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Building a better SHM
As we enter the holiday season, the Society of Hospital Medicine is preparing to unwrap a refreshed experience for all members and partners.
Next month, SHM will launch its new association management system (AMS), its new online community platform for the Hospital Medicine Exchange (HMX), and a brand new website to better serve the needs of its constituents.
While many may be unaware of the systems and platforms SHM currently uses, an AMS is essentially SHM’s EHR for its members. It houses each member’s information, so the more information SHM has, the more SHM can customize the types of information you receive. All systems will be integrated so you can quickly access information on the chapter, interest group, or committee to which you belong.
What does this mean to you?
• You’ll be prompted to create a new password for your SHM account. When you set up your new password, we urge you to update your profile to make sure your information is current and that you are receiving content that is most relevant to you.
• As you update your profile, you will have an opportunity to edit your email preferences. If you have previously opted out of SHM emails, we urge you to opt back in to receive information on your local chapter meetings and more targeted messages about SHM offerings tailored specifically to your interests.
• The SHM website, www.hospitalmedicine.org, will be optimized for your smartphone and tablet and have a fresh look and feel on all devices, complete with new, intuitive navigation and streamlined content – making it easier for you to find the information that is the most relevant for you in even less time.
• The Hospital Medicine Exchange (HMX) will move to an intuitive new platform to enhance your online discussions and group collaborations, including chapters, interest groups, committees, and more.
In addition to these technological enhancements, watch for a refreshed design of The Hospitalist, the Journal of Hospital Medicine, and the overall SHM brand to bring a refined, sleek look to all SHM-related products, programs, and communications.
We look forward to better serving the needs of our members and partners with these improvements and encourage you to share your thoughts at [email protected].
Mr. Radler is marketing communications manager at the Society of Hospital Medicine.
As we enter the holiday season, the Society of Hospital Medicine is preparing to unwrap a refreshed experience for all members and partners.
Next month, SHM will launch its new association management system (AMS), its new online community platform for the Hospital Medicine Exchange (HMX), and a brand new website to better serve the needs of its constituents.
While many may be unaware of the systems and platforms SHM currently uses, an AMS is essentially SHM’s EHR for its members. It houses each member’s information, so the more information SHM has, the more SHM can customize the types of information you receive. All systems will be integrated so you can quickly access information on the chapter, interest group, or committee to which you belong.
What does this mean to you?
• You’ll be prompted to create a new password for your SHM account. When you set up your new password, we urge you to update your profile to make sure your information is current and that you are receiving content that is most relevant to you.
• As you update your profile, you will have an opportunity to edit your email preferences. If you have previously opted out of SHM emails, we urge you to opt back in to receive information on your local chapter meetings and more targeted messages about SHM offerings tailored specifically to your interests.
• The SHM website, www.hospitalmedicine.org, will be optimized for your smartphone and tablet and have a fresh look and feel on all devices, complete with new, intuitive navigation and streamlined content – making it easier for you to find the information that is the most relevant for you in even less time.
• The Hospital Medicine Exchange (HMX) will move to an intuitive new platform to enhance your online discussions and group collaborations, including chapters, interest groups, committees, and more.
In addition to these technological enhancements, watch for a refreshed design of The Hospitalist, the Journal of Hospital Medicine, and the overall SHM brand to bring a refined, sleek look to all SHM-related products, programs, and communications.
We look forward to better serving the needs of our members and partners with these improvements and encourage you to share your thoughts at [email protected].
Mr. Radler is marketing communications manager at the Society of Hospital Medicine.
As we enter the holiday season, the Society of Hospital Medicine is preparing to unwrap a refreshed experience for all members and partners.
Next month, SHM will launch its new association management system (AMS), its new online community platform for the Hospital Medicine Exchange (HMX), and a brand new website to better serve the needs of its constituents.
While many may be unaware of the systems and platforms SHM currently uses, an AMS is essentially SHM’s EHR for its members. It houses each member’s information, so the more information SHM has, the more SHM can customize the types of information you receive. All systems will be integrated so you can quickly access information on the chapter, interest group, or committee to which you belong.
What does this mean to you?
• You’ll be prompted to create a new password for your SHM account. When you set up your new password, we urge you to update your profile to make sure your information is current and that you are receiving content that is most relevant to you.
• As you update your profile, you will have an opportunity to edit your email preferences. If you have previously opted out of SHM emails, we urge you to opt back in to receive information on your local chapter meetings and more targeted messages about SHM offerings tailored specifically to your interests.
• The SHM website, www.hospitalmedicine.org, will be optimized for your smartphone and tablet and have a fresh look and feel on all devices, complete with new, intuitive navigation and streamlined content – making it easier for you to find the information that is the most relevant for you in even less time.
• The Hospital Medicine Exchange (HMX) will move to an intuitive new platform to enhance your online discussions and group collaborations, including chapters, interest groups, committees, and more.
In addition to these technological enhancements, watch for a refreshed design of The Hospitalist, the Journal of Hospital Medicine, and the overall SHM brand to bring a refined, sleek look to all SHM-related products, programs, and communications.
We look forward to better serving the needs of our members and partners with these improvements and encourage you to share your thoughts at [email protected].
Mr. Radler is marketing communications manager at the Society of Hospital Medicine.
Different perspectives on the care delivery process
Editor’s note: The Society of Hospital Medicine’s (SHM’s) Physician in Training Committee launched a scholarship program in 2015 for medical students to help transform health care and revolutionize patient care. The program has been expanded for the 2017-18 year, offering two options for students to receive funding and engage in scholarly work during their first, second and third years of medical school. As a part of the longitudinal (18-month) program, recipients are required to write about their experience on a monthly basis.
Last month I was able to conduct five interviews with key stakeholders, generate the patient flow diagram, define the problems, and propose potential interventions. The project is on time for the allotted time frame.
Interviewees include physicians and managers from infectious disease, hospital medicine, psychiatry and care management. They represent the services which admitted IVDU patients have contacts with: inpatient primary team, inpatient ID consult time, BIT (behavior intervention team), and OPAT (Outpatient Parenteral Antibiotic Therapy) program. I asked each interviewee about the specific challenges of care delivery during the inpatient, discharge, and outpatient follow up process.
It is not surprising that most would agree that discharge was the most difficult part. The ID service showed me data that those with IVDU history may have a one-time longer length of stay compared to the average. The social-psychological issues, including medication compliance, insurance coverage, and mental health comorbidities, are the most commonly mentioned factor for delayed discharge.
When asked about a suggestion for a particular area for quality improvement, different services came up with different recommendations. ID suggested looking at availability of community resources and improving patients’ access to them. Psychiatry has been trying to screen all admitted patients for substance use disorders, with an intention of early intervention. Hospital medicine and care management were contemplating the potential means for a repatriation program, i.e., making the transferring acute care facility agree to receive patients back once tertiary care was complete. Given that Dartmouth-Hitchcock Medical Center has a few satellite community hospitals, it would make sense to establish some institutional protocol to optimize patient flow within the system.
My next step would be to pursue one or two areas for improvement from the above options. I will work with the relevant stakeholders to define the problems and come up with a plan. I am excited about moving forward to the next phase.
My research approach has changed slightly during the process. Initially I was narrowly focused on the desired outcomes of decreasing length of stay and readmission rate. Dr. Huntington challenged me to understand the whole process thoroughly as well as to spend time on defining the problems before diving into interventions. I enjoyed my role of being a learner, researcher, and consultant in this project. I gained a very in-depth perspective on how each service operates and coordinates. Also, it is both challenging and fun to coming up with an improvement plan. In my future residency and physician career, I am definitely going to pursue more care improvement initiatives.
Yun Li is an MD/MBA student attending Geisel School of Medicine and Tuck School of Business at Dartmouth. She obtained her Bachelor of Arts degree from Hanover College double-majoring in Economics and Biological Chemistry. Ms. Li participated in research in injury epidemiology and genetics, and has conducted studies on traditional Tibetan medicine, rural health, health NGOs, and digital health. Her career interest is practicing hospital medicine and geriatrics as a clinician/administrator, either in the US or China. Ms. Li is a student member of the Society of Hospital Medicine.
Editor’s note: The Society of Hospital Medicine’s (SHM’s) Physician in Training Committee launched a scholarship program in 2015 for medical students to help transform health care and revolutionize patient care. The program has been expanded for the 2017-18 year, offering two options for students to receive funding and engage in scholarly work during their first, second and third years of medical school. As a part of the longitudinal (18-month) program, recipients are required to write about their experience on a monthly basis.
Last month I was able to conduct five interviews with key stakeholders, generate the patient flow diagram, define the problems, and propose potential interventions. The project is on time for the allotted time frame.
Interviewees include physicians and managers from infectious disease, hospital medicine, psychiatry and care management. They represent the services which admitted IVDU patients have contacts with: inpatient primary team, inpatient ID consult time, BIT (behavior intervention team), and OPAT (Outpatient Parenteral Antibiotic Therapy) program. I asked each interviewee about the specific challenges of care delivery during the inpatient, discharge, and outpatient follow up process.
It is not surprising that most would agree that discharge was the most difficult part. The ID service showed me data that those with IVDU history may have a one-time longer length of stay compared to the average. The social-psychological issues, including medication compliance, insurance coverage, and mental health comorbidities, are the most commonly mentioned factor for delayed discharge.
When asked about a suggestion for a particular area for quality improvement, different services came up with different recommendations. ID suggested looking at availability of community resources and improving patients’ access to them. Psychiatry has been trying to screen all admitted patients for substance use disorders, with an intention of early intervention. Hospital medicine and care management were contemplating the potential means for a repatriation program, i.e., making the transferring acute care facility agree to receive patients back once tertiary care was complete. Given that Dartmouth-Hitchcock Medical Center has a few satellite community hospitals, it would make sense to establish some institutional protocol to optimize patient flow within the system.
My next step would be to pursue one or two areas for improvement from the above options. I will work with the relevant stakeholders to define the problems and come up with a plan. I am excited about moving forward to the next phase.
My research approach has changed slightly during the process. Initially I was narrowly focused on the desired outcomes of decreasing length of stay and readmission rate. Dr. Huntington challenged me to understand the whole process thoroughly as well as to spend time on defining the problems before diving into interventions. I enjoyed my role of being a learner, researcher, and consultant in this project. I gained a very in-depth perspective on how each service operates and coordinates. Also, it is both challenging and fun to coming up with an improvement plan. In my future residency and physician career, I am definitely going to pursue more care improvement initiatives.
Yun Li is an MD/MBA student attending Geisel School of Medicine and Tuck School of Business at Dartmouth. She obtained her Bachelor of Arts degree from Hanover College double-majoring in Economics and Biological Chemistry. Ms. Li participated in research in injury epidemiology and genetics, and has conducted studies on traditional Tibetan medicine, rural health, health NGOs, and digital health. Her career interest is practicing hospital medicine and geriatrics as a clinician/administrator, either in the US or China. Ms. Li is a student member of the Society of Hospital Medicine.
