From the Society

In conjunction with the Centers for Disease Control & Prevention’s Get Smart about Antibiotics Week, SHM is committed to promoting improved antibiotic-prescribing behaviors among the nation’s hospitalists through its “Fight the Resistance” awareness campaign.

Display SHM’s three downloadable “Fight the Resistance” posters, available at www.fighttheresistance.org. Hang them in your break rooms, hallways, or other high-profile locations to help remind your colleagues about the dangers of antibiotic resistance. SHM will be launching a mentored implementation program on antibiotics in early 2017. To be notified when the program becomes available, visit www.hospitalmedicine.org/ABX16.

In conjunction with the Centers for Disease Control & Prevention’s Get Smart about Antibiotics Week, SHM is committed to promoting improved antibiotic-prescribing behaviors among the nation’s hospitalists through its “Fight the Resistance” awareness campaign.

Display SHM’s three downloadable “Fight the Resistance” posters, available at www.fighttheresistance.org. Hang them in your break rooms, hallways, or other high-profile locations to help remind your colleagues about the dangers of antibiotic resistance. SHM will be launching a mentored implementation program on antibiotics in early 2017. To be notified when the program becomes available, visit www.hospitalmedicine.org/ABX16.

In conjunction with the Centers for Disease Control & Prevention’s Get Smart about Antibiotics Week, SHM is committed to promoting improved antibiotic-prescribing behaviors among the nation’s hospitalists through its “Fight the Resistance” awareness campaign.

Display SHM’s three downloadable “Fight the Resistance” posters, available at www.fighttheresistance.org. Hang them in your break rooms, hallways, or other high-profile locations to help remind your colleagues about the dangers of antibiotic resistance. SHM will be launching a mentored implementation program on antibiotics in early 2017. To be notified when the program becomes available, visit www.hospitalmedicine.org/ABX16.

There is no better time than American Diabetes Month to learn more about SHM’s Glycemic Control Program. 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 in order to track their individual performance as well as compare overall performance.

View a recent case study on three sites that demonstrated more rapid definitive improvements in measurable outcomes with the mentoring program, driving change through ongoing objective support, data collection, and analysis. Don’t wait: Be one of the 100 hospitals nationwide supported by SHM’s respected Glycemic Control Program. Learn more at www.hospitalmedicine.org/gc.

There is no better time than American Diabetes Month to learn more about SHM’s Glycemic Control Program. 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 in order to track their individual performance as well as compare overall performance.

View a recent case study on three sites that demonstrated more rapid definitive improvements in measurable outcomes with the mentoring program, driving change through ongoing objective support, data collection, and analysis. Don’t wait: Be one of the 100 hospitals nationwide supported by SHM’s respected Glycemic Control Program. Learn more at www.hospitalmedicine.org/gc.

There is no better time than American Diabetes Month to learn more about SHM’s Glycemic Control Program. 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 in order to track their individual performance as well as compare overall performance.

View a recent case study on three sites that demonstrated more rapid definitive improvements in measurable outcomes with the mentoring program, driving change through ongoing objective support, data collection, and analysis. Don’t wait: Be one of the 100 hospitals nationwide supported by SHM’s respected Glycemic Control Program. Learn more at www.hospitalmedicine.org/gc.

Now through December 31, 2016, all active SHM members can earn 2017–2018 dues credits and special recognition for recruiting new physician, physician assistant, nurse practitioner, pharmacist, or affiliate members. Active members will be eligible for:

• A $35 credit toward 2017–2018 dues when recruiting 1 new member.
• A $50 credit toward 2017–2018 dues when recruiting 2–4 new members.
• A $75 credit toward 2017–2018 dues when recruiting 5–9 new members.
• A $125 credit toward 2017–2018 dues when recruiting 10+ new members.

For each member recruited, referrers will receive one entry into a grand-prize drawing to receive complimentary registration to Hospital Medicine 2017 in Las Vegas.

