Leadership Training

Click here to listen to Scott Strassels, PhD, PharmD, BCPS, an assistant professor in the College of Pharmacy at the University of Texas at Austin and a board member of the American Pain Society, discuss the risks and rewards of opioid therapies, and why continuing education is important for all clinicians.

Click here to listen to Scott Strassels, PhD, PharmD, BCPS, an assistant professor in the College of Pharmacy at the University of Texas at Austin and a board member of the American Pain Society, discuss the risks and rewards of opioid therapies, and why continuing education is important for all clinicians.

Click here to listen to Scott Strassels, PhD, PharmD, BCPS, an assistant professor in the College of Pharmacy at the University of Texas at Austin and a board member of the American Pain Society, discuss the risks and rewards of opioid therapies, and why continuing education is important for all clinicians.

When it comes to Medicare, the Affordable Care Act, and a host of other healthcare-reform-related topics, hospitalists have lots of good questions, such as:

• When does the Physician Value-Based Payment Modifier (VBPM) take effect? And will I be included?
• Which primary-care services are covered by the increased Medicaid payments?
• Are hospitalists eligible to bill for Medicare’s new CPT Transitional Care Management (TCM) codes? (see “New Codes Bridge Billing Gap,”).

Now, SHM’s Public Policy Committee has answered all of the above—and many more—in a set of three “Frequently Asked Questions” documents available at www.hospitalmedicine.org/advocacy. Each document goes in-depth on the most cutting-edge policy issues that are top of mind for hospitalists and the hospitals they serve on these issues:

The Physician Value-Based Payment Modifier (VBPM): The VBPM seeks to connect cost and quality of services in order to begin reimbursement for the value, rather than the quantity, of care. It combines the quality measuring in the Physician Quality Reporting System (PQRS), cost measures, and a payment adjustment for physicians. Measurement begins this year, and many hospitalists will be included.

Medicaid/Medicare parity regulation: On Nov. 1, 2012, the Centers for Medicare & Medicaid Services (CMS) released the final regulations implementing Section 1202 of the Affordable Care Act, which increases Medicaid payments for specified primary-care services to 100% of Medicare levels in 2013 and 2014.

New CPT Transitional Care Management (TCM) codes 99495-99496: CMS has created two new CPT Transitional Care Management (TCM) codes designed to improve care coordination and provide better incentives to ensure patients are seen in a physician’s office, rather than be at risk for readmission.

New Action: Getting Involved Just Got Easier

SHM’s Legislative Action Center also makes getting involved easier with a new grassroots outreach tool called Voter Voice. SHM’s first action alert on Voter Voice was sent to members in December. Hospitalists’ willingness to take a few minutes and contact their congressional leaders using Voter Voice increased SHM’s visibility to Congress by nearly five times compared with prior similar alerts.

Getting involved is easy and only takes a few seconds. You can use either your ZIP code to look up your members of Congress or search active legislation by keyword. SHM members can sign up for SHM Legislative Action Center alerts by entering their email address.

To download the new SHM advocacy FAQs or use the improved Legislative Action Center, visit www.hospitalmedicine.org/advocacy.

When it comes to Medicare, the Affordable Care Act, and a host of other healthcare-reform-related topics, hospitalists have lots of good questions, such as:

• When does the Physician Value-Based Payment Modifier (VBPM) take effect? And will I be included?
• Which primary-care services are covered by the increased Medicaid payments?
• Are hospitalists eligible to bill for Medicare’s new CPT Transitional Care Management (TCM) codes? (see “New Codes Bridge Billing Gap,”).

Now, SHM’s Public Policy Committee has answered all of the above—and many more—in a set of three “Frequently Asked Questions” documents available at www.hospitalmedicine.org/advocacy. Each document goes in-depth on the most cutting-edge policy issues that are top of mind for hospitalists and the hospitals they serve on these issues:

The Physician Value-Based Payment Modifier (VBPM): The VBPM seeks to connect cost and quality of services in order to begin reimbursement for the value, rather than the quantity, of care. It combines the quality measuring in the Physician Quality Reporting System (PQRS), cost measures, and a payment adjustment for physicians. Measurement begins this year, and many hospitalists will be included.