Editor’s note: The Society of Hospital Medicine’s (SHM’s) Physician in Training Committee launched a scholarship program in 2015 for medical students to help transform health care and revolutionize patient care. The program has been expanded for the 2017-18 year, offering two options for students to receive funding and engage in scholarly work during their first, second and third years of medical school. As a part of the longitudinal (18-month) program, recipients are required to write about their experience on a monthly basis.
Last month I was able to conduct five interviews with key stakeholders, generate the patient flow diagram, define the problems, and propose potential interventions. The project is on time for the allotted time frame.
Interviewees include physicians and managers from infectious disease, hospital medicine, psychiatry and care management. They represent the services which admitted IVDU patients have contacts with: inpatient primary team, inpatient ID consult time, BIT (behavior intervention team), and OPAT (Outpatient Parenteral Antibiotic Therapy) program. I asked each interviewee about the specific challenges of care delivery during the inpatient, discharge, and outpatient follow up process.
It is not surprising that most would agree that discharge was the most difficult part. The ID service showed me data that those with IVDU history may have a one-time longer length of stay compared to the average. The social-psychological issues, including medication compliance, insurance coverage, and mental health comorbidities, are the most commonly mentioned factor for delayed discharge.
When asked about a suggestion for a particular area for quality improvement, different services came up with different recommendations. ID suggested looking at availability of community resources and improving patients’ access to them. Psychiatry has been trying to screen all admitted patients for substance use disorders, with an intention of early intervention. Hospital medicine and care management were contemplating the potential means for a repatriation program, i.e., making the transferring acute care facility agree to receive patients back once tertiary care was complete. Given that Dartmouth-Hitchcock Medical Center has a few satellite community hospitals, it would make sense to establish some institutional protocol to optimize patient flow within the system.
My next step would be to pursue one or two areas for improvement from the above options. I will work with the relevant stakeholders to define the problems and come up with a plan. I am excited about moving forward to the next phase.
My research approach has changed slightly during the process. Initially I was narrowly focused on the desired outcomes of decreasing length of stay and readmission rate. Dr. Huntington challenged me to understand the whole process thoroughly as well as to spend time on defining the problems before diving into interventions. I enjoyed my role of being a learner, researcher, and consultant in this project. I gained a very in-depth perspective on how each service operates and coordinates. Also, it is both challenging and fun to coming up with an improvement plan. In my future residency and physician career, I am definitely going to pursue more care improvement initiatives.
Yun Li is an MD/MBA student attending Geisel School of Medicine and Tuck School of Business at Dartmouth. She obtained her Bachelor of Arts degree from Hanover College double-majoring in Economics and Biological Chemistry. Ms. Li participated in research in injury epidemiology and genetics, and has conducted studies on traditional Tibetan medicine, rural health, health NGOs, and digital health. Her career interest is practicing hospital medicine and geriatrics as a clinician/administrator, either in the US or China. Ms. Li is a student member of the Society of Hospital Medicine.
Transition in care from the MICU to the ward
Editor’s Note: The Society of Hospital Medicine’s (SHM’s) Physician in Training Committee launched a scholarship program in 2015 for medical students to help transform healthcare and revolutionize patient care. The program has been expanded for the 2017-18 year, offering two options for students to receive funding and engage in scholarly work during their first, second and third years of medical school. As a part of the program, recipients are required to write about their experience on a biweekly basis.
This summer, my research project focused on the highly vulnerable patients who are transferred from the medical intensive care unit to the general floor. Patients who are readmitted tend to have worse health outcomes, longer stays, higher mortality rates, and higher health care costs. Previous research shows that higher quality handoffs, where receiving and transferring providers share the same shared mental model, result in better outcomes. We were interested in learning whether these shared mental models are being formed as a result of handoffs between the ward and the MICU.
After surveying providers this summer, and using data from past surveys, we have been able to make headway codifying the level of concordance between providers. We asked ward and MICU providers what they thought was the most important component of care in regards to the care of their patient while they are on the general floor. We focused on two levels of agreement in the handoff: intra-team agreement within the MICU team, and inter-team agreement between the MICU team and the ward. We coded intra-team agreement within the categories of “Complete,” “Strong,” “Weak,” and “No” agreement based on a random sampling of 40 unique patient encounters determined in meetings with Dr. Vineet Arora, Dr. Juan Rojas, Dr. Julie Neborak, and me. Due to a variable number of responses from providers on either side, we also coded the inter-team responses as “Full,” “Partial,” and “No” in order to determine the amount of concordance between teams.
The current results reveal that 18% of MICU teams shared a complete mental model, 25% shared a strong shared mental model, 9% shared a weak mental model, 30% shared no mental model, and 18% of patient encounters did not have a sufficient number of MICU respondents. Regarding inter-team communication, 7% shared a full shared mental model, 49% shared a partial mental model, 30% shared no shared mental model, and 14% of unique patient encounters did not have enough respondents.
With complex patient cases, it can be difficult to identify the most important factor of care for a particular patient. However, I think this information would be very useful in identifying whether these exchanges result in individuals prioritizing the same factor of care for their respective patient. I think this information would be very useful in future quality improvement, and seeing whether this communication results in the formation of shared mental models.
Anton Garazha is a medical student at Chicago Medical School at Rosalind Franklin University in North Chicago. He received his bachelor of science degree in biology from Loyola University in Chicago in 2015 and his master of biomedical science degree from Rosalind Franklin University in 2016. Anton is very interested in community outreach and quality improvement, and in his spare time tutors students in science-based subjects.
Editor’s Note: The Society of Hospital Medicine’s (SHM’s) Physician in Training Committee launched a scholarship program in 2015 for medical students to help transform healthcare and revolutionize patient care. The program has been expanded for the 2017-18 year, offering two options for students to receive funding and engage in scholarly work during their first, second and third years of medical school. As a part of the program, recipients are required to write about their experience on a biweekly basis.
This summer, my research project focused on the highly vulnerable patients who are transferred from the medical intensive care unit to the general floor. Patients who are readmitted tend to have worse health outcomes, longer stays, higher mortality rates, and higher health care costs. Previous research shows that higher quality handoffs, where receiving and transferring providers share the same shared mental model, result in better outcomes. We were interested in learning whether these shared mental models are being formed as a result of handoffs between the ward and the MICU.
After surveying providers this summer, and using data from past surveys, we have been able to make headway codifying the level of concordance between providers. We asked ward and MICU providers what they thought was the most important component of care in regards to the care of their patient while they are on the general floor. We focused on two levels of agreement in the handoff: intra-team agreement within the MICU team, and inter-team agreement between the MICU team and the ward. We coded intra-team agreement within the categories of “Complete,” “Strong,” “Weak,” and “No” agreement based on a random sampling of 40 unique patient encounters determined in meetings with Dr. Vineet Arora, Dr. Juan Rojas, Dr. Julie Neborak, and me. Due to a variable number of responses from providers on either side, we also coded the inter-team responses as “Full,” “Partial,” and “No” in order to determine the amount of concordance between teams.
The current results reveal that 18% of MICU teams shared a complete mental model, 25% shared a strong shared mental model, 9% shared a weak mental model, 30% shared no mental model, and 18% of patient encounters did not have a sufficient number of MICU respondents. Regarding inter-team communication, 7% shared a full shared mental model, 49% shared a partial mental model, 30% shared no shared mental model, and 14% of unique patient encounters did not have enough respondents.
With complex patient cases, it can be difficult to identify the most important factor of care for a particular patient. However, I think this information would be very useful in identifying whether these exchanges result in individuals prioritizing the same factor of care for their respective patient. I think this information would be very useful in future quality improvement, and seeing whether this communication results in the formation of shared mental models.
Anton Garazha is a medical student at Chicago Medical School at Rosalind Franklin University in North Chicago. He received his bachelor of science degree in biology from Loyola University in Chicago in 2015 and his master of biomedical science degree from Rosalind Franklin University in 2016. Anton is very interested in community outreach and quality improvement, and in his spare time tutors students in science-based subjects.
Editor’s Note: The Society of Hospital Medicine’s (SHM’s) Physician in Training Committee launched a scholarship program in 2015 for medical students to help transform healthcare and revolutionize patient care. The program has been expanded for the 2017-18 year, offering two options for students to receive funding and engage in scholarly work during their first, second and third years of medical school. As a part of the program, recipients are required to write about their experience on a biweekly basis.
This summer, my research project focused on the highly vulnerable patients who are transferred from the medical intensive care unit to the general floor. Patients who are readmitted tend to have worse health outcomes, longer stays, higher mortality rates, and higher health care costs. Previous research shows that higher quality handoffs, where receiving and transferring providers share the same shared mental model, result in better outcomes. We were interested in learning whether these shared mental models are being formed as a result of handoffs between the ward and the MICU.
After surveying providers this summer, and using data from past surveys, we have been able to make headway codifying the level of concordance between providers. We asked ward and MICU providers what they thought was the most important component of care in regards to the care of their patient while they are on the general floor. We focused on two levels of agreement in the handoff: intra-team agreement within the MICU team, and inter-team agreement between the MICU team and the ward. We coded intra-team agreement within the categories of “Complete,” “Strong,” “Weak,” and “No” agreement based on a random sampling of 40 unique patient encounters determined in meetings with Dr. Vineet Arora, Dr. Juan Rojas, Dr. Julie Neborak, and me. Due to a variable number of responses from providers on either side, we also coded the inter-team responses as “Full,” “Partial,” and “No” in order to determine the amount of concordance between teams.
The current results reveal that 18% of MICU teams shared a complete mental model, 25% shared a strong shared mental model, 9% shared a weak mental model, 30% shared no mental model, and 18% of patient encounters did not have a sufficient number of MICU respondents. Regarding inter-team communication, 7% shared a full shared mental model, 49% shared a partial mental model, 30% shared no shared mental model, and 14% of unique patient encounters did not have enough respondents.
With complex patient cases, it can be difficult to identify the most important factor of care for a particular patient. However, I think this information would be very useful in identifying whether these exchanges result in individuals prioritizing the same factor of care for their respective patient. I think this information would be very useful in future quality improvement, and seeing whether this communication results in the formation of shared mental models.
Anton Garazha is a medical student at Chicago Medical School at Rosalind Franklin University in North Chicago. He received his bachelor of science degree in biology from Loyola University in Chicago in 2015 and his master of biomedical science degree from Rosalind Franklin University in 2016. Anton is very interested in community outreach and quality improvement, and in his spare time tutors students in science-based subjects.
Here’s what’s trending at SHM – Dec. 2017
State of Hospital Medicine Survey opens next month!
The 2018 State of Hospital Medicine Survey will begin in January and last through March with the release of the report in September 2018. Whether you are in a hospital medicine group in an academic or community setting, employed by a hospital or health system, a management company, a private group, or you serve adult or pediatric patients (or both), we need your participation.
Help us help you have the most comprehensive, up-to-date landscape of hospital medicine at your fingertips by participating. As a thank-you for your participation, your group will receive a free copy of the report. Sign up at hospitalmedicine.org/survey.
Apply for SHM’s MARQUIS Med Rec Collaborative kicking off in February 2018
SHM’s MARQUIS Med Rec Collaborative is designed to help hospitals across the United States implement evidence-based best practice medication reconciliation process change and improvement. The collaborative is a 14-month program, spanning from prelaunch to completion.