Now through December 31, 2016, all active SHM members can earn 2017–2018 dues credits and special recognition for recruiting new physician, physician assistant, nurse practitioner, pharmacist, or affiliate members. Active members will be eligible for:

• A $35 credit toward 2017–2018 dues when recruiting 1 new member.
• A $50 credit toward 2017–2018 dues when recruiting 2–4 new members.
• A $75 credit toward 2017–2018 dues when recruiting 5–9 new members.
• A $125 credit toward 2017–2018 dues when recruiting 10+ new members.

For each member recruited, referrers will receive one entry into a grand-prize drawing to receive complimentary registration to Hospital Medicine 2017 in Las Vegas.

Now through December 31, 2016, all active SHM members can earn 2017–2018 dues credits and special recognition for recruiting new physician, physician assistant, nurse practitioner, pharmacist, or affiliate members. Active members will be eligible for:

• A $35 credit toward 2017–2018 dues when recruiting 1 new member.
• A $50 credit toward 2017–2018 dues when recruiting 2–4 new members.
• A $75 credit toward 2017–2018 dues when recruiting 5–9 new members.
• A $125 credit toward 2017–2018 dues when recruiting 10+ new members.

For each member recruited, referrers will receive one entry into a grand-prize drawing to receive complimentary registration to Hospital Medicine 2017 in Las Vegas.

SHM recently partnered with the Human Diagnosis Project, also referred to as Human Dx, for Global Morning Report. Human Dx is the world’s first open diagnostic system, which aims to understand the fundamental data structure of diagnosis and considerably impact the future cost of, access to, and effectiveness of healthcare globally.

The Hospitalist spoke with Shantanu Nundy, MD, MBA, a primary-care physician for the Human Diagnosis Project, to learn more about its inception and SHM’s partnership.

Question: How did the Global Morning Report project start?

Answer: We were at the University of California, San Francisco (UCSF), working on a morning report with master diagnostician Gurpreet Dhaliwal, MD, when we had an “aha moment” of sorts. Instead of the typical morning report, which uses a whiteboard or slide deck, residents and Dr. Dhaliwal worked through the case using the Human Dx open case collaboration software. At the end of the morning report, the case was tweeted out on social media for anyone in the world to solve, and within minutes, a medical student in Bangladesh not only was able to access the case but also access insights from the UCSF residents and Dr. Dhaliwal. That’s when we realized we were onto something big.

Q: What are the goals of Human Dx and Global Morning Report?

A: Repeated, rapid cycles of practice, feedback, and reinforcement are key components of learning. Sports training is a useful analogy—the best athletes practice drills daily, often for hours a day, and monitor their performance rigorously—but the same can be said for many other professions, including musicians, chefs, and public speakers.

In medicine, we call seeing patients every day “practice.” But we aren’t practicing if we aren’t getting feedback and improving—we are just performing. None of us can hope to be the Michael Phelps, Yo-Yo Ma, or Grant Achatz of medicine that our patients deserve us to be without real practice.

Human Dx builds on the science of learning by enabling physicians and students to quickly test and get feedback on their clinical reasoning skills. This is done both by receiving input on their own cases as well as giving input on other contributors’ cases to compare their thinking with physicians and students from around the world. Our goal is for Global Morning Report to become the daily personalized workout schedule for doctors everywhere. What I’d like to see is that rigorous practice and pursuit of excellence in clinical reasoning, diagnosis, and management becoming a core part of the physician experience.

Q: What kind of feedback are you hearing from participants?

A: Doctors love it! Many tell us this is their daily Sudoku or crossword that they do every morning to wake their minds up on the way to work. And our numbers show it: The average active participant contributes five cases per week. And today, that’s without any CME credit or other clear reward other than learning and enjoyment.

That said, we have much to improve, and we aren’t resting on our laurels. The whole ethos of the Human Diagnosis Project is created and led by the global medical community. We are lucky to have an incredible community of physicians and trainees globally who keep us moving forward each day.

Q: Why was a partnership with SHM appealing for this project?

A: At Human Dx, we look at ourselves simply as enablers. We are making it possible for the global medical community to come together and build something important for current and future generations. As such, we want to work with the best institutions in medicine to take their expertise, content, and community and make them more available to the world. As one of the largest, fastest growing, and innovative communities in medicine, SHM is an ideal partner, and we count ourselves very fortunate to have your support.