Medicaid/Medicare parity regulation: On Nov. 1, 2012, the Centers for Medicare & Medicaid Services (CMS) released the final regulations implementing Section 1202 of the Affordable Care Act, which increases Medicaid payments for specified primary-care services to 100% of Medicare levels in 2013 and 2014.

New CPT Transitional Care Management (TCM) codes 99495-99496: CMS has created two new CPT Transitional Care Management (TCM) codes designed to improve care coordination and provide better incentives to ensure patients are seen in a physician’s office, rather than be at risk for readmission.

New Action: Getting Involved Just Got Easier

SHM’s Legislative Action Center also makes getting involved easier with a new grassroots outreach tool called Voter Voice. SHM’s first action alert on Voter Voice was sent to members in December. Hospitalists’ willingness to take a few minutes and contact their congressional leaders using Voter Voice increased SHM’s visibility to Congress by nearly five times compared with prior similar alerts.

Getting involved is easy and only takes a few seconds. You can use either your ZIP code to look up your members of Congress or search active legislation by keyword. SHM members can sign up for SHM Legislative Action Center alerts by entering their email address.

To download the new SHM advocacy FAQs or use the improved Legislative Action Center, visit www.hospitalmedicine.org/advocacy.

When it comes to Medicare, the Affordable Care Act, and a host of other healthcare-reform-related topics, hospitalists have lots of good questions, such as:

• When does the Physician Value-Based Payment Modifier (VBPM) take effect? And will I be included?
• Which primary-care services are covered by the increased Medicaid payments?
• Are hospitalists eligible to bill for Medicare’s new CPT Transitional Care Management (TCM) codes? (see “New Codes Bridge Billing Gap,”).

Now, SHM’s Public Policy Committee has answered all of the above—and many more—in a set of three “Frequently Asked Questions” documents available at www.hospitalmedicine.org/advocacy. Each document goes in-depth on the most cutting-edge policy issues that are top of mind for hospitalists and the hospitals they serve on these issues:

The Physician Value-Based Payment Modifier (VBPM): The VBPM seeks to connect cost and quality of services in order to begin reimbursement for the value, rather than the quantity, of care. It combines the quality measuring in the Physician Quality Reporting System (PQRS), cost measures, and a payment adjustment for physicians. Measurement begins this year, and many hospitalists will be included.

Medicaid/Medicare parity regulation: On Nov. 1, 2012, the Centers for Medicare & Medicaid Services (CMS) released the final regulations implementing Section 1202 of the Affordable Care Act, which increases Medicaid payments for specified primary-care services to 100% of Medicare levels in 2013 and 2014.

New CPT Transitional Care Management (TCM) codes 99495-99496: CMS has created two new CPT Transitional Care Management (TCM) codes designed to improve care coordination and provide better incentives to ensure patients are seen in a physician’s office, rather than be at risk for readmission.

New Action: Getting Involved Just Got Easier

SHM’s Legislative Action Center also makes getting involved easier with a new grassroots outreach tool called Voter Voice. SHM’s first action alert on Voter Voice was sent to members in December. Hospitalists’ willingness to take a few minutes and contact their congressional leaders using Voter Voice increased SHM’s visibility to Congress by nearly five times compared with prior similar alerts.

Getting involved is easy and only takes a few seconds. You can use either your ZIP code to look up your members of Congress or search active legislation by keyword. SHM members can sign up for SHM Legislative Action Center alerts by entering their email address.

To download the new SHM advocacy FAQs or use the improved Legislative Action Center, visit www.hospitalmedicine.org/advocacy.

This month, hospitalists can play a role in crowdsourcing the future of the community hospital. And one hospitalist is helping to shape the game.

On Jan. 8, the Institute for the Future launched its Future of Hospital foresight game (www.futureofhospital.org). The game will tap the wisdom of healthcare experts, urban planners, technologists, sociologists, local community leaders, social entrepreneurs, and citizens interested in engaging in a thoughtful discussion about future possibilities for community hospitals.

Hospitalist Jason Stein, MD, SFHM, is working with the Institute for the Future to help judge the responses and participation in the online, crowd-sourced game. As an advisor to the Centers for Medicare & Medicaid Services Innovation Center, Dr. Stein is no stranger to new ideas for hospitals. He was one of the co-architects of SHM’s Implementation Guides, which create step-wise approaches for system-level change. He also has been recognized nationally for his work redesigning traditional medical wards into accountable-care units, each featuring unit-based physician teams that conduct structured interdisciplinary bedside rounds (SIBRs).

