’re in the room,” Dr. Clardy explained. “All of that can be incredibly helpful.”
Dr. Clardy had no relevant financial disclosures.
Troubleshooting problems with mechanical ventilation starts with assessing how much control one has over specific variables, according to an expert at HM17.
“You want to be in charge of everything when you’re dealing with a ventilator, but you have to acknowledge that you only get to be in charge of some stuff,” said Peter Clardy, MD, an assistant professor of medicine at Harvard University in Cambridge, Mass., and its affiliate, Mount Auburn Hospital. He made his remarks during a rapid-fire science session at HM17.
Since successful algorithms for acute mechanical ventilation require control over many independent variables, knowing what is most stable and going from there can allow the physician to develop a workable plan of action, according to Dr. Clardy.
“It’s really good to be explicit about what is dependent and what is independent,” he said. Independent variables might be those specific to the ventilator, but will always include the positive end-expiratory pressure and the fraction of inspired oxygen. Other independent variables will depend on the mode of ventilation – either fully assisted, partially assisted, or noninvasive.
“If you’re in charge of volume, you have to worry about pressure,” he noted. “If you’re in charge of pressure you have to worry about volume.”
Dependent variables also can vary by mode of ventilation. Once the independent and dependent variables are mapped, it is easier to glean more information about the respiratory mechanics of the situation and the physiologic processes, such as the metabolic cost of breathing and whether it can be reduced, what can be done to prevent ventilator-induced lung injury, and how gas exchange can be supported.
Understanding the independent/dependent variable ratio can also help provide valuable clinical information, such as whether reversing hypoxemia and/or hypercarbia is necessary, or if there are signs of respiratory distress or dyspnea. Other clinical indications might include whether there is a need to prevent or reverse atelectasis, or reduce ventilatory muscle fatigue. Additionally, it will be easier to know whether sedation is possible, or if a neuromuscular blockade should be used. Such information can help determine whether to protect the airway.
“Respiratory distress in a patient who is already ventilated is quite common, so having a routinized way to assess these patients and their stability can help you think about what your moves are right there while you’re in the room,” Dr. Clardy explained. “All of that can be incredibly helpful.”
Dr. Clardy had no relevant financial disclosures.
VIDEO: Advocacy efforts spur CMS to drop HCAHPS pain domain assessment
How pain management is evaluated in the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey is changing, thanks in part to the advocacy efforts of the Society of Hospital Medicine’s public policy committee.
Based on input from SHM and other organizations, the Centers for Medicare & Medicaid Services decided that the way the survey was worded concerning pain management could be leading to unintended consequences, particularly in light of the opioid epidemic.
In a video interview recorded during HM17, John Biebelhausen, MD, MBA, discussed how SHM worked with the CMS to help “improve the HCAHPS survey to make a better patient satisfaction tool for our assessments and also eliminate some of the competing pressures the physician might face.”
Dr. Biebelhausen is a hospitalist and physician lead for quality reporting at Virginia Mason Hospital in Seattle. He had no relevant disclosures.hospitalist and Physician Lead for Quality Reporting.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
How pain management is evaluated in the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey is changing, thanks in part to the advocacy efforts of the Society of Hospital Medicine’s public policy committee.
Based on input from SHM and other organizations, the Centers for Medicare & Medicaid Services decided that the way the survey was worded concerning pain management could be leading to unintended consequences, particularly in light of the opioid epidemic.
In a video interview recorded during HM17, John Biebelhausen, MD, MBA, discussed how SHM worked with the CMS to help “improve the HCAHPS survey to make a better patient satisfaction tool for our assessments and also eliminate some of the competing pressures the physician might face.”
Dr. Biebelhausen is a hospitalist and physician lead for quality reporting at Virginia Mason Hospital in Seattle. He had no relevant disclosures.hospitalist and Physician Lead for Quality Reporting.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
How pain management is evaluated in the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey is changing, thanks in part to the advocacy efforts of the Society of Hospital Medicine’s public policy committee.