The staff has the expertise and experience of having completed two previous mentored implementation studies, involving 23 sites and thousands of patients. The collaborative also offers numerous resources, including training materials, project management and process improvement tools for hospitals to use to adapt for their needs to improve the medication reconciliation process. Visit hospitalmedicine.org/MARQUISrecruit to learn more.
Get engaged with public policy
Health care legislation is constantly evolving, and hospitalists play an important role in advocating for hospitalized patients and the hospital medicine movement. SHM is an active voice in many conversations on policy development and reform. Visit hospitalmedicine.org and sign up for the Grassroots Network to stay updated on developments in health care policy, share your experiences with health care programs and participate in policy forums.
Develop your career at Hospital Medicine 2018
Don’t miss SHM’s Annual Conference, Hospital Medicine 2018, to be held April 8-11, 2018. in Orlando. This year, the program was created to help you develop your hospital medicine career, no matter what stage you are in. Two new tracks include Seasoning Your Career and the Career Development Workshops.
Seasoning Your Career focuses on didactics designed to augment those committed to a career in hospital medicine, including topics such as career growth and development, resiliency, work-life balance, and how practical work matters such as schedules affect your career.
The new Career Development Workshops track includes six sessions that aim to help you use skills that will advance your career, such as: Leadership Essentials for Success in Hospital Medicine; Being Female in Hospital Medicine: Overcoming Individual and Institutional Barriers in the Workplace; Do You Have a Minute to Talk? Peer-to-Peer Feedback, and more.
Just starting out in hospital medicine? Back by popular demand, The Early-Career Hospitalists track has been designed for new hospitalists, resident physicians, and medical students interested in pursuing a career in hospital medicine. Designed by SHM’s Physicians-in-Training Committee, which includes nationally recognized hospitalists with expertise in scholarship, career development and medical education, this track aims to inspire future hospitalist leaders.
Visit shmannualconference.org/schedule to learn more.
Two new modules debut on SHM’s Learning Portal
SHM members have access to free continuing medical education (CME) and Maintenance of Certification (MOC) points with the SHM Learning Portal. Don’t miss two new modules: Role of the Medical Consultant and Anesthesia for Internists.
Medical consultation is an important clinical component for most hospitalists. Today, hospitalists also are asked to provide both “curbside” advice and more comprehensive comanagement of medical problems. Hospitalists who are effective consultants communicate skillfully and act professionally. The Role of the Medical Consultant module describes the different roles that hospitalists can perform as medical consultants and provides strategies for improving communications and referring physician satisfaction.
Looking for up-to-date information about surgical anesthesia? The Anesthesia for Internists module discusses the basic forms of surgical anesthesia and contraindications to each, as well as the most commonly used anesthetic drugs, their mechanisms of actions, and side effects.
Both modules are free for SHM members and $45.00 per module for nonmembers. Earn 2 AMA PRA Category 1 Credits™ and 2 MOC points per each module. Visit shmlearningportal.org to get started today.
Not a member? Join the movement today
More than 15,000 members have joined SHM to show their commitment to revolutionizing patient care. As a member, you will be connected with a wealth of opportunities designed to help you grow professionally, network with colleagues nationwide, and shape the practice of hospital medicine. See a full list of member benefits or become a member today at hospitalmedicine.org/join.
Join a chapter and connect to your local hospital medicine community
SHM hosts more than 50 local chapters nationwide to encourage networking, collaboration, and innovation within the hospital medicine community. Getting involved with your local chapter allows you to share knowledge, engage with colleagues, and stay current on the latest developments in hospital medicine.
Visit hospitalmedicine.org/chapters to find a chapter in your area.
Mr. Radler is marketing communications manager at the Society of Hospital Medicine.
State of Hospital Medicine Survey opens next month!
The 2018 State of Hospital Medicine Survey will begin in January and last through March with the release of the report in September 2018. Whether you are in a hospital medicine group in an academic or community setting, employed by a hospital or health system, a management company, a private group, or you serve adult or pediatric patients (or both), we need your participation.
Help us help you have the most comprehensive, up-to-date landscape of hospital medicine at your fingertips by participating. As a thank-you for your participation, your group will receive a free copy of the report. Sign up at hospitalmedicine.org/survey.
Apply for SHM’s MARQUIS Med Rec Collaborative kicking off in February 2018
SHM’s MARQUIS Med Rec Collaborative is designed to help hospitals across the United States implement evidence-based best practice medication reconciliation process change and improvement. The collaborative is a 14-month program, spanning from prelaunch to completion.
The staff has the expertise and experience of having completed two previous mentored implementation studies, involving 23 sites and thousands of patients. The collaborative also offers numerous resources, including training materials, project management and process improvement tools for hospitals to use to adapt for their needs to improve the medication reconciliation process. Visit hospitalmedicine.org/MARQUISrecruit to learn more.
Get engaged with public policy
Health care legislation is constantly evolving, and hospitalists play an important role in advocating for hospitalized patients and the hospital medicine movement. SHM is an active voice in many conversations on policy development and reform. Visit hospitalmedicine.org and sign up for the Grassroots Network to stay updated on developments in health care policy, share your experiences with health care programs and participate in policy forums.
Develop your career at Hospital Medicine 2018
Don’t miss SHM’s Annual Conference, Hospital Medicine 2018, to be held April 8-11, 2018. in Orlando. This year, the program was created to help you develop your hospital medicine career, no matter what stage you are in. Two new tracks include Seasoning Your Career and the Career Development Workshops.
Seasoning Your Career focuses on didactics designed to augment those committed to a career in hospital medicine, including topics such as career growth and development, resiliency, work-life balance, and how practical work matters such as schedules affect your career.
The new Career Development Workshops track includes six sessions that aim to help you use skills that will advance your career, such as: Leadership Essentials for Success in Hospital Medicine; Being Female in Hospital Medicine: Overcoming Individual and Institutional Barriers in the Workplace; Do You Have a Minute to Talk? Peer-to-Peer Feedback, and more.
Just starting out in hospital medicine? Back by popular demand, The Early-Career Hospitalists track has been designed for new hospitalists, resident physicians, and medical students interested in pursuing a career in hospital medicine. Designed by SHM’s Physicians-in-Training Committee, which includes nationally recognized hospitalists with expertise in scholarship, career development and medical education, this track aims to inspire future hospitalist leaders.
Visit shmannualconference.org/schedule to learn more.
Two new modules debut on SHM’s Learning Portal
SHM members have access to free continuing medical education (CME) and Maintenance of Certification (MOC) points with the SHM Learning Portal. Don’t miss two new modules: Role of the Medical Consultant and Anesthesia for Internists.
Medical consultation is an important clinical component for most hospitalists. Today, hospitalists also are asked to provide both “curbside” advice and more comprehensive comanagement of medical problems. Hospitalists who are effective consultants communicate skillfully and act professionally. The Role of the Medical Consultant module describes the different roles that hospitalists can perform as medical consultants and provides strategies for improving communications and referring physician satisfaction.
Looking for up-to-date information about surgical anesthesia? The Anesthesia for Internists module discusses the basic forms of surgical anesthesia and contraindications to each, as well as the most commonly used anesthetic drugs, their mechanisms of actions, and side effects.
Both modules are free for SHM members and $45.00 per module for nonmembers. Earn 2 AMA PRA Category 1 Credits™ and 2 MOC points per each module. Visit shmlearningportal.org to get started today.
Not a member? Join the movement today
More than 15,000 members have joined SHM to show their commitment to revolutionizing patient care. As a member, you will be connected with a wealth of opportunities designed to help you grow professionally, network with colleagues nationwide, and shape the practice of hospital medicine. See a full list of member benefits or become a member today at hospitalmedicine.org/join.
Join a chapter and connect to your local hospital medicine community
SHM hosts more than 50 local chapters nationwide to encourage networking, collaboration, and innovation within the hospital medicine community. Getting involved with your local chapter allows you to share knowledge, engage with colleagues, and stay current on the latest developments in hospital medicine.
Visit hospitalmedicine.org/chapters to find a chapter in your area.
Mr. Radler is marketing communications manager at the Society of Hospital Medicine.
State of Hospital Medicine Survey opens next month!
The 2018 State of Hospital Medicine Survey will begin in January and last through March with the release of the report in September 2018. Whether you are in a hospital medicine group in an academic or community setting, employed by a hospital or health system, a management company, a private group, or you serve adult or pediatric patients (or both), we need your participation.
Help us help you have the most comprehensive, up-to-date landscape of hospital medicine at your fingertips by participating. As a thank-you for your participation, your group will receive a free copy of the report. Sign up at hospitalmedicine.org/survey.
Apply for SHM’s MARQUIS Med Rec Collaborative kicking off in February 2018
SHM’s MARQUIS Med Rec Collaborative is designed to help hospitals across the United States implement evidence-based best practice medication reconciliation process change and improvement. The collaborative is a 14-month program, spanning from prelaunch to completion.
The staff has the expertise and experience of having completed two previous mentored implementation studies, involving 23 sites and thousands of patients. The collaborative also offers numerous resources, including training materials, project management and process improvement tools for hospitals to use to adapt for their needs to improve the medication reconciliation process. Visit hospitalmedicine.org/MARQUISrecruit to learn more.
Get engaged with public policy
Health care legislation is constantly evolving, and hospitalists play an important role in advocating for hospitalized patients and the hospital medicine movement. SHM is an active voice in many conversations on policy development and reform. Visit hospitalmedicine.org and sign up for the Grassroots Network to stay updated on developments in health care policy, share your experiences with health care programs and participate in policy forums.
Develop your career at Hospital Medicine 2018
Don’t miss SHM’s Annual Conference, Hospital Medicine 2018, to be held April 8-11, 2018. in Orlando. This year, the program was created to help you develop your hospital medicine career, no matter what stage you are in. Two new tracks include Seasoning Your Career and the Career Development Workshops.
Seasoning Your Career focuses on didactics designed to augment those committed to a career in hospital medicine, including topics such as career growth and development, resiliency, work-life balance, and how practical work matters such as schedules affect your career.
The new Career Development Workshops track includes six sessions that aim to help you use skills that will advance your career, such as: Leadership Essentials for Success in Hospital Medicine; Being Female in Hospital Medicine: Overcoming Individual and Institutional Barriers in the Workplace; Do You Have a Minute to Talk? Peer-to-Peer Feedback, and more.
Just starting out in hospital medicine? Back by popular demand, The Early-Career Hospitalists track has been designed for new hospitalists, resident physicians, and medical students interested in pursuing a career in hospital medicine. Designed by SHM’s Physicians-in-Training Committee, which includes nationally recognized hospitalists with expertise in scholarship, career development and medical education, this track aims to inspire future hospitalist leaders.
Visit shmannualconference.org/schedule to learn more.
Two new modules debut on SHM’s Learning Portal
SHM members have access to free continuing medical education (CME) and Maintenance of Certification (MOC) points with the SHM Learning Portal. Don’t miss two new modules: Role of the Medical Consultant and Anesthesia for Internists.