“This is an exciting way for hospitalists to join a dynamic conversation about how hospitals—and their staff—provide the best care possible to their patients in 21st-century, American healthcare,” Dr. Stein says.

The Future of the Hospital is a game that anyone can play; all that is required is ideas. If others build on those ideas, contributors win points and create award-winning chains of innovation, linking people and their ideas from all over the world.

“Hospitalists have been on the cutting edge of some of the best ideas in healthcare for the last two decades,” Dr. Stein says. “This is an exciting and innovative way for all of us to contribute ideas and leverage our collective experience for the good of our hospitals and patients.”

This month, hospitalists can play a role in crowdsourcing the future of the community hospital. And one hospitalist is helping to shape the game.

On Jan. 8, the Institute for the Future launched its Future of Hospital foresight game (www.futureofhospital.org). The game will tap the wisdom of healthcare experts, urban planners, technologists, sociologists, local community leaders, social entrepreneurs, and citizens interested in engaging in a thoughtful discussion about future possibilities for community hospitals.

Hospitalist Jason Stein, MD, SFHM, is working with the Institute for the Future to help judge the responses and participation in the online, crowd-sourced game. As an advisor to the Centers for Medicare & Medicaid Services Innovation Center, Dr. Stein is no stranger to new ideas for hospitals. He was one of the co-architects of SHM’s Implementation Guides, which create step-wise approaches for system-level change. He also has been recognized nationally for his work redesigning traditional medical wards into accountable-care units, each featuring unit-based physician teams that conduct structured interdisciplinary bedside rounds (SIBRs).

“This is an exciting way for hospitalists to join a dynamic conversation about how hospitals—and their staff—provide the best care possible to their patients in 21st-century, American healthcare,” Dr. Stein says.

The Future of the Hospital is a game that anyone can play; all that is required is ideas. If others build on those ideas, contributors win points and create award-winning chains of innovation, linking people and their ideas from all over the world.

“Hospitalists have been on the cutting edge of some of the best ideas in healthcare for the last two decades,” Dr. Stein says. “This is an exciting and innovative way for all of us to contribute ideas and leverage our collective experience for the good of our hospitals and patients.”

This month, hospitalists can play a role in crowdsourcing the future of the community hospital. And one hospitalist is helping to shape the game.

On Jan. 8, the Institute for the Future launched its Future of Hospital foresight game (www.futureofhospital.org). The game will tap the wisdom of healthcare experts, urban planners, technologists, sociologists, local community leaders, social entrepreneurs, and citizens interested in engaging in a thoughtful discussion about future possibilities for community hospitals.

Hospitalist Jason Stein, MD, SFHM, is working with the Institute for the Future to help judge the responses and participation in the online, crowd-sourced game. As an advisor to the Centers for Medicare & Medicaid Services Innovation Center, Dr. Stein is no stranger to new ideas for hospitals. He was one of the co-architects of SHM’s Implementation Guides, which create step-wise approaches for system-level change. He also has been recognized nationally for his work redesigning traditional medical wards into accountable-care units, each featuring unit-based physician teams that conduct structured interdisciplinary bedside rounds (SIBRs).

“This is an exciting way for hospitalists to join a dynamic conversation about how hospitals—and their staff—provide the best care possible to their patients in 21st-century, American healthcare,” Dr. Stein says.

The Future of the Hospital is a game that anyone can play; all that is required is ideas. If others build on those ideas, contributors win points and create award-winning chains of innovation, linking people and their ideas from all over the world.

“Hospitalists have been on the cutting edge of some of the best ideas in healthcare for the last two decades,” Dr. Stein says. “This is an exciting and innovative way for all of us to contribute ideas and leverage our collective experience for the good of our hospitals and patients.”

University of Minnesota hospitalist Karyn Baum, MD, MSEd, directs one of six regional training centers for Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS), an evidence-based, multimedia curriculum, tool set, and system for healthcare organizations to improve their teamwork.