Q: How can hospitalists participate?

A: Start contributing cases! Not every doctor is interested in medical education, technology, or policy, but every physician I know has great cases and insights to share with the world. My hope is that for physicians and medical students, contributing to Human Dx is their 10 minutes a day to be a part of something greater than themselves, allowing them to share their insights with humankind, build a resource for current and future generations, and, in doing so, renew the reasons that brought them to medicine in the first place and find joy in clinical practice. TH

Join the movement today and solve a case now at www.humandx.org/shm.

SHM recently partnered with the Human Diagnosis Project, also referred to as Human Dx, for Global Morning Report. Human Dx is the world’s first open diagnostic system, which aims to understand the fundamental data structure of diagnosis and considerably impact the future cost of, access to, and effectiveness of healthcare globally.

The Hospitalist spoke with Shantanu Nundy, MD, MBA, a primary-care physician for the Human Diagnosis Project, to learn more about its inception and SHM’s partnership.

Question: How did the Global Morning Report project start?

Answer: We were at the University of California, San Francisco (UCSF), working on a morning report with master diagnostician Gurpreet Dhaliwal, MD, when we had an “aha moment” of sorts. Instead of the typical morning report, which uses a whiteboard or slide deck, residents and Dr. Dhaliwal worked through the case using the Human Dx open case collaboration software. At the end of the morning report, the case was tweeted out on social media for anyone in the world to solve, and within minutes, a medical student in Bangladesh not only was able to access the case but also access insights from the UCSF residents and Dr. Dhaliwal. That’s when we realized we were onto something big.

Q: What are the goals of Human Dx and Global Morning Report?

A: Repeated, rapid cycles of practice, feedback, and reinforcement are key components of learning. Sports training is a useful analogy—the best athletes practice drills daily, often for hours a day, and monitor their performance rigorously—but the same can be said for many other professions, including musicians, chefs, and public speakers.

In medicine, we call seeing patients every day “practice.” But we aren’t practicing if we aren’t getting feedback and improving—we are just performing. None of us can hope to be the Michael Phelps, Yo-Yo Ma, or Grant Achatz of medicine that our patients deserve us to be without real practice.

Human Dx builds on the science of learning by enabling physicians and students to quickly test and get feedback on their clinical reasoning skills. This is done both by receiving input on their own cases as well as giving input on other contributors’ cases to compare their thinking with physicians and students from around the world. Our goal is for Global Morning Report to become the daily personalized workout schedule for doctors everywhere. What I’d like to see is that rigorous practice and pursuit of excellence in clinical reasoning, diagnosis, and management becoming a core part of the physician experience.

Q: What kind of feedback are you hearing from participants?

A: Doctors love it! Many tell us this is their daily Sudoku or crossword that they do every morning to wake their minds up on the way to work. And our numbers show it: The average active participant contributes five cases per week. And today, that’s without any CME credit or other clear reward other than learning and enjoyment.

That said, we have much to improve, and we aren’t resting on our laurels. The whole ethos of the Human Diagnosis Project is created and led by the global medical community. We are lucky to have an incredible community of physicians and trainees globally who keep us moving forward each day.

Q: Why was a partnership with SHM appealing for this project?

A: At Human Dx, we look at ourselves simply as enablers. We are making it possible for the global medical community to come together and build something important for current and future generations. As such, we want to work with the best institutions in medicine to take their expertise, content, and community and make them more available to the world. As one of the largest, fastest growing, and innovative communities in medicine, SHM is an ideal partner, and we count ourselves very fortunate to have your support.

Q: How can hospitalists participate?

A: Start contributing cases! Not every doctor is interested in medical education, technology, or policy, but every physician I know has great cases and insights to share with the world. My hope is that for physicians and medical students, contributing to Human Dx is their 10 minutes a day to be a part of something greater than themselves, allowing them to share their insights with humankind, build a resource for current and future generations, and, in doing so, renew the reasons that brought them to medicine in the first place and find joy in clinical practice. TH

Join the movement today and solve a case now at www.humandx.org/shm.