Medical consultation is an important clinical component for most hospitalists. Today, hospitalists also are asked to provide both “curbside” advice and more comprehensive comanagement of medical problems. Hospitalists who are effective consultants communicate skillfully and act professionally. The Role of the Medical Consultant module describes the different roles that hospitalists can perform as medical consultants and provides strategies for improving communications and referring physician satisfaction.
Looking for up-to-date information about surgical anesthesia? The Anesthesia for Internists module discusses the basic forms of surgical anesthesia and contraindications to each, as well as the most commonly used anesthetic drugs, their mechanisms of actions, and side effects.
Both modules are free for SHM members and $45.00 per module for nonmembers. Earn 2 AMA PRA Category 1 Credits™ and 2 MOC points per each module. Visit shmlearningportal.org to get started today.
Not a member? Join the movement today
More than 15,000 members have joined SHM to show their commitment to revolutionizing patient care. As a member, you will be connected with a wealth of opportunities designed to help you grow professionally, network with colleagues nationwide, and shape the practice of hospital medicine. See a full list of member benefits or become a member today at hospitalmedicine.org/join.
Join a chapter and connect to your local hospital medicine community
SHM hosts more than 50 local chapters nationwide to encourage networking, collaboration, and innovation within the hospital medicine community. Getting involved with your local chapter allows you to share knowledge, engage with colleagues, and stay current on the latest developments in hospital medicine.
Visit hospitalmedicine.org/chapters to find a chapter in your area.
Mr. Radler is marketing communications manager at the Society of Hospital Medicine.
Ensuring a smooth data collection process
Editor’s note: The Society of Hospital Medicine’s (SHM’s) Physician in Training Committee launched a scholarship program in 2015 for medical students to help transform health care and revolutionize patient care. The program has been expanded for the 2017-18 year, offering two options for students to receive funding and engage in scholarly work during their first, second and third years of medical school. As a part of the longitudinal (18-month) program, recipients are required to write about their experience on a monthly basis.
Piloting of data collection is finally underway! My mentor, Dr. Ian Jenkins, an attending in the Division of Hospital Medicine at the University of California, San Diego, and I are currently collaborating with the Surgical Intensive Care Unit at UC San Diego to conduct a daily review of urinary catheter (UC) necessity for patients on the unit, and subsequently coordinating with nursing staff on the unit to look for opportunities to implement UC alternatives.
Specifically, we are collecting data about the percentage of appropriate UC as well as data regarding the response to intervention for inappropriate UC identified. We decided to pilot the data in the ICU because of its excellent safety culture. A potential downside to piloting data on this hospital unit is that fewer catheters are typically removable in this setting, but we are hopeful that we will still obtain a rich data set, with a better understanding of how to expand data collection to other hospital units.
As far as timeline, we are past the halfway point. One thing that has surprised me is how long it has taken to get piloting phase underway. To that end, I think that our initial project timeline was ambitious, especially because we were unclear on how well initial project enthusiasm would translate into subsequent project participation. Up until this point, our research approach has largely been to fine tune each process prospectively. For instance, we decided a pilot run of data collection prior to final project data collection would allow us to ensure a smoother data collection process. While this has slowed things initially, we are optimistic that this will allow us to progress more quickly and smoothly in the latter stages of the project. We are not currently planning to change this research approach for the time being, but we are open to the idea depending on how well the data piloting phase progresses.
Outside of data collection, the project has provided an excellent opportunity to learn and improve clinical skills. Specifically, the project has improved my understanding of the indications for urinary catheter use, as well as helped me to develop a more critical mindset regarding medical indications in general. The project has made me more aware of the importance of really asking and thinking about why a patient is on a specific medication or using a specific medical device, which is something that is very helpful for anticipating and avoiding errors in the clinical setting.
Overall, I have enjoyed my participation in the project to date and it has increased my enthusiasm for participating in a quality improvement project.
Victor Ekuta is a third-year medical student at UC San Diego.
Editor’s note: The Society of Hospital Medicine’s (SHM’s) Physician in Training Committee launched a scholarship program in 2015 for medical students to help transform health care and revolutionize patient care. The program has been expanded for the 2017-18 year, offering two options for students to receive funding and engage in scholarly work during their first, second and third years of medical school. As a part of the longitudinal (18-month) program, recipients are required to write about their experience on a monthly basis.
Piloting of data collection is finally underway! My mentor, Dr. Ian Jenkins, an attending in the Division of Hospital Medicine at the University of California, San Diego, and I are currently collaborating with the Surgical Intensive Care Unit at UC San Diego to conduct a daily review of urinary catheter (UC) necessity for patients on the unit, and subsequently coordinating with nursing staff on the unit to look for opportunities to implement UC alternatives.
Specifically, we are collecting data about the percentage of appropriate UC as well as data regarding the response to intervention for inappropriate UC identified. We decided to pilot the data in the ICU because of its excellent safety culture. A potential downside to piloting data on this hospital unit is that fewer catheters are typically removable in this setting, but we are hopeful that we will still obtain a rich data set, with a better understanding of how to expand data collection to other hospital units.
As far as timeline, we are past the halfway point. One thing that has surprised me is how long it has taken to get piloting phase underway. To that end, I think that our initial project timeline was ambitious, especially because we were unclear on how well initial project enthusiasm would translate into subsequent project participation. Up until this point, our research approach has largely been to fine tune each process prospectively. For instance, we decided a pilot run of data collection prior to final project data collection would allow us to ensure a smoother data collection process. While this has slowed things initially, we are optimistic that this will allow us to progress more quickly and smoothly in the latter stages of the project. We are not currently planning to change this research approach for the time being, but we are open to the idea depending on how well the data piloting phase progresses.
Outside of data collection, the project has provided an excellent opportunity to learn and improve clinical skills. Specifically, the project has improved my understanding of the indications for urinary catheter use, as well as helped me to develop a more critical mindset regarding medical indications in general. The project has made me more aware of the importance of really asking and thinking about why a patient is on a specific medication or using a specific medical device, which is something that is very helpful for anticipating and avoiding errors in the clinical setting.
Overall, I have enjoyed my participation in the project to date and it has increased my enthusiasm for participating in a quality improvement project.
Victor Ekuta is a third-year medical student at UC San Diego.
Editor’s note: The Society of Hospital Medicine’s (SHM’s) Physician in Training Committee launched a scholarship program in 2015 for medical students to help transform health care and revolutionize patient care. The program has been expanded for the 2017-18 year, offering two options for students to receive funding and engage in scholarly work during their first, second and third years of medical school. As a part of the longitudinal (18-month) program, recipients are required to write about their experience on a monthly basis.
Piloting of data collection is finally underway! My mentor, Dr. Ian Jenkins, an attending in the Division of Hospital Medicine at the University of California, San Diego, and I are currently collaborating with the Surgical Intensive Care Unit at UC San Diego to conduct a daily review of urinary catheter (UC) necessity for patients on the unit, and subsequently coordinating with nursing staff on the unit to look for opportunities to implement UC alternatives.
Specifically, we are collecting data about the percentage of appropriate UC as well as data regarding the response to intervention for inappropriate UC identified. We decided to pilot the data in the ICU because of its excellent safety culture. A potential downside to piloting data on this hospital unit is that fewer catheters are typically removable in this setting, but we are hopeful that we will still obtain a rich data set, with a better understanding of how to expand data collection to other hospital units.
As far as timeline, we are past the halfway point. One thing that has surprised me is how long it has taken to get piloting phase underway. To that end, I think that our initial project timeline was ambitious, especially because we were unclear on how well initial project enthusiasm would translate into subsequent project participation. Up until this point, our research approach has largely been to fine tune each process prospectively. For instance, we decided a pilot run of data collection prior to final project data collection would allow us to ensure a smoother data collection process. While this has slowed things initially, we are optimistic that this will allow us to progress more quickly and smoothly in the latter stages of the project. We are not currently planning to change this research approach for the time being, but we are open to the idea depending on how well the data piloting phase progresses.
Outside of data collection, the project has provided an excellent opportunity to learn and improve clinical skills. Specifically, the project has improved my understanding of the indications for urinary catheter use, as well as helped me to develop a more critical mindset regarding medical indications in general. The project has made me more aware of the importance of really asking and thinking about why a patient is on a specific medication or using a specific medical device, which is something that is very helpful for anticipating and avoiding errors in the clinical setting.
Overall, I have enjoyed my participation in the project to date and it has increased my enthusiasm for participating in a quality improvement project.
Victor Ekuta is a third-year medical student at UC San Diego.
Delving into the details
Editor’s note: The Society of Hospital Medicine’s (SHM’s) Physician in Training Committee launched a scholarship program in 2015 for medical students to help transform health care and revolutionize patient care. The program has been expanded for the 2017-2018 year, offering two options for students to receive funding and engage in scholarly work during their first, second, and third years of medical school. As a part of the longitudinal (18-month) program, recipients are required to write about their experience on a monthly basis.
For my research project, we are looking to develop a tool that would use data from within 24 hours of a patient’s admission to the hospital to predict whether they will require post-acute care placement after discharge. While I have often been summarizing my project with this broad one-liner, in the last two weeks I have been delving more into the details of what exactly we mean by “data from within 24 hours of a patient’s admission.”
We have access to a large set of de-identified patient data from our institution, from which we are going to construct this model. However, it contains vast amounts of information about every patient’s hospital stay, and we only need a subset of that information. Making detailed decisions about which lab values, vital signs, and other information is most relevant will take some careful parsing. For example, for some lab values, we are looking to get the highest, lowest, and the median value to make sure we have a picture of the patient’s status in the first 24 hours that would be much more informative than any value alone. Others may not have enough data points to often collect three times in the first 24 hours, and so first and last may be more appropriate. Others still may not be recorded correctly in the database we have often enough to be a reliable piece of information to use in the analysis.
We are going through each of the variables systematically to take into account prior literature on how they were treated in other studies, as well as the practical limitations imposed by the data-gathering within our own system to choose how these values will be selected for each admission. My mentor Dr. Eduard Vasilevskis is helping me with making these decisions, based on the prototype model that was the inspiration for this project. Once we have identified all of the details of each variable we want to track, Dr. Jesse Ehrenfeld will be facilitating our use of the database.
Certainly this project has helped illuminate not only research-specific hurdles, but also underscores the fundamental difficulty of clinical decision-making in the first 24 hours of a patient’s admission. With data changing rapidly and sometimes incomplete data, clinicians need to quickly make care decisions that can impact a lot more than the patient’s post-discharge destination.
We anticipate that once we’ve made these choices, there will be further choices to make about how to treat these variables in the analysis. We hope to have the assistance of an experienced statistician to help guide us in making those decisions.
Monisha Bhatia, a native of Nashville, Tenn., is a fourth-year medical student at Vanderbilt University in Nashville. She is hoping to pursue either a residency in internal medicine or a combined internal medicine/emergency medicine program. Prior to medical school, she completed a JD/MPH program at Boston University, and she hopes to use her legal training in working with regulatory authorities to improve access to health care for all Americans.