Based on input from SHM and other organizations, the Centers for Medicare & Medicaid Services decided that the way the survey was worded concerning pain management could be leading to unintended consequences, particularly in light of the opioid epidemic.
In a video interview recorded during HM17, John Biebelhausen, MD, MBA, discussed how SHM worked with the CMS to help “improve the HCAHPS survey to make a better patient satisfaction tool for our assessments and also eliminate some of the competing pressures the physician might face.”
Dr. Biebelhausen is a hospitalist and physician lead for quality reporting at Virginia Mason Hospital in Seattle. He had no relevant disclosures.hospitalist and Physician Lead for Quality Reporting.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
On the big stage, SHM leaders discuss pressing issues
When Society of Hospital Medicine president Brian Harte, MD, SFHM, made remarks last year as president-elect, he outlined four areas that call for attention and action.
On Tuesday, as the outgoing president making remarks at the opening plenary session, he traced the progress in those areas, while also airing some concerns as the society moves forward.
On the “absolute necessity” for SHM to reach out and connect with all practicing hospitalists, he reported that the society continued to expand its footprint, making contact with 50,000 hospitalists.
“SHM continues to be a strong professional organization,” Dr. Harte said, noting how the society cleared the 15,000 mark in membership last year. He also emphasized the “big tent” concept – making SHM the home for practitioners in many disciplines – and the importance of leadership.
“Sometimes it feels like everyone thinks of themselves as someone that we have to report to and therefore leadership development continues to be an important driver for our activities,” said Dr. Harte, president of Cleveland Clinic’s Akron General Hospital.
On the need to continue to focus on patient and family-centered care, he said, the curriculum at this meeting and past meetings shows a recognition of how important communication and empathy are.
“By doing so, we support a culture and environment wherein patients and families can actively participate in their care,” he said.
On being involved in shaping the changing healthcare landscape, the SHM board last fall held a retreat with hospitalist leaders to outline a framework for SHM to take advantage of members’ experience and expertise in this effort. The society is also working with the American College of Surgeons on designing an alternative payment model that could be more favorable for hospitals and hospitalists.
On the push for recognition of the hospitalist specialty, the new C6 Medicare billing code for hospitalists was a big step forward.
There are also some “things that keep me up at night,” he said.
“Having to prove our value continuously is absolutely essential, and it worries me that we may not always have this at the fore of our minds,” he said. Things that help him “get back to sleep,” he said, are the youthfulness and forward-thinking nature of hospitalists and the strength of the society.
“While respecting our past,” Dr. Harte said, “we can only be successful in moving forward if we refuse to be too beholden to it.”
President-elect Ron Greeno, MD, MHM, senior adviser for medical affairs at Team Health, in brief remarks, reminded the audience about how hospital medicine itself was a reform intended to deliver better care at lower prices, and that it therefore makes perfect sense for hospitalists to be involved in this latest wave of reform.
He made an enthusiastic call for more hospitalists to be involved.
“We need more – this is a big challenge,” he said. “At the end of the day, it’s going to take more than us knowing how to take care of patients at the bedside. We have to get involved in designing the new delivery system if we’re going to make sure that we actually have a say in the kind of care that our patients get.”
When Society of Hospital Medicine president Brian Harte, MD, SFHM, made remarks last year as president-elect, he outlined four areas that call for attention and action.
On Tuesday, as the outgoing president making remarks at the opening plenary session, he traced the progress in those areas, while also airing some concerns as the society moves forward.
On the “absolute necessity” for SHM to reach out and connect with all practicing hospitalists, he reported that the society continued to expand its footprint, making contact with 50,000 hospitalists.
“SHM continues to be a strong professional organization,” Dr. Harte said, noting how the society cleared the 15,000 mark in membership last year. He also emphasized the “big tent” concept – making SHM the home for practitioners in many disciplines – and the importance of leadership.
“Sometimes it feels like everyone thinks of themselves as someone that we have to report to and therefore leadership development continues to be an important driver for our activities,” said Dr. Harte, president of Cleveland Clinic’s Akron General Hospital.