SHM recently partnered with the Human Diagnosis Project, also referred to as Human Dx, for Global Morning Report. Human Dx is the world’s first open diagnostic system, which aims to understand the fundamental data structure of diagnosis and considerably impact the future cost of, access to, and effectiveness of healthcare globally.

The Hospitalist spoke with Shantanu Nundy, MD, MBA, a primary-care physician for the Human Diagnosis Project, to learn more about its inception and SHM’s partnership.

Question: How did the Global Morning Report project start?

Answer: We were at the University of California, San Francisco (UCSF), working on a morning report with master diagnostician Gurpreet Dhaliwal, MD, when we had an “aha moment” of sorts. Instead of the typical morning report, which uses a whiteboard or slide deck, residents and Dr. Dhaliwal worked through the case using the Human Dx open case collaboration software. At the end of the morning report, the case was tweeted out on social media for anyone in the world to solve, and within minutes, a medical student in Bangladesh not only was able to access the case but also access insights from the UCSF residents and Dr. Dhaliwal. That’s when we realized we were onto something big.

Q: What are the goals of Human Dx and Global Morning Report?

A: Repeated, rapid cycles of practice, feedback, and reinforcement are key components of learning. Sports training is a useful analogy—the best athletes practice drills daily, often for hours a day, and monitor their performance rigorously—but the same can be said for many other professions, including musicians, chefs, and public speakers.

In medicine, we call seeing patients every day “practice.” But we aren’t practicing if we aren’t getting feedback and improving—we are just performing. None of us can hope to be the Michael Phelps, Yo-Yo Ma, or Grant Achatz of medicine that our patients deserve us to be without real practice.

Human Dx builds on the science of learning by enabling physicians and students to quickly test and get feedback on their clinical reasoning skills. This is done both by receiving input on their own cases as well as giving input on other contributors’ cases to compare their thinking with physicians and students from around the world. Our goal is for Global Morning Report to become the daily personalized workout schedule for doctors everywhere. What I’d like to see is that rigorous practice and pursuit of excellence in clinical reasoning, diagnosis, and management becoming a core part of the physician experience.

Q: What kind of feedback are you hearing from participants?

A: Doctors love it! Many tell us this is their daily Sudoku or crossword that they do every morning to wake their minds up on the way to work. And our numbers show it: The average active participant contributes five cases per week. And today, that’s without any CME credit or other clear reward other than learning and enjoyment.

That said, we have much to improve, and we aren’t resting on our laurels. The whole ethos of the Human Diagnosis Project is created and led by the global medical community. We are lucky to have an incredible community of physicians and trainees globally who keep us moving forward each day.

Q: Why was a partnership with SHM appealing for this project?

A: At Human Dx, we look at ourselves simply as enablers. We are making it possible for the global medical community to come together and build something important for current and future generations. As such, we want to work with the best institutions in medicine to take their expertise, content, and community and make them more available to the world. As one of the largest, fastest growing, and innovative communities in medicine, SHM is an ideal partner, and we count ourselves very fortunate to have your support.

Q: How can hospitalists participate?

A: Start contributing cases! Not every doctor is interested in medical education, technology, or policy, but every physician I know has great cases and insights to share with the world. My hope is that for physicians and medical students, contributing to Human Dx is their 10 minutes a day to be a part of something greater than themselves, allowing them to share their insights with humankind, build a resource for current and future generations, and, in doing so, renew the reasons that brought them to medicine in the first place and find joy in clinical practice. TH

Join the movement today and solve a case now at www.humandx.org/shm.

SHM is now accepting submissions for the Hospital Medicine 2017 (HM17) Research, Innovations, and Clinical Vignettes (RIV) abstract and poster competition. Seize the opportunity to present your research, innovative ideas, and clinical stories to a national audience at HM17, May 1–4, 2017, in Las Vegas. Learn more by visiting www.hospitalmedicine2017.org.

SHM strongly recommends that you complete your submission well ahead of the deadline of Monday, December 5, 2016. New to SHM? Registration for HM17 includes a complimentary one-year SHM membership. Register online prior to March 6, 2017, to receive the best registration rates.