Using the TeamSTEPPS approach, Dr. Baum collaborated with hospitalist Albertine Beard, MD, and the charge nurse on a 28-bed medical unit at the Minneapolis VA Medical Center to present a half-day training session for all VA staff, including four hospitalists. The seminar mixed didactics, discussions, and simulations, similar to traditional role-playing techniques but using a high-fidelity manikin that talks and displays vital signs.

"Teamwork is a set of knowledge, skills, and attitudes that lead to the creation of a culture where it’s about us as a team, not about who is highest in the hierarchy," Dr. Baum says. Hospitalists want to be leaders, "but we have a responsibility to be intentional leaders, learning the skills and modeling them," she adds.

Improved teamwork benefits patients through more effective communication and reduction in medical errors, Dr. Baum says, "but it also helps to create a healthy environment in which to work, where we all have each other’s backs."

TeamSTEPPS, developed jointly by the federal Agency for Healthcare Research and Quality (AHRQ) and the Department of Defense, has reached 25% to 30% of U.S. hospitals by annually training about 700 masters. The masters then go back to their institutions and share the techniques.

Read more about why improving teamwork is good for your patients.

University of Minnesota hospitalist Karyn Baum, MD, MSEd, directs one of six regional training centers for Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS), an evidence-based, multimedia curriculum, tool set, and system for healthcare organizations to improve their teamwork.

Using the TeamSTEPPS approach, Dr. Baum collaborated with hospitalist Albertine Beard, MD, and the charge nurse on a 28-bed medical unit at the Minneapolis VA Medical Center to present a half-day training session for all VA staff, including four hospitalists. The seminar mixed didactics, discussions, and simulations, similar to traditional role-playing techniques but using a high-fidelity manikin that talks and displays vital signs.

"Teamwork is a set of knowledge, skills, and attitudes that lead to the creation of a culture where it’s about us as a team, not about who is highest in the hierarchy," Dr. Baum says. Hospitalists want to be leaders, "but we have a responsibility to be intentional leaders, learning the skills and modeling them," she adds.

Improved teamwork benefits patients through more effective communication and reduction in medical errors, Dr. Baum says, "but it also helps to create a healthy environment in which to work, where we all have each other’s backs."

TeamSTEPPS, developed jointly by the federal Agency for Healthcare Research and Quality (AHRQ) and the Department of Defense, has reached 25% to 30% of U.S. hospitals by annually training about 700 masters. The masters then go back to their institutions and share the techniques.

Read more about why improving teamwork is good for your patients.

University of Minnesota hospitalist Karyn Baum, MD, MSEd, directs one of six regional training centers for Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS), an evidence-based, multimedia curriculum, tool set, and system for healthcare organizations to improve their teamwork.

Using the TeamSTEPPS approach, Dr. Baum collaborated with hospitalist Albertine Beard, MD, and the charge nurse on a 28-bed medical unit at the Minneapolis VA Medical Center to present a half-day training session for all VA staff, including four hospitalists. The seminar mixed didactics, discussions, and simulations, similar to traditional role-playing techniques but using a high-fidelity manikin that talks and displays vital signs.

"Teamwork is a set of knowledge, skills, and attitudes that lead to the creation of a culture where it’s about us as a team, not about who is highest in the hierarchy," Dr. Baum says. Hospitalists want to be leaders, "but we have a responsibility to be intentional leaders, learning the skills and modeling them," she adds.

Improved teamwork benefits patients through more effective communication and reduction in medical errors, Dr. Baum says, "but it also helps to create a healthy environment in which to work, where we all have each other’s backs."

TeamSTEPPS, developed jointly by the federal Agency for Healthcare Research and Quality (AHRQ) and the Department of Defense, has reached 25% to 30% of U.S. hospitals by annually training about 700 masters. The masters then go back to their institutions and share the techniques.

Read more about why improving teamwork is good for your patients.

University of Colorado at Denver geriatrician Eric Coleman, MD, MPH—who pioneered the celebrated Care Transitions Model (www.caretransitions.org), which sends “coaches” on home visits and has them make phone calls to patients in an effort to smooth post-hospital discharge transitions and enhance self-care—has been honored with a MacArthur Foundation “genius” award.

Dr. Coleman also co-chairs the advisory board for SHM’s Project BOOST (Better Outcomes for Older Adults through Safe Transitions) national quality initiative.