Editor’s note: The Society of Hospital Medicine’s (SHM’s) Physician in Training Committee launched a scholarship program in 2015 for medical students to help transform health care and revolutionize patient care. The program has been expanded for the 2017-2018 year, offering two options for students to receive funding and engage in scholarly work during their first, second, and third years of medical school. As a part of the longitudinal (18-month) program, recipients are required to write about their experience on a monthly basis.
For my research project, we are looking to develop a tool that would use data from within 24 hours of a patient’s admission to the hospital to predict whether they will require post-acute care placement after discharge. While I have often been summarizing my project with this broad one-liner, in the last two weeks I have been delving more into the details of what exactly we mean by “data from within 24 hours of a patient’s admission.”
We have access to a large set of de-identified patient data from our institution, from which we are going to construct this model. However, it contains vast amounts of information about every patient’s hospital stay, and we only need a subset of that information. Making detailed decisions about which lab values, vital signs, and other information is most relevant will take some careful parsing. For example, for some lab values, we are looking to get the highest, lowest, and the median value to make sure we have a picture of the patient’s status in the first 24 hours that would be much more informative than any value alone. Others may not have enough data points to often collect three times in the first 24 hours, and so first and last may be more appropriate. Others still may not be recorded correctly in the database we have often enough to be a reliable piece of information to use in the analysis.
We are going through each of the variables systematically to take into account prior literature on how they were treated in other studies, as well as the practical limitations imposed by the data-gathering within our own system to choose how these values will be selected for each admission. My mentor Dr. Eduard Vasilevskis is helping me with making these decisions, based on the prototype model that was the inspiration for this project. Once we have identified all of the details of each variable we want to track, Dr. Jesse Ehrenfeld will be facilitating our use of the database.
Certainly this project has helped illuminate not only research-specific hurdles, but also underscores the fundamental difficulty of clinical decision-making in the first 24 hours of a patient’s admission. With data changing rapidly and sometimes incomplete data, clinicians need to quickly make care decisions that can impact a lot more than the patient’s post-discharge destination.
We anticipate that once we’ve made these choices, there will be further choices to make about how to treat these variables in the analysis. We hope to have the assistance of an experienced statistician to help guide us in making those decisions.
Monisha Bhatia, a native of Nashville, Tenn., is a fourth-year medical student at Vanderbilt University in Nashville. She is hoping to pursue either a residency in internal medicine or a combined internal medicine/emergency medicine program. Prior to medical school, she completed a JD/MPH program at Boston University, and she hopes to use her legal training in working with regulatory authorities to improve access to health care for all Americans.
Editor’s note: The Society of Hospital Medicine’s (SHM’s) Physician in Training Committee launched a scholarship program in 2015 for medical students to help transform health care and revolutionize patient care. The program has been expanded for the 2017-2018 year, offering two options for students to receive funding and engage in scholarly work during their first, second, and third years of medical school. As a part of the longitudinal (18-month) program, recipients are required to write about their experience on a monthly basis.
For my research project, we are looking to develop a tool that would use data from within 24 hours of a patient’s admission to the hospital to predict whether they will require post-acute care placement after discharge. While I have often been summarizing my project with this broad one-liner, in the last two weeks I have been delving more into the details of what exactly we mean by “data from within 24 hours of a patient’s admission.”
We have access to a large set of de-identified patient data from our institution, from which we are going to construct this model. However, it contains vast amounts of information about every patient’s hospital stay, and we only need a subset of that information. Making detailed decisions about which lab values, vital signs, and other information is most relevant will take some careful parsing. For example, for some lab values, we are looking to get the highest, lowest, and the median value to make sure we have a picture of the patient’s status in the first 24 hours that would be much more informative than any value alone. Others may not have enough data points to often collect three times in the first 24 hours, and so first and last may be more appropriate. Others still may not be recorded correctly in the database we have often enough to be a reliable piece of information to use in the analysis.
We are going through each of the variables systematically to take into account prior literature on how they were treated in other studies, as well as the practical limitations imposed by the data-gathering within our own system to choose how these values will be selected for each admission. My mentor Dr. Eduard Vasilevskis is helping me with making these decisions, based on the prototype model that was the inspiration for this project. Once we have identified all of the details of each variable we want to track, Dr. Jesse Ehrenfeld will be facilitating our use of the database.
Certainly this project has helped illuminate not only research-specific hurdles, but also underscores the fundamental difficulty of clinical decision-making in the first 24 hours of a patient’s admission. With data changing rapidly and sometimes incomplete data, clinicians need to quickly make care decisions that can impact a lot more than the patient’s post-discharge destination.
We anticipate that once we’ve made these choices, there will be further choices to make about how to treat these variables in the analysis. We hope to have the assistance of an experienced statistician to help guide us in making those decisions.
Monisha Bhatia, a native of Nashville, Tenn., is a fourth-year medical student at Vanderbilt University in Nashville. She is hoping to pursue either a residency in internal medicine or a combined internal medicine/emergency medicine program. Prior to medical school, she completed a JD/MPH program at Boston University, and she hopes to use her legal training in working with regulatory authorities to improve access to health care for all Americans.
Inclusion valued by advanced practice providers
Editor’s note: Each month, the Society of Hospital Medicine puts the spotlight on some of our most active members who are making substantial contributions to hospital medicine. Log on to www.hospitalmedicine.org/getinvolved for more information on how you can lend your expertise to help SHM improve the care of hospitalized patients.
This month, The Hospitalist spotlights Lorraine Britting, ANP, SFHM, clinical director of advanced practice in cardiology medicine at Beth Israel Deaconess Medical Center, Boston. Ms. Britting has been an SHM member for over 10 years, has served on various SHM committees, and was one of the first nurse practitioners to earn the Senior Fellow in Hospital Medicine designation.
How did you become a hospital medicine nurse practitioner, and when did you join SHM?
I was a nurse working in a CCU and MICU for 19 years when I graduated from a master’s program as a nurse practitioner (NP) in adult care. I thought I was going to work in the outpatient side after graduation, but my experience was much more suited to hospital medicine.
My first job in 2004 was as a hospitalist in a very small community hospital affiliated with Beth Israel Deaconess Medical Center. I was the first NP to work as an inpatient provider there, which was challenging, but I had the opportunity to wear many hats and be involved with numerous quality initiatives that helped me grow as a provider and a leader. I was working as the clinical manager of three hospitalist programs under the director by the time I left. I now work in inpatient cardiology and am the director of advanced practice providers (APPs) for cardiology medicine. I joined SHM in 2005 when it was a small but rapidly growing society, and I started work on the NP/PA Committee. I was also involved in the Hospital Quality and Patient Safety Committee for 6 years and worked as a peer reviewer for the Journal of Hospital Medicine.
Describe your role on the Membership Committee. What is the committee currently working on?
I am finishing my 3rd year on the committee. In the last few months, we have been focusing on member engagement. We have collected information on why members choose to join SHM and what deters potential members from joining SHM and we are developing strategies to build and retain our membership. The Membership Committee also reviews Fellows applications and discusses modifications of requirements each year.
As an NP, I have unique insight into motivations for why other APPs would join SHM and which membership benefits are most valuable. I find that many APPs join SHM because they feel that SHM treats them as equals, not junior members, as in some other physician organizations.
What does the Senior Fellow in Hospital Medicine designation mean to you?
I am grateful that SHM allows all members to be a part of the Fellows program, and I was honored to be one of the first NPs to become a Senior Fellow. Many medical societies allow APPs to join but do not offer the opportunity to become Fellows.
The Senior Fellowship application was a rigorous process and required experience in multiple areas, including quality projects, hospital committees, SHM Annual Conference attendance, and other clinical and nonclinical work that advances the profession.
As a nurse practitioner, which SHM resources do you find most valuable?
As a specialist NP, it’s easy for me to be current in cardiology but harder to keep current in general medicine. I find the clinical information very helpful to keep me up to date on hospital medicine. The Journal of Hospital Medicine and The Hospitalist are must reads, and the Annual Conference is, of course, very informative. I also enjoy the conversations on the Hospital Medicine Exchange and feel that the Choosing Wisely campaign is an excellent contribution to the goal of cost containment in everyday practice.
One of the best features of SHM is that I can meet other clinicians from around the country and around the world who have innovations or novel ideas that I can bring back to my institution.
What advice do you have for nurse practitioners as their role in hospital medicine continues to evolve?
I say to my staff that they should always say yes. Yes to continuing education, yes to opportunities for growth and advancement, yes to promotions, yes to research, etc. Careers develop in nonlinear ways, and you have to follow the opportunities as they come.
Ms. Steele is the marketing communications specialist at the Society of Hospital Medicine.
Editor’s note: Each month, the Society of Hospital Medicine puts the spotlight on some of our most active members who are making substantial contributions to hospital medicine. Log on to www.hospitalmedicine.org/getinvolved for more information on how you can lend your expertise to help SHM improve the care of hospitalized patients.
This month, The Hospitalist spotlights Lorraine Britting, ANP, SFHM, clinical director of advanced practice in cardiology medicine at Beth Israel Deaconess Medical Center, Boston. Ms. Britting has been an SHM member for over 10 years, has served on various SHM committees, and was one of the first nurse practitioners to earn the Senior Fellow in Hospital Medicine designation.
How did you become a hospital medicine nurse practitioner, and when did you join SHM?
I was a nurse working in a CCU and MICU for 19 years when I graduated from a master’s program as a nurse practitioner (NP) in adult care. I thought I was going to work in the outpatient side after graduation, but my experience was much more suited to hospital medicine.
My first job in 2004 was as a hospitalist in a very small community hospital affiliated with Beth Israel Deaconess Medical Center. I was the first NP to work as an inpatient provider there, which was challenging, but I had the opportunity to wear many hats and be involved with numerous quality initiatives that helped me grow as a provider and a leader. I was working as the clinical manager of three hospitalist programs under the director by the time I left. I now work in inpatient cardiology and am the director of advanced practice providers (APPs) for cardiology medicine. I joined SHM in 2005 when it was a small but rapidly growing society, and I started work on the NP/PA Committee. I was also involved in the Hospital Quality and Patient Safety Committee for 6 years and worked as a peer reviewer for the Journal of Hospital Medicine.
Describe your role on the Membership Committee. What is the committee currently working on?
I am finishing my 3rd year on the committee. In the last few months, we have been focusing on member engagement. We have collected information on why members choose to join SHM and what deters potential members from joining SHM and we are developing strategies to build and retain our membership. The Membership Committee also reviews Fellows applications and discusses modifications of requirements each year.
As an NP, I have unique insight into motivations for why other APPs would join SHM and which membership benefits are most valuable. I find that many APPs join SHM because they feel that SHM treats them as equals, not junior members, as in some other physician organizations.
What does the Senior Fellow in Hospital Medicine designation mean to you?
I am grateful that SHM allows all members to be a part of the Fellows program, and I was honored to be one of the first NPs to become a Senior Fellow. Many medical societies allow APPs to join but do not offer the opportunity to become Fellows.
The Senior Fellowship application was a rigorous process and required experience in multiple areas, including quality projects, hospital committees, SHM Annual Conference attendance, and other clinical and nonclinical work that advances the profession.
As a nurse practitioner, which SHM resources do you find most valuable?