SHM is now accepting submissions for the Hospital Medicine 2017 (HM17) Research, Innovations, and Clinical Vignettes (RIV) abstract and poster competition. Seize the opportunity to present your research, innovative ideas, and clinical stories to a national audience at HM17, May 1–4, 2017, in Las Vegas. Learn more by visiting www.hospitalmedicine2017.org.

SHM strongly recommends that you complete your submission well ahead of the deadline of Monday, December 5, 2016. New to SHM? Registration for HM17 includes a complimentary one-year SHM membership. Register online prior to March 6, 2017, to receive the best registration rates.

SHM is now accepting submissions for the Hospital Medicine 2017 (HM17) Research, Innovations, and Clinical Vignettes (RIV) abstract and poster competition. Seize the opportunity to present your research, innovative ideas, and clinical stories to a national audience at HM17, May 1–4, 2017, in Las Vegas. Learn more by visiting www.hospitalmedicine2017.org.

SHM strongly recommends that you complete your submission well ahead of the deadline of Monday, December 5, 2016. New to SHM? Registration for HM17 includes a complimentary one-year SHM membership. Register online prior to March 6, 2017, to receive the best registration rates.

The regular decision application is open through November 30, with a decision on or before December 31, 2016. Learn how you can join other hospitalists who have earned this exclusive designation and recognition at www.hospitalmedicine.org/fellows.

The regular decision application is open through November 30, with a decision on or before December 31, 2016. Learn how you can join other hospitalists who have earned this exclusive designation and recognition at www.hospitalmedicine.org/fellows.

The regular decision application is open through November 30, with a decision on or before December 31, 2016. Learn how you can join other hospitalists who have earned this exclusive designation and recognition at www.hospitalmedicine.org/fellows.

October 16–22 is the National Association for Healthcare Quality’s “Healthcare Quality Week,” and SHM’s Center for Hospital Innovation & Improvement provides a variety of resources, tools, and programs to help address quality and patient safety issues at your institution. Find out how SHM can help you improve patient safety and outcomes through our Center for Hospital Innovation & Improvement at www.hospialmedicine.org/QI.

October 16–22 is the National Association for Healthcare Quality’s “Healthcare Quality Week,” and SHM’s Center for Hospital Innovation & Improvement provides a variety of resources, tools, and programs to help address quality and patient safety issues at your institution. Find out how SHM can help you improve patient safety and outcomes through our Center for Hospital Innovation & Improvement at www.hospialmedicine.org/QI.

October 16–22 is the National Association for Healthcare Quality’s “Healthcare Quality Week,” and SHM’s Center for Hospital Innovation & Improvement provides a variety of resources, tools, and programs to help address quality and patient safety issues at your institution. Find out how SHM can help you improve patient safety and outcomes through our Center for Hospital Innovation & Improvement at www.hospialmedicine.org/QI.

• Model 1: Mentors/Mentees. Less experienced administrators will be paired with seasoned professionals to gain more experience or exposure.
• Model 2: Buddy System. Administrators at any level of expertise or experience will be paired with a peer so they both can learn from each other.

Interested in being a mentor or mentee for the 2017 program? Complete the online form at www.hospitalmedicine.org/pamentor used to match you up to other individuals who have similar needs for improvement.

• Model 1: Mentors/Mentees. Less experienced administrators will be paired with seasoned professionals to gain more experience or exposure.
• Model 2: Buddy System. Administrators at any level of expertise or experience will be paired with a peer so they both can learn from each other.

Interested in being a mentor or mentee for the 2017 program? Complete the online form at www.hospitalmedicine.org/pamentor used to match you up to other individuals who have similar needs for improvement.

• Model 1: Mentors/Mentees. Less experienced administrators will be paired with seasoned professionals to gain more experience or exposure.
• Model 2: Buddy System. Administrators at any level of expertise or experience will be paired with a peer so they both can learn from each other.

Interested in being a mentor or mentee for the 2017 program? Complete the online form at www.hospitalmedicine.org/pamentor used to match you up to other individuals who have similar needs for improvement.