The MacArthur Fellowship is known for honoring individuals who have shown exceptional originality and creativity, bestowing them with a $500,000 award—no strings attached. Dr. Coleman says the award “promotes the opportunity for approaching complex problems in new light—taking risks with new approaches and serving in the role of a ‘change agent.’”

“I look forward to working collaboratively with hospitalists and hospitals on finding new strategies and solutions for improving the discharge experience,” he says.

University of Colorado at Denver geriatrician Eric Coleman, MD, MPH—who pioneered the celebrated Care Transitions Model (www.caretransitions.org), which sends “coaches” on home visits and has them make phone calls to patients in an effort to smooth post-hospital discharge transitions and enhance self-care—has been honored with a MacArthur Foundation “genius” award.

Dr. Coleman also co-chairs the advisory board for SHM’s Project BOOST (Better Outcomes for Older Adults through Safe Transitions) national quality initiative.

The MacArthur Fellowship is known for honoring individuals who have shown exceptional originality and creativity, bestowing them with a $500,000 award—no strings attached. Dr. Coleman says the award “promotes the opportunity for approaching complex problems in new light—taking risks with new approaches and serving in the role of a ‘change agent.’”

“I look forward to working collaboratively with hospitalists and hospitals on finding new strategies and solutions for improving the discharge experience,” he says.

University of Colorado at Denver geriatrician Eric Coleman, MD, MPH—who pioneered the celebrated Care Transitions Model (www.caretransitions.org), which sends “coaches” on home visits and has them make phone calls to patients in an effort to smooth post-hospital discharge transitions and enhance self-care—has been honored with a MacArthur Foundation “genius” award.

Dr. Coleman also co-chairs the advisory board for SHM’s Project BOOST (Better Outcomes for Older Adults through Safe Transitions) national quality initiative.

The MacArthur Fellowship is known for honoring individuals who have shown exceptional originality and creativity, bestowing them with a $500,000 award—no strings attached. Dr. Coleman says the award “promotes the opportunity for approaching complex problems in new light—taking risks with new approaches and serving in the role of a ‘change agent.’”

“I look forward to working collaboratively with hospitalists and hospitals on finding new strategies and solutions for improving the discharge experience,” he says.

Hospitalist David J. Yu, MD, FACP, MBA, SFHM, medical director of the adult inpatient service at Presbyterian Healthcare Services in Albuquerque, N.M., began his quality journey by earning an MBA, then spending a week at University of Toyota in Gardena, Calif., to learn its Lean process-management techniques. He presented a Research, Innovations, and Clinical Vignettes poster at HM12 that outlined the multidisciplinary quality initiative at 453-bed Presbyterian Hospital in Albuquerque.

The project identified problems of throughput, ED diversion, disjointed team rounding, inadequate communication, multiple patient handoffs, low staff morale, and greater-than-expected length of stay (LOS).

“We really dug into the issues on a granular level,” with the participation of finance, nursing, care coordinators, physical therapy, and other staffers alongside the hospitalists, Dr. Yu says. The project ended up changing the practice from a model in which 11 hospitalist teams and five admitting hospitalists cared for patients throughout the hospital’s various floors while carrying caseloads too high to manage optimally. They replaced it with a unit-based rounding model, with hospitalists and care coordinators geographically segregated on units and multidisciplinary rounds to improve the efficiency of team communication (see “A Holy Grail,” July 2012, p. 30).

The group also used data to persuade the hospital’s administration to add hospitalist FTEs. As a result, LOS on two pilot units decreased by nearly half a day, with increased inpatient volume, higher patient satisfaction scores on Press-Ganey surveys, and an estimated net financial benefit of nearly $3.5 million between April 2010 and December 2011—even counting the additional hospitalist FTEs. This model has since spread to all medical units in the hospital.

“We need to be in the business of producing ‘defect-free’ discharges,” Dr. Yu quips. “Every group needs a local solution. But the mantra for this work is standardization....That’s where the leadership of the hospitalist comes in. It’s not, ‘Follow me,’ but ‘Hey, join us in collaborating together to come up with a solution.’

“It has been a two-year journey, and we’re still learning.”