As a specialist NP, it’s easy for me to be current in cardiology but harder to keep current in general medicine. I find the clinical information very helpful to keep me up to date on hospital medicine. The Journal of Hospital Medicine and The Hospitalist are must reads, and the Annual Conference is, of course, very informative. I also enjoy the conversations on the Hospital Medicine Exchange and feel that the Choosing Wisely campaign is an excellent contribution to the goal of cost containment in everyday practice.
One of the best features of SHM is that I can meet other clinicians from around the country and around the world who have innovations or novel ideas that I can bring back to my institution.
What advice do you have for nurse practitioners as their role in hospital medicine continues to evolve?
I say to my staff that they should always say yes. Yes to continuing education, yes to opportunities for growth and advancement, yes to promotions, yes to research, etc. Careers develop in nonlinear ways, and you have to follow the opportunities as they come.
Ms. Steele is the marketing communications specialist at the Society of Hospital Medicine.
Editor’s note: Each month, the Society of Hospital Medicine puts the spotlight on some of our most active members who are making substantial contributions to hospital medicine. Log on to www.hospitalmedicine.org/getinvolved for more information on how you can lend your expertise to help SHM improve the care of hospitalized patients.
This month, The Hospitalist spotlights Lorraine Britting, ANP, SFHM, clinical director of advanced practice in cardiology medicine at Beth Israel Deaconess Medical Center, Boston. Ms. Britting has been an SHM member for over 10 years, has served on various SHM committees, and was one of the first nurse practitioners to earn the Senior Fellow in Hospital Medicine designation.
How did you become a hospital medicine nurse practitioner, and when did you join SHM?
I was a nurse working in a CCU and MICU for 19 years when I graduated from a master’s program as a nurse practitioner (NP) in adult care. I thought I was going to work in the outpatient side after graduation, but my experience was much more suited to hospital medicine.
My first job in 2004 was as a hospitalist in a very small community hospital affiliated with Beth Israel Deaconess Medical Center. I was the first NP to work as an inpatient provider there, which was challenging, but I had the opportunity to wear many hats and be involved with numerous quality initiatives that helped me grow as a provider and a leader. I was working as the clinical manager of three hospitalist programs under the director by the time I left. I now work in inpatient cardiology and am the director of advanced practice providers (APPs) for cardiology medicine. I joined SHM in 2005 when it was a small but rapidly growing society, and I started work on the NP/PA Committee. I was also involved in the Hospital Quality and Patient Safety Committee for 6 years and worked as a peer reviewer for the Journal of Hospital Medicine.
Describe your role on the Membership Committee. What is the committee currently working on?
I am finishing my 3rd year on the committee. In the last few months, we have been focusing on member engagement. We have collected information on why members choose to join SHM and what deters potential members from joining SHM and we are developing strategies to build and retain our membership. The Membership Committee also reviews Fellows applications and discusses modifications of requirements each year.
As an NP, I have unique insight into motivations for why other APPs would join SHM and which membership benefits are most valuable. I find that many APPs join SHM because they feel that SHM treats them as equals, not junior members, as in some other physician organizations.
What does the Senior Fellow in Hospital Medicine designation mean to you?
I am grateful that SHM allows all members to be a part of the Fellows program, and I was honored to be one of the first NPs to become a Senior Fellow. Many medical societies allow APPs to join but do not offer the opportunity to become Fellows.
The Senior Fellowship application was a rigorous process and required experience in multiple areas, including quality projects, hospital committees, SHM Annual Conference attendance, and other clinical and nonclinical work that advances the profession.
As a nurse practitioner, which SHM resources do you find most valuable?
As a specialist NP, it’s easy for me to be current in cardiology but harder to keep current in general medicine. I find the clinical information very helpful to keep me up to date on hospital medicine. The Journal of Hospital Medicine and The Hospitalist are must reads, and the Annual Conference is, of course, very informative. I also enjoy the conversations on the Hospital Medicine Exchange and feel that the Choosing Wisely campaign is an excellent contribution to the goal of cost containment in everyday practice.
One of the best features of SHM is that I can meet other clinicians from around the country and around the world who have innovations or novel ideas that I can bring back to my institution.
What advice do you have for nurse practitioners as their role in hospital medicine continues to evolve?
I say to my staff that they should always say yes. Yes to continuing education, yes to opportunities for growth and advancement, yes to promotions, yes to research, etc. Careers develop in nonlinear ways, and you have to follow the opportunities as they come.
Ms. Steele is the marketing communications specialist at the Society of Hospital Medicine.
Physicians do not trust bone biopsy culture data
Editor’s Note: The Society of Hospital Medicine’s (SHM’s) Physician in Training Committee launched a scholarship program in 2015 for medical students to help transform health care and revolutionize patient care. The program has been expanded for the 2017-18 year, offering two options for students to receive funding and engage in scholarly work during their 1st, 2nd, and 3rd years of medical school. As a part of the program, recipients are required to write about their experience on a biweekly basis.
As I approach the end of my summer research project, my team and I have reflected on what we’ve learned from both the research itself and the experience of working on the project.
First, I am completely finished with the research and analysis portion of the project. In the last week, I’ve mostly been working on the abstract which we plan to submit to the Society of Hospital Medicine 2018 conference. While I would have liked to make more progress on the manuscript, I realize that writing almost always takes longer than I anticipate, and that I will need to continue working on the manuscript in the fall semester.
As work-life balance is important to me, I would usually I would balk at the idea of sacrificing my personal time, but in this case, I am driven by a sense of ownership and pride over the project that I haven’t felt with past projects. I truly believe the results of this research have the potential to change the way physicians think about and manage patients with osteomyelitis, and I am eager to publish our results and attend conferences where I can present and discuss the findings with the medical community.
We hypothesized that the use of image-guided bone biopsies in patients with non-vertebral osteomyelitis would not have a significant impact on antibiotic management. Our results showed that physicians usually do not trust culture data provided by bone biopsy results. Negative bone cultures almost never lead physicians to discontinue antibiotics due to the low yield and reliability of bone biopsy culture data. Similarly, positive cultures almost never lead physicians to prescribe targeted antibiotics. 75% of the patients in our study had contiguous osteomyelitis caused by an overlying ulcer (e.g., diabetic foot ulcers or sacral decubitus ulcers). Exposure of the wound to the outside world often results in polymicrobial infections, and as such physicians rarely narrowed antibiotic coverage when a single organism was cultured. We also found that empiric antibiotic therapy adequately treated cultured micro-organisms in 95% of cases.
While many questions remained unanswered by this study, our results are an important contribution to the body of evidence that image-guided bone biopsies have low utility in the management of contiguous non-vertebral osteomyelitis. I look forward to seeing how the results of future research will compare with our findings. I am grateful to have had the opportunity to work in such an exciting area of research and I hope to continue participating in research projects throughout my medical career.
Cole Hirschfeld is originally from Phoenix. He received undergraduate degrees in finance and entrepreneurship from the University of Arizona and went on to work in the finance industry for 2 years before deciding to change careers and attend medical school. He is now a 4th year medical student at Cornell University, New York, and plans to apply for residency in internal medicine.
Editor’s Note: The Society of Hospital Medicine’s (SHM’s) Physician in Training Committee launched a scholarship program in 2015 for medical students to help transform health care and revolutionize patient care. The program has been expanded for the 2017-18 year, offering two options for students to receive funding and engage in scholarly work during their 1st, 2nd, and 3rd years of medical school. As a part of the program, recipients are required to write about their experience on a biweekly basis.
As I approach the end of my summer research project, my team and I have reflected on what we’ve learned from both the research itself and the experience of working on the project.
First, I am completely finished with the research and analysis portion of the project. In the last week, I’ve mostly been working on the abstract which we plan to submit to the Society of Hospital Medicine 2018 conference. While I would have liked to make more progress on the manuscript, I realize that writing almost always takes longer than I anticipate, and that I will need to continue working on the manuscript in the fall semester.
As work-life balance is important to me, I would usually I would balk at the idea of sacrificing my personal time, but in this case, I am driven by a sense of ownership and pride over the project that I haven’t felt with past projects. I truly believe the results of this research have the potential to change the way physicians think about and manage patients with osteomyelitis, and I am eager to publish our results and attend conferences where I can present and discuss the findings with the medical community.
We hypothesized that the use of image-guided bone biopsies in patients with non-vertebral osteomyelitis would not have a significant impact on antibiotic management. Our results showed that physicians usually do not trust culture data provided by bone biopsy results. Negative bone cultures almost never lead physicians to discontinue antibiotics due to the low yield and reliability of bone biopsy culture data. Similarly, positive cultures almost never lead physicians to prescribe targeted antibiotics. 75% of the patients in our study had contiguous osteomyelitis caused by an overlying ulcer (e.g., diabetic foot ulcers or sacral decubitus ulcers). Exposure of the wound to the outside world often results in polymicrobial infections, and as such physicians rarely narrowed antibiotic coverage when a single organism was cultured. We also found that empiric antibiotic therapy adequately treated cultured micro-organisms in 95% of cases.
While many questions remained unanswered by this study, our results are an important contribution to the body of evidence that image-guided bone biopsies have low utility in the management of contiguous non-vertebral osteomyelitis. I look forward to seeing how the results of future research will compare with our findings. I am grateful to have had the opportunity to work in such an exciting area of research and I hope to continue participating in research projects throughout my medical career.
Cole Hirschfeld is originally from Phoenix. He received undergraduate degrees in finance and entrepreneurship from the University of Arizona and went on to work in the finance industry for 2 years before deciding to change careers and attend medical school. He is now a 4th year medical student at Cornell University, New York, and plans to apply for residency in internal medicine.
Editor’s Note: The Society of Hospital Medicine’s (SHM’s) Physician in Training Committee launched a scholarship program in 2015 for medical students to help transform health care and revolutionize patient care. The program has been expanded for the 2017-18 year, offering two options for students to receive funding and engage in scholarly work during their 1st, 2nd, and 3rd years of medical school. As a part of the program, recipients are required to write about their experience on a biweekly basis.
As I approach the end of my summer research project, my team and I have reflected on what we’ve learned from both the research itself and the experience of working on the project.
First, I am completely finished with the research and analysis portion of the project. In the last week, I’ve mostly been working on the abstract which we plan to submit to the Society of Hospital Medicine 2018 conference. While I would have liked to make more progress on the manuscript, I realize that writing almost always takes longer than I anticipate, and that I will need to continue working on the manuscript in the fall semester.
As work-life balance is important to me, I would usually I would balk at the idea of sacrificing my personal time, but in this case, I am driven by a sense of ownership and pride over the project that I haven’t felt with past projects. I truly believe the results of this research have the potential to change the way physicians think about and manage patients with osteomyelitis, and I am eager to publish our results and attend conferences where I can present and discuss the findings with the medical community.