This month, The Hospitalist spotlights G. Randy Smith Jr., MD, MS, SFHM, assistant professor in the Division of Hospital Medicine at the Northwestern University Feinberg School of Medicine and medical director of Unit 16 West at Northwestern Memorial Hospital in Chicago. Dr. Smith is an active member of SHM’s Practice Analysis Committee and a Leadership Academy veteran who has translated his learnings into more efficient rounding and patient-flow methodology.

Question: What inspired you to begin working in hospital medicine and later join SHM?

Answer: Interest in taking care of acutely ill patients inspired me to start working in hospital medicine. Evolution of this interest into care-delivery design inspired me to remain in hospital medicine. Joining SHM enabled me to make contacts nationally with people who share similar interests and engage in collaboration, which has been helpful for my growth as a physician.

Q: How has SHM provided you with resources to improve patient care during your time as a member?

A: The SHM annual meetings have provided a consistent framework for dissemination of clinically relevant innovations and discoveries. Each year I’ve attended, I’ve always learned something new from both the posters on display and from a quality improvement presentation. Last year at Hospital Medicine 2016, the HEADS-UP plenary abstract presentation was one very good example of a different approach to interdisciplinary rounding that I would not have been aware of without attending the SHM annual meeting.

Q: How did attending Leadership Academy help you grow to reach your medical director position at Northwestern Memorial?

A: Leadership Academy helped to open my mind to principles of negotiation and expectation management as well as self-awareness, which are not usually presented in medical school or residency. Many of the skills taught can be learned the hard way through the trials of life, but the Leadership Academy accelerated my real-world learning.

My hospital’s leadership recognized the skills I developed with the assistance of Leadership Academy, which helped me to maintain my effectiveness in my medical director role.

Skills obtained in the Leadership Academy helped me to incorporate ward-based afternoon throughput meetings into a hospital-wide patient-flow management network. I also learned to successfully negotiate procurement of chairs for our physicians to sit at the patient’s bedside in the hopes of improving patient satisfaction.

Q: How has your work on the Practice Analysis Committee impacted how you manage your hospital medicine teams?

A: My involvement in the Practice Analysis Committee is yet another example of an opportunity provided by SHM to develop a skills set I would not otherwise have the opportunity to develop. Working on the State of Hospital Medicine survey involves prioritizing information with the burden of the respondents’ time and effort in mind. Sensitivities to stakeholder interest play a major role as well.

Achieving balance between aspiring definitions of concepts to help drive the field and working definitions used heterogeneously throughout the country represents the hardest task of the committee members to sort; I’m very privileged to take the lessons learned through member dialogue and help colleagues apply the lessons locally.

Q: Hospital medicine is celebrating its 20th anniversary this year. How do you see the role of hospitalists evolving over the next 20 years?

A: Change has been a constant in hospital medicine since I began in 2004 and will continue to remain so. Because of the financial and documentary pressures placed on hospitals and physicians, hospital medicine finds itself in a state of flux at the moment. I believe these pressures will drive the 7-on/7-off hospitalist direct-care model as it exists today to evolve into something else. In particular, hospitalist groups, which engage solely in documentation and “decision in name” only and devolve all clinical decision making to another set of physicians in the hospital, are especially nonviable over the long term. I think many hospital administrators believe this as well. Hospital medicine must show value, including in the realm of direct clinical care.

One possibility is that we evolve into a “supervisor” model, where a program is composed of a few experienced hospitalists supervising numerous physician extenders, who in turn rely on multidisciplinary teams in the hospital for clinical decision-making input. Hospitalist physicians will slightly move away from direct clinical decision making in such a model.

Another possibility involves evolution of information support systems to a point where teams of providers organized around a single medical problem, e.g., congestive heart failure, can be replaced, leaving the hospitalist to make patient-centered clinical decisions with updated multidisciplinary input available electronically.

With information systems that provide equal access to evidence-driven guidance for optimal clinical practice, hospitalists will outperform subspecialists at the bedside on patient-centeredness, cost, and availability.