On the need to continue to focus on patient and family-centered care, he said, the curriculum at this meeting and past meetings shows a recognition of how important communication and empathy are.
“By doing so, we support a culture and environment wherein patients and families can actively participate in their care,” he said.
On being involved in shaping the changing healthcare landscape, the SHM board last fall held a retreat with hospitalist leaders to outline a framework for SHM to take advantage of members’ experience and expertise in this effort. The society is also working with the American College of Surgeons on designing an alternative payment model that could be more favorable for hospitals and hospitalists.
On the push for recognition of the hospitalist specialty, the new C6 Medicare billing code for hospitalists was a big step forward.
There are also some “things that keep me up at night,” he said.
“Having to prove our value continuously is absolutely essential, and it worries me that we may not always have this at the fore of our minds,” he said. Things that help him “get back to sleep,” he said, are the youthfulness and forward-thinking nature of hospitalists and the strength of the society.
“While respecting our past,” Dr. Harte said, “we can only be successful in moving forward if we refuse to be too beholden to it.”
President-elect Ron Greeno, MD, MHM, senior adviser for medical affairs at Team Health, in brief remarks, reminded the audience about how hospital medicine itself was a reform intended to deliver better care at lower prices, and that it therefore makes perfect sense for hospitalists to be involved in this latest wave of reform.
He made an enthusiastic call for more hospitalists to be involved.
“We need more – this is a big challenge,” he said. “At the end of the day, it’s going to take more than us knowing how to take care of patients at the bedside. We have to get involved in designing the new delivery system if we’re going to make sure that we actually have a say in the kind of care that our patients get.”
When Society of Hospital Medicine president Brian Harte, MD, SFHM, made remarks last year as president-elect, he outlined four areas that call for attention and action.
On Tuesday, as the outgoing president making remarks at the opening plenary session, he traced the progress in those areas, while also airing some concerns as the society moves forward.
On the “absolute necessity” for SHM to reach out and connect with all practicing hospitalists, he reported that the society continued to expand its footprint, making contact with 50,000 hospitalists.
“SHM continues to be a strong professional organization,” Dr. Harte said, noting how the society cleared the 15,000 mark in membership last year. He also emphasized the “big tent” concept – making SHM the home for practitioners in many disciplines – and the importance of leadership.
“Sometimes it feels like everyone thinks of themselves as someone that we have to report to and therefore leadership development continues to be an important driver for our activities,” said Dr. Harte, president of Cleveland Clinic’s Akron General Hospital.
On the need to continue to focus on patient and family-centered care, he said, the curriculum at this meeting and past meetings shows a recognition of how important communication and empathy are.
“By doing so, we support a culture and environment wherein patients and families can actively participate in their care,” he said.
On being involved in shaping the changing healthcare landscape, the SHM board last fall held a retreat with hospitalist leaders to outline a framework for SHM to take advantage of members’ experience and expertise in this effort. The society is also working with the American College of Surgeons on designing an alternative payment model that could be more favorable for hospitals and hospitalists.
On the push for recognition of the hospitalist specialty, the new C6 Medicare billing code for hospitalists was a big step forward.
There are also some “things that keep me up at night,” he said.
“Having to prove our value continuously is absolutely essential, and it worries me that we may not always have this at the fore of our minds,” he said. Things that help him “get back to sleep,” he said, are the youthfulness and forward-thinking nature of hospitalists and the strength of the society.
“While respecting our past,” Dr. Harte said, “we can only be successful in moving forward if we refuse to be too beholden to it.”
President-elect Ron Greeno, MD, MHM, senior adviser for medical affairs at Team Health, in brief remarks, reminded the audience about how hospital medicine itself was a reform intended to deliver better care at lower prices, and that it therefore makes perfect sense for hospitalists to be involved in this latest wave of reform.
He made an enthusiastic call for more hospitalists to be involved.
“We need more – this is a big challenge,” he said. “At the end of the day, it’s going to take more than us knowing how to take care of patients at the bedside. We have to get involved in designing the new delivery system if we’re going to make sure that we actually have a say in the kind of care that our patients get.”