Hospitalist David J. Yu, MD, FACP, MBA, SFHM, medical director of the adult inpatient service at Presbyterian Healthcare Services in Albuquerque, N.M., began his quality journey by earning an MBA, then spending a week at University of Toyota in Gardena, Calif., to learn its Lean process-management techniques. He presented a Research, Innovations, and Clinical Vignettes poster at HM12 that outlined the multidisciplinary quality initiative at 453-bed Presbyterian Hospital in Albuquerque.

The project identified problems of throughput, ED diversion, disjointed team rounding, inadequate communication, multiple patient handoffs, low staff morale, and greater-than-expected length of stay (LOS).

“We really dug into the issues on a granular level,” with the participation of finance, nursing, care coordinators, physical therapy, and other staffers alongside the hospitalists, Dr. Yu says. The project ended up changing the practice from a model in which 11 hospitalist teams and five admitting hospitalists cared for patients throughout the hospital’s various floors while carrying caseloads too high to manage optimally. They replaced it with a unit-based rounding model, with hospitalists and care coordinators geographically segregated on units and multidisciplinary rounds to improve the efficiency of team communication (see “A Holy Grail,” July 2012, p. 30).

The group also used data to persuade the hospital’s administration to add hospitalist FTEs. As a result, LOS on two pilot units decreased by nearly half a day, with increased inpatient volume, higher patient satisfaction scores on Press-Ganey surveys, and an estimated net financial benefit of nearly $3.5 million between April 2010 and December 2011—even counting the additional hospitalist FTEs. This model has since spread to all medical units in the hospital.

“We need to be in the business of producing ‘defect-free’ discharges,” Dr. Yu quips. “Every group needs a local solution. But the mantra for this work is standardization....That’s where the leadership of the hospitalist comes in. It’s not, ‘Follow me,’ but ‘Hey, join us in collaborating together to come up with a solution.’

“It has been a two-year journey, and we’re still learning.”

Hospitalist David J. Yu, MD, FACP, MBA, SFHM, medical director of the adult inpatient service at Presbyterian Healthcare Services in Albuquerque, N.M., began his quality journey by earning an MBA, then spending a week at University of Toyota in Gardena, Calif., to learn its Lean process-management techniques. He presented a Research, Innovations, and Clinical Vignettes poster at HM12 that outlined the multidisciplinary quality initiative at 453-bed Presbyterian Hospital in Albuquerque.

The project identified problems of throughput, ED diversion, disjointed team rounding, inadequate communication, multiple patient handoffs, low staff morale, and greater-than-expected length of stay (LOS).

“We really dug into the issues on a granular level,” with the participation of finance, nursing, care coordinators, physical therapy, and other staffers alongside the hospitalists, Dr. Yu says. The project ended up changing the practice from a model in which 11 hospitalist teams and five admitting hospitalists cared for patients throughout the hospital’s various floors while carrying caseloads too high to manage optimally. They replaced it with a unit-based rounding model, with hospitalists and care coordinators geographically segregated on units and multidisciplinary rounds to improve the efficiency of team communication (see “A Holy Grail,” July 2012, p. 30).

The group also used data to persuade the hospital’s administration to add hospitalist FTEs. As a result, LOS on two pilot units decreased by nearly half a day, with increased inpatient volume, higher patient satisfaction scores on Press-Ganey surveys, and an estimated net financial benefit of nearly $3.5 million between April 2010 and December 2011—even counting the additional hospitalist FTEs. This model has since spread to all medical units in the hospital.

“We need to be in the business of producing ‘defect-free’ discharges,” Dr. Yu quips. “Every group needs a local solution. But the mantra for this work is standardization....That’s where the leadership of the hospitalist comes in. It’s not, ‘Follow me,’ but ‘Hey, join us in collaborating together to come up with a solution.’

“It has been a two-year journey, and we’re still learning.”

Every year, hundreds of thousands of people from all parts of the country travel to Washington, D.C., and visit Congress. Regardless of the organizations they represent, almost all of them have one thing in common: They go to Capitol Hill with an “ask.”

Some ask for a vote on a particular piece of legislation; some request funding for their projects. Regardless, there is almost always an ask.

But hospitalists are different, according to SHM Public Policy Committee chair Ron Greeno, MD, FCCP, MHM, and committee member Brad Flansbaum, DO, MPH, SFHM. They are featured in a new video about “Hospitalists on the Hill,” SHM’s day to meet with members of Congress.