Regardless of how inpatient care evolves, hospital medicine will undoubtedly be at the epicenter of change for years to come. TH

This month, The Hospitalist spotlights G. Randy Smith Jr., MD, MS, SFHM, assistant professor in the Division of Hospital Medicine at the Northwestern University Feinberg School of Medicine and medical director of Unit 16 West at Northwestern Memorial Hospital in Chicago. Dr. Smith is an active member of SHM’s Practice Analysis Committee and a Leadership Academy veteran who has translated his learnings into more efficient rounding and patient-flow methodology.

Question: What inspired you to begin working in hospital medicine and later join SHM?

Answer: Interest in taking care of acutely ill patients inspired me to start working in hospital medicine. Evolution of this interest into care-delivery design inspired me to remain in hospital medicine. Joining SHM enabled me to make contacts nationally with people who share similar interests and engage in collaboration, which has been helpful for my growth as a physician.

Q: How has SHM provided you with resources to improve patient care during your time as a member?

A: The SHM annual meetings have provided a consistent framework for dissemination of clinically relevant innovations and discoveries. Each year I’ve attended, I’ve always learned something new from both the posters on display and from a quality improvement presentation. Last year at Hospital Medicine 2016, the HEADS-UP plenary abstract presentation was one very good example of a different approach to interdisciplinary rounding that I would not have been aware of without attending the SHM annual meeting.

Q: How did attending Leadership Academy help you grow to reach your medical director position at Northwestern Memorial?

A: Leadership Academy helped to open my mind to principles of negotiation and expectation management as well as self-awareness, which are not usually presented in medical school or residency. Many of the skills taught can be learned the hard way through the trials of life, but the Leadership Academy accelerated my real-world learning.

My hospital’s leadership recognized the skills I developed with the assistance of Leadership Academy, which helped me to maintain my effectiveness in my medical director role.

Skills obtained in the Leadership Academy helped me to incorporate ward-based afternoon throughput meetings into a hospital-wide patient-flow management network. I also learned to successfully negotiate procurement of chairs for our physicians to sit at the patient’s bedside in the hopes of improving patient satisfaction.

Q: How has your work on the Practice Analysis Committee impacted how you manage your hospital medicine teams?

A: My involvement in the Practice Analysis Committee is yet another example of an opportunity provided by SHM to develop a skills set I would not otherwise have the opportunity to develop. Working on the State of Hospital Medicine survey involves prioritizing information with the burden of the respondents’ time and effort in mind. Sensitivities to stakeholder interest play a major role as well.

Achieving balance between aspiring definitions of concepts to help drive the field and working definitions used heterogeneously throughout the country represents the hardest task of the committee members to sort; I’m very privileged to take the lessons learned through member dialogue and help colleagues apply the lessons locally.

Q: Hospital medicine is celebrating its 20th anniversary this year. How do you see the role of hospitalists evolving over the next 20 years?

A: Change has been a constant in hospital medicine since I began in 2004 and will continue to remain so. Because of the financial and documentary pressures placed on hospitals and physicians, hospital medicine finds itself in a state of flux at the moment. I believe these pressures will drive the 7-on/7-off hospitalist direct-care model as it exists today to evolve into something else. In particular, hospitalist groups, which engage solely in documentation and “decision in name” only and devolve all clinical decision making to another set of physicians in the hospital, are especially nonviable over the long term. I think many hospital administrators believe this as well. Hospital medicine must show value, including in the realm of direct clinical care.

One possibility is that we evolve into a “supervisor” model, where a program is composed of a few experienced hospitalists supervising numerous physician extenders, who in turn rely on multidisciplinary teams in the hospital for clinical decision-making input. Hospitalist physicians will slightly move away from direct clinical decision making in such a model.

Another possibility involves evolution of information support systems to a point where teams of providers organized around a single medical problem, e.g., congestive heart failure, can be replaced, leaving the hospitalist to make patient-centered clinical decisions with updated multidisciplinary input available electronically.

With information systems that provide equal access to evidence-driven guidance for optimal clinical practice, hospitalists will outperform subspecialists at the bedside on patient-centeredness, cost, and availability.