VIDEO: Low-tech system tweaks help hospitalists minimize workflow disruptions
What are some of the most common interruptions physicians face, and what simple solutions exist to help minimize the breaks in workflow?
Physicians are interrupted, on average, 15 times an hour, according to Roberta Himebaugh, a senior vice president at TeamHealth in Pleasanton, Calif., but as she explains in this video recorded at HM17, there are some simple, low-tech – and other – solutions that health systems can use to help hospitalists streamline workflow.
What are some of the most common interruptions physicians face, and what simple solutions exist to help minimize the breaks in workflow?
Physicians are interrupted, on average, 15 times an hour, according to Roberta Himebaugh, a senior vice president at TeamHealth in Pleasanton, Calif., but as she explains in this video recorded at HM17, there are some simple, low-tech – and other – solutions that health systems can use to help hospitalists streamline workflow.
What are some of the most common interruptions physicians face, and what simple solutions exist to help minimize the breaks in workflow?
Physicians are interrupted, on average, 15 times an hour, according to Roberta Himebaugh, a senior vice president at TeamHealth in Pleasanton, Calif., but as she explains in this video recorded at HM17, there are some simple, low-tech – and other – solutions that health systems can use to help hospitalists streamline workflow.
Novel med-rec program keys on timely, accurate patient histories
A novel medication reconciliation program that hospitalists might adopt in their own centers will be featured Wednesday during a 4:15 p.m. session, “Medication Reconciliation Implementation: A Hospital Case.”
Dr. Shabbir’s hospital was one of six that participated in the nationwide Multi-Center Medication Reconciliation Quality Improvement Study (MARQUIS), an effort to develop a more accurate and safe med-rec process when patients enter and leave the hospital. Among other interventions, the hospitals employed pharmacy technicians in the newly created role of “medication reconciliation assistants,” responsible for taking a best possible medication history. These technicians had expertise in recognizing frequently prescribed pills and verified patient medication lists with at least two sources (i.e., local pharmacies, nursing homes, doctor’s offices). They entered the information in patients’ electronic health records and, if they noticed discrepancies, alerted the hospitalist attending.
The service “gave me, as a physician, a sigh of relief and a confidence in that history,” Dr. Shabbir said, noting that it also saved time. “In the age of polypharmacy and medication complexity, this is really new work that we didn’t have anybody to do until we had this program.”
A med-rec assistant program is worth considering, Dr. Shabbir said, as it has “the potential to impact the quadruple aim – patient outcomes, patient experience, joy in work, and lower costs.”
“Hospitalists may not appreciate the extent to which quality is often lacking in medication reconciliation,” he said. “We will teach hospitalists how to make a case for a good medication reconciliation program at their own medical centers. Not having a good history as a hospitalist – and trying to obtain it when a patient is moved up to the floor [and] the family has left with the medications, if they even were brought in – and having out-of-date medication lists is really troubling. This is something that affects anyone who’s admitting, following, or discharging a patient.
“It’s a big deal. This program perhaps will give some ideas and guidance. Hopefully, if it’s replicated, it can prevent harm to patients. There’s a very compelling case to be made for these programs from a business point of view.”
Medication Reconciliation Implementation: A Hospital Case
Wednesday, 4:15–5:20 p.m.
A novel medication reconciliation program that hospitalists might adopt in their own centers will be featured Wednesday during a 4:15 p.m. session, “Medication Reconciliation Implementation: A Hospital Case.”
Dr. Shabbir’s hospital was one of six that participated in the nationwide Multi-Center Medication Reconciliation Quality Improvement Study (MARQUIS), an effort to develop a more accurate and safe med-rec process when patients enter and leave the hospital. Among other interventions, the hospitals employed pharmacy technicians in the newly created role of “medication reconciliation assistants,” responsible for taking a best possible medication history. These technicians had expertise in recognizing frequently prescribed pills and verified patient medication lists with at least two sources (i.e., local pharmacies, nursing homes, doctor’s offices). They entered the information in patients’ electronic health records and, if they noticed discrepancies, alerted the hospitalist attending.