Rather than lobbying or asking for assistance, hospitalists bring solutions to the healthcare problems currently vexing communities throughout the country. By introducing the hospitalist model and its role in quality improvement (QI) to some of the most influential government figures in public health, hospitalists who make the visit to Capitol Hill help to spread some of the best practices in hospital-based healthcare and share their personal experiences at the same time.

“Every constituency that comes in is asking them for something,” Dr. Greeno says in one of the SHM-produced videos. “We don’t ask for anything. We offer. We offer our expertise. We offer to help them make better decisions than they would make otherwise.”

That contribution matters to members of Congress and their healthcare staff. Drs. Greeno and Flansbaum are “Hill Day” veterans who have seen firsthand how legislators and their staff absorb SHM’s message and materials.

“I thought that if we are leaving materials behind, that the minute we walk out of the office, it was going in the trash,” Dr. Greeno says. “That’s not what happens. They read this stuff.”

In 2013, Hospitalists on the Hill will take place May 16, the day before the official start of HM’s annual meeting at the Gaylord National Resort & Convention Center in National Harbor, Md., just a few minutes south of Washington, D.C. The agenda is ambitious, starting with a briefing about what to expect when meeting Congress members on Capitol Hill, followed by a full day of meetings with policymakers, regulators, and their staff.

“We spend our day going back and forth, from the Senate side of the Capitol to the House side of the Capitol, in and out of the office buildings, walking the halls of Congress,” Dr. Greeno says. “It’s a blast. It’s so interesting. And we’re getting a chance to sit down and deliver our message.”

For Dr. Flansbaum, it’s an opportunity to promote action in Washington.

“It really brings government to life,” he says. “You realize that, as bottlenecked as things might be sometimes, things have to get done.”

HM13 attendees can sign-up for Hospitalists on the Hill during annual-meeing registration. For more information, visit www.hospitalmedicine2013.org/onthehill.

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

Every year, hundreds of thousands of people from all parts of the country travel to Washington, D.C., and visit Congress. Regardless of the organizations they represent, almost all of them have one thing in common: They go to Capitol Hill with an “ask.”

Some ask for a vote on a particular piece of legislation; some request funding for their projects. Regardless, there is almost always an ask.

But hospitalists are different, according to SHM Public Policy Committee chair Ron Greeno, MD, FCCP, MHM, and committee member Brad Flansbaum, DO, MPH, SFHM. They are featured in a new video about “Hospitalists on the Hill,” SHM’s day to meet with members of Congress.

Rather than lobbying or asking for assistance, hospitalists bring solutions to the healthcare problems currently vexing communities throughout the country. By introducing the hospitalist model and its role in quality improvement (QI) to some of the most influential government figures in public health, hospitalists who make the visit to Capitol Hill help to spread some of the best practices in hospital-based healthcare and share their personal experiences at the same time.

“Every constituency that comes in is asking them for something,” Dr. Greeno says in one of the SHM-produced videos. “We don’t ask for anything. We offer. We offer our expertise. We offer to help them make better decisions than they would make otherwise.”

That contribution matters to members of Congress and their healthcare staff. Drs. Greeno and Flansbaum are “Hill Day” veterans who have seen firsthand how legislators and their staff absorb SHM’s message and materials.

“I thought that if we are leaving materials behind, that the minute we walk out of the office, it was going in the trash,” Dr. Greeno says. “That’s not what happens. They read this stuff.”

In 2013, Hospitalists on the Hill will take place May 16, the day before the official start of HM’s annual meeting at the Gaylord National Resort & Convention Center in National Harbor, Md., just a few minutes south of Washington, D.C. The agenda is ambitious, starting with a briefing about what to expect when meeting Congress members on Capitol Hill, followed by a full day of meetings with policymakers, regulators, and their staff.

“We spend our day going back and forth, from the Senate side of the Capitol to the House side of the Capitol, in and out of the office buildings, walking the halls of Congress,” Dr. Greeno says. “It’s a blast. It’s so interesting. And we’re getting a chance to sit down and deliver our message.”

For Dr. Flansbaum, it’s an opportunity to promote action in Washington.

“It really brings government to life,” he says. “You realize that, as bottlenecked as things might be sometimes, things have to get done.”