We hypothesized that the use of image-guided bone biopsies in patients with non-vertebral osteomyelitis would not have a significant impact on antibiotic management. Our results showed that physicians usually do not trust culture data provided by bone biopsy results. Negative bone cultures almost never lead physicians to discontinue antibiotics due to the low yield and reliability of bone biopsy culture data. Similarly, positive cultures almost never lead physicians to prescribe targeted antibiotics. 75% of the patients in our study had contiguous osteomyelitis caused by an overlying ulcer (e.g., diabetic foot ulcers or sacral decubitus ulcers). Exposure of the wound to the outside world often results in polymicrobial infections, and as such physicians rarely narrowed antibiotic coverage when a single organism was cultured. We also found that empiric antibiotic therapy adequately treated cultured micro-organisms in 95% of cases.
While many questions remained unanswered by this study, our results are an important contribution to the body of evidence that image-guided bone biopsies have low utility in the management of contiguous non-vertebral osteomyelitis. I look forward to seeing how the results of future research will compare with our findings. I am grateful to have had the opportunity to work in such an exciting area of research and I hope to continue participating in research projects throughout my medical career.
Cole Hirschfeld is originally from Phoenix. He received undergraduate degrees in finance and entrepreneurship from the University of Arizona and went on to work in the finance industry for 2 years before deciding to change careers and attend medical school. He is now a 4th year medical student at Cornell University, New York, and plans to apply for residency in internal medicine.
Here’s what’s trending at SHM – Nov. 2017
Recognizing American Diabetes Month, COPD Awareness Month, and CDC’s Get Smart Week with QI Solutions
- There’s no better time than during American Diabetes Month to learn more about SHM’s Glycemic Control programs. Find out how your institution can submit point-of-care data to SHM’s Data Center, generate monthly reports and be included in the national glucometrics benchmark report. Hospital systems are also encouraged to subscribe to track and compare their individual as well as overall performance. Be one of the 100-plus hospitals nationwide that are supported by SHM’s respected Glycemic Control Programs. Contact Sara Platt for a free demo at [email protected] or by phone at 267-702-2672. For additional information, visit hospitalmedicine.org/gc.
- November marks Chronic Obstructive Pulmonary Disease (COPD) Month, and it is critical that hospitals begin to direct QI resources to improving care for COPD patients. SHM developed a free guide to help you make changes to COPD care at both the individual patient and the institutional levels. Whether you are a clinician, medical director, VP of quality or chief medical officer, these resources can help you. Visit hospitalmedicine.org/COPD to download the guide.
- And, in conjunction with the Centers for Disease Control & Prevention’s (CDC’s) Get Smart Week, SHM is committed to promoting improved antibiotic prescribing behaviors among U.S. hospitalists. Through the Fight the Resistance campaign, SHM has developed many antimicrobial stewardship resources, including an implementation guide, four educational modules, and posters to hang in your hospital. Learn more at hospitalmedicine.org/abx.
Present your abstract in front of a national audience at HM18
SHM is accepting submissions for the Research, Innovations, and Clinical Vignettes (RIV) Competition at Hospital Medicine 2018 (HM18). Based on past experience, the RIV Competition is likely to be one of the most popular events at HM18, enabling hospitalists from across the country to discuss emerging science and clinical cases, share feedback, and make valuable professional connections.
The competition features more than 1,700 applicants vying for approximately 900 poster spots. Plenary and oral sessions are chosen from the pool of abstracts prior to the conference, and authors are invited to present on-site at HM18 in front of a national audience.
Many of the cutting-edge abstracts that are first presented at SHM’s RIV sessions go on to be published in highly respected medical journals. The competition also includes a special Trainee Award category for resident and student authors.
SHM is excited to launch the Resident Travel Grant for 10 residents to receive funding to help cover the costs of travel and accommodations to attend SHM’s annual conference. See full details on how to apply and the selection process at shmannualconference.org/riv.
The submission deadline is Sunday, Dec. 3, 2017.
Distinguish yourself as a Class of 2018 Fellow in Hospital Medicine
SHM’s Fellows designation is a prestigious way to differentiate yourself in the rapidly growing profession of hospital medicine. There are currently over 2,000 hospitalists who have earned the Fellow in Hospital Medicine (FHM) or Senior Fellow in Hospital Medicine (SFHM) designation by demonstrating the core values of leadership, teamwork, and quality improvement.
Apply now and learn how you can join this prestigious group of hospitalists at hospitalmedicine.org/fellows. Applications officially close on Nov. 30, 2017.
The hospital observation care problem: Perspectives and solutions from SHM
Hospitalists provide the majority of observation care to Medicare beneficiaries and are often the primary points of contact for patients as they navigate the impact of inpatient and observation care determinations during and after their hospitalizations.
In 2017, SHM re-surveyed members to understand the state of hospital observation care after several legislative and regulatory changes. Through this new survey, hospitalists reported on their experience with the two-midnight rule and the impact of the recent Notification of Observation Treatment and Implication of Care Eligibility (NOTICE) Act, which requires hospitals to inform patients through the Medicare Outpatient Observation Notice (MOON) form that they are hospitalized under observation. Read the white paper to get perspectives and solutions from SHM at hospitalmedicine.org/advocacy.
Introducing ‘Ultrasonography: Essentials in Critical Care’
Brought to you by SHM and CHEST®, the Ultrasonography: Essentials in Critical Care course will be held Dec. 1-3, 2017, at the CHEST Innovation, Simulation, and Training Center in Glenview, Ill.
Enhance your point-of-care ultrasonography skills through hands-on training by experts in the field. Discover key elements of critical care ultrasonography and practice image acquisition with human models using high-quality ultrasound machines in this intensive 3-day course. Participants will earn 20.50 AMA PRA Category 1 Credits™ and MOC points.
Topics include:
- Vascular Access
- Vascular Diagnostic
- Echocardiography: Techniques and Standard Views
- Basic Critical Care and Echocardiography Overview
- Common Clinical Application of Ultrasonography to Guide Management of the Critically Ill
Learn more and register at livelearning.chestnet.org/ultrasonography.
Not a member? Join the movement today
Over 15,000 members have joined SHM to show their commitment to transforming health care and revolutionizing patient care. As an SHM member you will be connected to a wealth of opportunities designed to help you grow professionally, network with colleagues nationwide, and shape the practice of hospital medicine. See a full list of SHM member benefits or become a member today by visiting hospitalmedicine.org/join.
Mr. Radler is marketing communications manager at the Society of Hospital Medicine.
Recognizing American Diabetes Month, COPD Awareness Month, and CDC’s Get Smart Week with QI Solutions
- There’s no better time than during American Diabetes Month to learn more about SHM’s Glycemic Control programs. Find out how your institution can submit point-of-care data to SHM’s Data Center, generate monthly reports and be included in the national glucometrics benchmark report. Hospital systems are also encouraged to subscribe to track and compare their individual as well as overall performance. Be one of the 100-plus hospitals nationwide that are supported by SHM’s respected Glycemic Control Programs. Contact Sara Platt for a free demo at [email protected] or by phone at 267-702-2672. For additional information, visit hospitalmedicine.org/gc.
- November marks Chronic Obstructive Pulmonary Disease (COPD) Month, and it is critical that hospitals begin to direct QI resources to improving care for COPD patients. SHM developed a free guide to help you make changes to COPD care at both the individual patient and the institutional levels. Whether you are a clinician, medical director, VP of quality or chief medical officer, these resources can help you. Visit hospitalmedicine.org/COPD to download the guide.
- And, in conjunction with the Centers for Disease Control & Prevention’s (CDC’s) Get Smart Week, SHM is committed to promoting improved antibiotic prescribing behaviors among U.S. hospitalists. Through the Fight the Resistance campaign, SHM has developed many antimicrobial stewardship resources, including an implementation guide, four educational modules, and posters to hang in your hospital. Learn more at hospitalmedicine.org/abx.
Present your abstract in front of a national audience at HM18
SHM is accepting submissions for the Research, Innovations, and Clinical Vignettes (RIV) Competition at Hospital Medicine 2018 (HM18). Based on past experience, the RIV Competition is likely to be one of the most popular events at HM18, enabling hospitalists from across the country to discuss emerging science and clinical cases, share feedback, and make valuable professional connections.
The competition features more than 1,700 applicants vying for approximately 900 poster spots. Plenary and oral sessions are chosen from the pool of abstracts prior to the conference, and authors are invited to present on-site at HM18 in front of a national audience.
Many of the cutting-edge abstracts that are first presented at SHM’s RIV sessions go on to be published in highly respected medical journals. The competition also includes a special Trainee Award category for resident and student authors.
SHM is excited to launch the Resident Travel Grant for 10 residents to receive funding to help cover the costs of travel and accommodations to attend SHM’s annual conference. See full details on how to apply and the selection process at shmannualconference.org/riv.
The submission deadline is Sunday, Dec. 3, 2017.
Distinguish yourself as a Class of 2018 Fellow in Hospital Medicine
SHM’s Fellows designation is a prestigious way to differentiate yourself in the rapidly growing profession of hospital medicine. There are currently over 2,000 hospitalists who have earned the Fellow in Hospital Medicine (FHM) or Senior Fellow in Hospital Medicine (SFHM) designation by demonstrating the core values of leadership, teamwork, and quality improvement.
Apply now and learn how you can join this prestigious group of hospitalists at hospitalmedicine.org/fellows. Applications officially close on Nov. 30, 2017.
The hospital observation care problem: Perspectives and solutions from SHM
Hospitalists provide the majority of observation care to Medicare beneficiaries and are often the primary points of contact for patients as they navigate the impact of inpatient and observation care determinations during and after their hospitalizations.
In 2017, SHM re-surveyed members to understand the state of hospital observation care after several legislative and regulatory changes. Through this new survey, hospitalists reported on their experience with the two-midnight rule and the impact of the recent Notification of Observation Treatment and Implication of Care Eligibility (NOTICE) Act, which requires hospitals to inform patients through the Medicare Outpatient Observation Notice (MOON) form that they are hospitalized under observation. Read the white paper to get perspectives and solutions from SHM at hospitalmedicine.org/advocacy.
Introducing ‘Ultrasonography: Essentials in Critical Care’
Brought to you by SHM and CHEST®, the Ultrasonography: Essentials in Critical Care course will be held Dec. 1-3, 2017, at the CHEST Innovation, Simulation, and Training Center in Glenview, Ill.
Enhance your point-of-care ultrasonography skills through hands-on training by experts in the field. Discover key elements of critical care ultrasonography and practice image acquisition with human models using high-quality ultrasound machines in this intensive 3-day course. Participants will earn 20.50 AMA PRA Category 1 Credits™ and MOC points.
Topics include:
- Vascular Access
- Vascular Diagnostic
- Echocardiography: Techniques and Standard Views
- Basic Critical Care and Echocardiography Overview
- Common Clinical Application of Ultrasonography to Guide Management of the Critically Ill
Learn more and register at livelearning.chestnet.org/ultrasonography.
Not a member? Join the movement today
Over 15,000 members have joined SHM to show their commitment to transforming health care and revolutionizing patient care. As an SHM member you will be connected to a wealth of opportunities designed to help you grow professionally, network with colleagues nationwide, and shape the practice of hospital medicine. See a full list of SHM member benefits or become a member today by visiting hospitalmedicine.org/join.
Mr. Radler is marketing communications manager at the Society of Hospital Medicine.