The service “gave me, as a physician, a sigh of relief and a confidence in that history,” Dr. Shabbir said, noting that it also saved time. “In the age of polypharmacy and medication complexity, this is really new work that we didn’t have anybody to do until we had this program.”
A med-rec assistant program is worth considering, Dr. Shabbir said, as it has “the potential to impact the quadruple aim – patient outcomes, patient experience, joy in work, and lower costs.”
“Hospitalists may not appreciate the extent to which quality is often lacking in medication reconciliation,” he said. “We will teach hospitalists how to make a case for a good medication reconciliation program at their own medical centers. Not having a good history as a hospitalist – and trying to obtain it when a patient is moved up to the floor [and] the family has left with the medications, if they even were brought in – and having out-of-date medication lists is really troubling. This is something that affects anyone who’s admitting, following, or discharging a patient.
“It’s a big deal. This program perhaps will give some ideas and guidance. Hopefully, if it’s replicated, it can prevent harm to patients. There’s a very compelling case to be made for these programs from a business point of view.”
Medication Reconciliation Implementation: A Hospital Case
Wednesday, 4:15–5:20 p.m.
A novel medication reconciliation program that hospitalists might adopt in their own centers will be featured Wednesday during a 4:15 p.m. session, “Medication Reconciliation Implementation: A Hospital Case.”
Dr. Shabbir’s hospital was one of six that participated in the nationwide Multi-Center Medication Reconciliation Quality Improvement Study (MARQUIS), an effort to develop a more accurate and safe med-rec process when patients enter and leave the hospital. Among other interventions, the hospitals employed pharmacy technicians in the newly created role of “medication reconciliation assistants,” responsible for taking a best possible medication history. These technicians had expertise in recognizing frequently prescribed pills and verified patient medication lists with at least two sources (i.e., local pharmacies, nursing homes, doctor’s offices). They entered the information in patients’ electronic health records and, if they noticed discrepancies, alerted the hospitalist attending.
The service “gave me, as a physician, a sigh of relief and a confidence in that history,” Dr. Shabbir said, noting that it also saved time. “In the age of polypharmacy and medication complexity, this is really new work that we didn’t have anybody to do until we had this program.”
A med-rec assistant program is worth considering, Dr. Shabbir said, as it has “the potential to impact the quadruple aim – patient outcomes, patient experience, joy in work, and lower costs.”
“Hospitalists may not appreciate the extent to which quality is often lacking in medication reconciliation,” he said. “We will teach hospitalists how to make a case for a good medication reconciliation program at their own medical centers. Not having a good history as a hospitalist – and trying to obtain it when a patient is moved up to the floor [and] the family has left with the medications, if they even were brought in – and having out-of-date medication lists is really troubling. This is something that affects anyone who’s admitting, following, or discharging a patient.
“It’s a big deal. This program perhaps will give some ideas and guidance. Hopefully, if it’s replicated, it can prevent harm to patients. There’s a very compelling case to be made for these programs from a business point of view.”
Medication Reconciliation Implementation: A Hospital Case
Wednesday, 4:15–5:20 p.m.
Exploring issues at academic centers affiliated with HM
How hospitalists at community hospitals can leverage resources from their larger, affiliated academic centers will be discussed Wednesday at 4:20 p.m. at “Hospitalists Affiliated with Academic Centers: Challenges & How to Address Them.”
“In a lot of community hospitals, pediatric units tend to be fairly small,” said copresenter James O’Callaghan, MD, FAAP, SFHM, lead pediatric hospitalist at a community hospital affiliated with Seattle Children’s Hospital. “You may feel you’re a little bit isolated from the main center and a very small piece of the pie. There are sometimes difficulties getting resources or quality work done, partly because, at a community site, you can’t justify spending money for QI [quality improvement] resources or helping the pediatric unit do chart review when they’ve got much bigger fish to fry in the adult world.”
During a bed crunch at the main hospital over the winter, he and his colleagues worked to accept some patients from the main hospital because the community site had some open beds.