Regardless of how inpatient care evolves, hospital medicine will undoubtedly be at the epicenter of change for years to come. TH

This month, The Hospitalist spotlights G. Randy Smith Jr., MD, MS, SFHM, assistant professor in the Division of Hospital Medicine at the Northwestern University Feinberg School of Medicine and medical director of Unit 16 West at Northwestern Memorial Hospital in Chicago. Dr. Smith is an active member of SHM’s Practice Analysis Committee and a Leadership Academy veteran who has translated his learnings into more efficient rounding and patient-flow methodology.

Question: What inspired you to begin working in hospital medicine and later join SHM?

Answer: Interest in taking care of acutely ill patients inspired me to start working in hospital medicine. Evolution of this interest into care-delivery design inspired me to remain in hospital medicine. Joining SHM enabled me to make contacts nationally with people who share similar interests and engage in collaboration, which has been helpful for my growth as a physician.

Q: How has SHM provided you with resources to improve patient care during your time as a member?

A: The SHM annual meetings have provided a consistent framework for dissemination of clinically relevant innovations and discoveries. Each year I’ve attended, I’ve always learned something new from both the posters on display and from a quality improvement presentation. Last year at Hospital Medicine 2016, the HEADS-UP plenary abstract presentation was one very good example of a different approach to interdisciplinary rounding that I would not have been aware of without attending the SHM annual meeting.

Q: How did attending Leadership Academy help you grow to reach your medical director position at Northwestern Memorial?

A: Leadership Academy helped to open my mind to principles of negotiation and expectation management as well as self-awareness, which are not usually presented in medical school or residency. Many of the skills taught can be learned the hard way through the trials of life, but the Leadership Academy accelerated my real-world learning.

My hospital’s leadership recognized the skills I developed with the assistance of Leadership Academy, which helped me to maintain my effectiveness in my medical director role.

Skills obtained in the Leadership Academy helped me to incorporate ward-based afternoon throughput meetings into a hospital-wide patient-flow management network. I also learned to successfully negotiate procurement of chairs for our physicians to sit at the patient’s bedside in the hopes of improving patient satisfaction.

Q: How has your work on the Practice Analysis Committee impacted how you manage your hospital medicine teams?

A: My involvement in the Practice Analysis Committee is yet another example of an opportunity provided by SHM to develop a skills set I would not otherwise have the opportunity to develop. Working on the State of Hospital Medicine survey involves prioritizing information with the burden of the respondents’ time and effort in mind. Sensitivities to stakeholder interest play a major role as well.

Achieving balance between aspiring definitions of concepts to help drive the field and working definitions used heterogeneously throughout the country represents the hardest task of the committee members to sort; I’m very privileged to take the lessons learned through member dialogue and help colleagues apply the lessons locally.

Q: Hospital medicine is celebrating its 20th anniversary this year. How do you see the role of hospitalists evolving over the next 20 years?

A: Change has been a constant in hospital medicine since I began in 2004 and will continue to remain so. Because of the financial and documentary pressures placed on hospitals and physicians, hospital medicine finds itself in a state of flux at the moment. I believe these pressures will drive the 7-on/7-off hospitalist direct-care model as it exists today to evolve into something else. In particular, hospitalist groups, which engage solely in documentation and “decision in name” only and devolve all clinical decision making to another set of physicians in the hospital, are especially nonviable over the long term. I think many hospital administrators believe this as well. Hospital medicine must show value, including in the realm of direct clinical care.

One possibility is that we evolve into a “supervisor” model, where a program is composed of a few experienced hospitalists supervising numerous physician extenders, who in turn rely on multidisciplinary teams in the hospital for clinical decision-making input. Hospitalist physicians will slightly move away from direct clinical decision making in such a model.

Another possibility involves evolution of information support systems to a point where teams of providers organized around a single medical problem, e.g., congestive heart failure, can be replaced, leaving the hospitalist to make patient-centered clinical decisions with updated multidisciplinary input available electronically.

With information systems that provide equal access to evidence-driven guidance for optimal clinical practice, hospitalists will outperform subspecialists at the bedside on patient-centeredness, cost, and availability.

Regardless of how inpatient care evolves, hospital medicine will undoubtedly be at the epicenter of change for years to come. TH