Recognizing American Diabetes Month, COPD Awareness Month, and CDC’s Get Smart Week with QI Solutions
- There’s no better time than during American Diabetes Month to learn more about SHM’s Glycemic Control programs. Find out how your institution can submit point-of-care data to SHM’s Data Center, generate monthly reports and be included in the national glucometrics benchmark report. Hospital systems are also encouraged to subscribe to track and compare their individual as well as overall performance. Be one of the 100-plus hospitals nationwide that are supported by SHM’s respected Glycemic Control Programs. Contact Sara Platt for a free demo at [email protected] or by phone at 267-702-2672. For additional information, visit hospitalmedicine.org/gc.
- November marks Chronic Obstructive Pulmonary Disease (COPD) Month, and it is critical that hospitals begin to direct QI resources to improving care for COPD patients. SHM developed a free guide to help you make changes to COPD care at both the individual patient and the institutional levels. Whether you are a clinician, medical director, VP of quality or chief medical officer, these resources can help you. Visit hospitalmedicine.org/COPD to download the guide.
- And, in conjunction with the Centers for Disease Control & Prevention’s (CDC’s) Get Smart Week, SHM is committed to promoting improved antibiotic prescribing behaviors among U.S. hospitalists. Through the Fight the Resistance campaign, SHM has developed many antimicrobial stewardship resources, including an implementation guide, four educational modules, and posters to hang in your hospital. Learn more at hospitalmedicine.org/abx.
Present your abstract in front of a national audience at HM18
SHM is accepting submissions for the Research, Innovations, and Clinical Vignettes (RIV) Competition at Hospital Medicine 2018 (HM18). Based on past experience, the RIV Competition is likely to be one of the most popular events at HM18, enabling hospitalists from across the country to discuss emerging science and clinical cases, share feedback, and make valuable professional connections.
The competition features more than 1,700 applicants vying for approximately 900 poster spots. Plenary and oral sessions are chosen from the pool of abstracts prior to the conference, and authors are invited to present on-site at HM18 in front of a national audience.
Many of the cutting-edge abstracts that are first presented at SHM’s RIV sessions go on to be published in highly respected medical journals. The competition also includes a special Trainee Award category for resident and student authors.
SHM is excited to launch the Resident Travel Grant for 10 residents to receive funding to help cover the costs of travel and accommodations to attend SHM’s annual conference. See full details on how to apply and the selection process at shmannualconference.org/riv.
The submission deadline is Sunday, Dec. 3, 2017.
Distinguish yourself as a Class of 2018 Fellow in Hospital Medicine
SHM’s Fellows designation is a prestigious way to differentiate yourself in the rapidly growing profession of hospital medicine. There are currently over 2,000 hospitalists who have earned the Fellow in Hospital Medicine (FHM) or Senior Fellow in Hospital Medicine (SFHM) designation by demonstrating the core values of leadership, teamwork, and quality improvement.
Apply now and learn how you can join this prestigious group of hospitalists at hospitalmedicine.org/fellows. Applications officially close on Nov. 30, 2017.
The hospital observation care problem: Perspectives and solutions from SHM
Hospitalists provide the majority of observation care to Medicare beneficiaries and are often the primary points of contact for patients as they navigate the impact of inpatient and observation care determinations during and after their hospitalizations.
In 2017, SHM re-surveyed members to understand the state of hospital observation care after several legislative and regulatory changes. Through this new survey, hospitalists reported on their experience with the two-midnight rule and the impact of the recent Notification of Observation Treatment and Implication of Care Eligibility (NOTICE) Act, which requires hospitals to inform patients through the Medicare Outpatient Observation Notice (MOON) form that they are hospitalized under observation. Read the white paper to get perspectives and solutions from SHM at hospitalmedicine.org/advocacy.
Introducing ‘Ultrasonography: Essentials in Critical Care’
Brought to you by SHM and CHEST®, the Ultrasonography: Essentials in Critical Care course will be held Dec. 1-3, 2017, at the CHEST Innovation, Simulation, and Training Center in Glenview, Ill.
Enhance your point-of-care ultrasonography skills through hands-on training by experts in the field. Discover key elements of critical care ultrasonography and practice image acquisition with human models using high-quality ultrasound machines in this intensive 3-day course. Participants will earn 20.50 AMA PRA Category 1 Credits™ and MOC points.
Topics include:
- Vascular Access
- Vascular Diagnostic
- Echocardiography: Techniques and Standard Views
- Basic Critical Care and Echocardiography Overview
- Common Clinical Application of Ultrasonography to Guide Management of the Critically Ill
Learn more and register at livelearning.chestnet.org/ultrasonography.
Not a member? Join the movement today
Over 15,000 members have joined SHM to show their commitment to transforming health care and revolutionizing patient care. As an SHM member you will be connected to a wealth of opportunities designed to help you grow professionally, network with colleagues nationwide, and shape the practice of hospital medicine. See a full list of SHM member benefits or become a member today by visiting hospitalmedicine.org/join.
Mr. Radler is marketing communications manager at the Society of Hospital Medicine.
Higher hospital mortality in pediatric emergency transfer patients
Editor’s Note: The Society of Hospital Medicine’s (SHM’s) Physician in Training Committee launched a scholarship program in 2015 for medical students to help transform health care and revolutionize patient care. The program has been expanded for the 2017-2018 year, offering two options for students to receive funding and engage in scholarly work during their first, second, and third years of medical school. As a part of the program, recipients are required to write about their experience on a biweekly basis.
I’ve learned so much this summer from working with Dr. Patrick Brady to better understand characteristics of pediatric patients who undergo clinical deterioration and unplanned transfers to the ICU. I’m very grateful to have spent my summer with a mentor who really cared about my growth as a student, and a fantastic group of physicians in the Division of Hospital Medicine at Cincinnati Children’s Hospital Medical Center.
Our work this summer revolved around working to define clinical characteristics and identifying predictors for emergency transfers to the ICU. An emergency transfer is when a patient is transferred from an acute care floor to an ICU where the patient received intubation, inotropes, or 3 or more fluid boluses in the first hour after arrival or before transfer. We designed a case-control study and compared emergency transfer cases from Cincinnati Children’s Hospital from 2013-2017 and matched controls 3:1 on age strata, hospital unit before transfer, and time of year. We recorded demographic data, as well as measured ICU length of stay, and hospital length of stay.
After data analysis, we discovered that children who have had an emergency transfer event spend a longer time in the ICU and in the hospital. After comparing hospital mortality, we can conclude that emergency transfer patients have a higher likelihood of hospital mortality.
From this preliminary research, the emergency transfer metric in children’s hospitals has the potential to enable more rapid learning and systems improvement. We have a few next steps to investigate these next couple months as well. We want to compare medical diagnoses and complex chronic conditions between the emergency transfer cases and controls. We also hope to describe the incidence using a patient-days denominator. Finally, our long term goals are to identify predictors for an emergency transfer event in children.
Farah Hussain is a 2nd-year medical student at University of Cincinnati College of Medicine and student researcher at Cincinnati Children’s Hospital Medical Center. Her research interests involve bettering patient care to vulnerable populations.
Editor’s Note: The Society of Hospital Medicine’s (SHM’s) Physician in Training Committee launched a scholarship program in 2015 for medical students to help transform health care and revolutionize patient care. The program has been expanded for the 2017-2018 year, offering two options for students to receive funding and engage in scholarly work during their first, second, and third years of medical school. As a part of the program, recipients are required to write about their experience on a biweekly basis.
I’ve learned so much this summer from working with Dr. Patrick Brady to better understand characteristics of pediatric patients who undergo clinical deterioration and unplanned transfers to the ICU. I’m very grateful to have spent my summer with a mentor who really cared about my growth as a student, and a fantastic group of physicians in the Division of Hospital Medicine at Cincinnati Children’s Hospital Medical Center.
Our work this summer revolved around working to define clinical characteristics and identifying predictors for emergency transfers to the ICU. An emergency transfer is when a patient is transferred from an acute care floor to an ICU where the patient received intubation, inotropes, or 3 or more fluid boluses in the first hour after arrival or before transfer. We designed a case-control study and compared emergency transfer cases from Cincinnati Children’s Hospital from 2013-2017 and matched controls 3:1 on age strata, hospital unit before transfer, and time of year. We recorded demographic data, as well as measured ICU length of stay, and hospital length of stay.
After data analysis, we discovered that children who have had an emergency transfer event spend a longer time in the ICU and in the hospital. After comparing hospital mortality, we can conclude that emergency transfer patients have a higher likelihood of hospital mortality.
From this preliminary research, the emergency transfer metric in children’s hospitals has the potential to enable more rapid learning and systems improvement. We have a few next steps to investigate these next couple months as well. We want to compare medical diagnoses and complex chronic conditions between the emergency transfer cases and controls. We also hope to describe the incidence using a patient-days denominator. Finally, our long term goals are to identify predictors for an emergency transfer event in children.
Farah Hussain is a 2nd-year medical student at University of Cincinnati College of Medicine and student researcher at Cincinnati Children’s Hospital Medical Center. Her research interests involve bettering patient care to vulnerable populations.
Editor’s Note: The Society of Hospital Medicine’s (SHM’s) Physician in Training Committee launched a scholarship program in 2015 for medical students to help transform health care and revolutionize patient care. The program has been expanded for the 2017-2018 year, offering two options for students to receive funding and engage in scholarly work during their first, second, and third years of medical school. As a part of the program, recipients are required to write about their experience on a biweekly basis.
I’ve learned so much this summer from working with Dr. Patrick Brady to better understand characteristics of pediatric patients who undergo clinical deterioration and unplanned transfers to the ICU. I’m very grateful to have spent my summer with a mentor who really cared about my growth as a student, and a fantastic group of physicians in the Division of Hospital Medicine at Cincinnati Children’s Hospital Medical Center.
Our work this summer revolved around working to define clinical characteristics and identifying predictors for emergency transfers to the ICU. An emergency transfer is when a patient is transferred from an acute care floor to an ICU where the patient received intubation, inotropes, or 3 or more fluid boluses in the first hour after arrival or before transfer. We designed a case-control study and compared emergency transfer cases from Cincinnati Children’s Hospital from 2013-2017 and matched controls 3:1 on age strata, hospital unit before transfer, and time of year. We recorded demographic data, as well as measured ICU length of stay, and hospital length of stay.
After data analysis, we discovered that children who have had an emergency transfer event spend a longer time in the ICU and in the hospital. After comparing hospital mortality, we can conclude that emergency transfer patients have a higher likelihood of hospital mortality.
From this preliminary research, the emergency transfer metric in children’s hospitals has the potential to enable more rapid learning and systems improvement. We have a few next steps to investigate these next couple months as well. We want to compare medical diagnoses and complex chronic conditions between the emergency transfer cases and controls. We also hope to describe the incidence using a patient-days denominator. Finally, our long term goals are to identify predictors for an emergency transfer event in children.
Farah Hussain is a 2nd-year medical student at University of Cincinnati College of Medicine and student researcher at Cincinnati Children’s Hospital Medical Center. Her research interests involve bettering patient care to vulnerable populations.