“It was a win-win arrangement,” he said. “The community site got more patients and filled more beds, and the main hospital was able to free up beds for more patients who were postsurgical or acutely ill.”
The talk also will explore benefits such as resources, academic research experience, and the potential to recruit skilled professionals. Dr. Alvarez said, “Affiliated community-based pediatric hospitalist programs have a significant resource advantage for quality and safety initiatives, stemming from the direct affiliation with their tertiary institution that they can use to make significant care improvement within their community.”
“If you are at a single community-based hospital without any larger affiliation, the challenges are bigger because you don’t have extra resources to draw on,” he said.
Community Hospitalists Affiliated with Academic Centers: Challenges & How to Address Them
Wednesday, 4:20–5:20 p.m.
Available via HM17 On Demand
How hospitalists at community hospitals can leverage resources from their larger, affiliated academic centers will be discussed Wednesday at 4:20 p.m. at “Hospitalists Affiliated with Academic Centers: Challenges & How to Address Them.”
“In a lot of community hospitals, pediatric units tend to be fairly small,” said copresenter James O’Callaghan, MD, FAAP, SFHM, lead pediatric hospitalist at a community hospital affiliated with Seattle Children’s Hospital. “You may feel you’re a little bit isolated from the main center and a very small piece of the pie. There are sometimes difficulties getting resources or quality work done, partly because, at a community site, you can’t justify spending money for QI [quality improvement] resources or helping the pediatric unit do chart review when they’ve got much bigger fish to fry in the adult world.”
During a bed crunch at the main hospital over the winter, he and his colleagues worked to accept some patients from the main hospital because the community site had some open beds.
“It was a win-win arrangement,” he said. “The community site got more patients and filled more beds, and the main hospital was able to free up beds for more patients who were postsurgical or acutely ill.”
The talk also will explore benefits such as resources, academic research experience, and the potential to recruit skilled professionals. Dr. Alvarez said, “Affiliated community-based pediatric hospitalist programs have a significant resource advantage for quality and safety initiatives, stemming from the direct affiliation with their tertiary institution that they can use to make significant care improvement within their community.”
“If you are at a single community-based hospital without any larger affiliation, the challenges are bigger because you don’t have extra resources to draw on,” he said.
Community Hospitalists Affiliated with Academic Centers: Challenges & How to Address Them
Wednesday, 4:20–5:20 p.m.
Available via HM17 On Demand
How hospitalists at community hospitals can leverage resources from their larger, affiliated academic centers will be discussed Wednesday at 4:20 p.m. at “Hospitalists Affiliated with Academic Centers: Challenges & How to Address Them.”
“In a lot of community hospitals, pediatric units tend to be fairly small,” said copresenter James O’Callaghan, MD, FAAP, SFHM, lead pediatric hospitalist at a community hospital affiliated with Seattle Children’s Hospital. “You may feel you’re a little bit isolated from the main center and a very small piece of the pie. There are sometimes difficulties getting resources or quality work done, partly because, at a community site, you can’t justify spending money for QI [quality improvement] resources or helping the pediatric unit do chart review when they’ve got much bigger fish to fry in the adult world.”
During a bed crunch at the main hospital over the winter, he and his colleagues worked to accept some patients from the main hospital because the community site had some open beds.
“It was a win-win arrangement,” he said. “The community site got more patients and filled more beds, and the main hospital was able to free up beds for more patients who were postsurgical or acutely ill.”
The talk also will explore benefits such as resources, academic research experience, and the potential to recruit skilled professionals. Dr. Alvarez said, “Affiliated community-based pediatric hospitalist programs have a significant resource advantage for quality and safety initiatives, stemming from the direct affiliation with their tertiary institution that they can use to make significant care improvement within their community.”
“If you are at a single community-based hospital without any larger affiliation, the challenges are bigger because you don’t have extra resources to draw on,” he said.
Community Hospitalists Affiliated with Academic Centers: Challenges & How to Address Them
Wednesday, 4:20–5:20 p.m.
Available via HM17 On Demand