HM13 attendees can sign-up for Hospitalists on the Hill during annual-meeing registration. For more information, visit www.hospitalmedicine2013.org/onthehill.

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

Every year, hundreds of thousands of people from all parts of the country travel to Washington, D.C., and visit Congress. Regardless of the organizations they represent, almost all of them have one thing in common: They go to Capitol Hill with an “ask.”

Some ask for a vote on a particular piece of legislation; some request funding for their projects. Regardless, there is almost always an ask.

But hospitalists are different, according to SHM Public Policy Committee chair Ron Greeno, MD, FCCP, MHM, and committee member Brad Flansbaum, DO, MPH, SFHM. They are featured in a new video about “Hospitalists on the Hill,” SHM’s day to meet with members of Congress.

Rather than lobbying or asking for assistance, hospitalists bring solutions to the healthcare problems currently vexing communities throughout the country. By introducing the hospitalist model and its role in quality improvement (QI) to some of the most influential government figures in public health, hospitalists who make the visit to Capitol Hill help to spread some of the best practices in hospital-based healthcare and share their personal experiences at the same time.

“Every constituency that comes in is asking them for something,” Dr. Greeno says in one of the SHM-produced videos. “We don’t ask for anything. We offer. We offer our expertise. We offer to help them make better decisions than they would make otherwise.”

That contribution matters to members of Congress and their healthcare staff. Drs. Greeno and Flansbaum are “Hill Day” veterans who have seen firsthand how legislators and their staff absorb SHM’s message and materials.

“I thought that if we are leaving materials behind, that the minute we walk out of the office, it was going in the trash,” Dr. Greeno says. “That’s not what happens. They read this stuff.”

In 2013, Hospitalists on the Hill will take place May 16, the day before the official start of HM’s annual meeting at the Gaylord National Resort & Convention Center in National Harbor, Md., just a few minutes south of Washington, D.C. The agenda is ambitious, starting with a briefing about what to expect when meeting Congress members on Capitol Hill, followed by a full day of meetings with policymakers, regulators, and their staff.

“We spend our day going back and forth, from the Senate side of the Capitol to the House side of the Capitol, in and out of the office buildings, walking the halls of Congress,” Dr. Greeno says. “It’s a blast. It’s so interesting. And we’re getting a chance to sit down and deliver our message.”

For Dr. Flansbaum, it’s an opportunity to promote action in Washington.

“It really brings government to life,” he says. “You realize that, as bottlenecked as things might be sometimes, things have to get done.”

HM13 attendees can sign-up for Hospitalists on the Hill during annual-meeing registration. For more information, visit www.hospitalmedicine2013.org/onthehill.

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

Chithra Perumalswami, MD, knew early on what she wanted to do with her life. As a teenager, she volunteered in an ED and with a hospice group, volunteerism that continued throughout her education. When she graduated from high school, she was tapped for Brown University’s Program in Liberal Medical Education, which calls itself the only baccalaureate-MD program in the Ivy League. And though she eventually turned down the offer, she pursued dual majors in cellular and molecular biology and English at the University of Michigan, where she earned her medical degree in 2004 and completed her residency.

In 2009, she participated in the Palliative Care Education and Practice Program at Harvard Medical School in Boston, a two-week post-graduate course aimed at professional development for physicians dedicated to careers in palliative-care education. “I really found that there were just so many aspects to caring for a patient as a palliative-care specialist and as a hospitalist that really strike at the heart of what being a doctor is,” says Dr. Perumalswami, assistant professor of medicine in the Division of Hospital Medicine at Northwestern Memorial Hospital in Chicago and one of four new members of Team Hospitalist. “I think it’s been an interest I’ve always had. During my residency training, I definitely experienced quite a few patient cases where I felt that we really needed to help patients and their families, and I didn’t necessarily have the best skill set to do that until I had more experience and more training.”

Dr. Perumalswami now wants to get better at her craft.

“As an academic hospitalist, it’s not just about doing research and writing papers and seeing papers,” she says, “but it’s also developing those leadership skills and helping that become an integral part of the educational experience.”

Question: What drew you to a career in HM?

Answer: I chose a career in academic hospital medicine primarily because I enjoy taking care of acutely ill, hospitalized, adult patients. I also really enjoy teaching medical students, residents, and fellows, and I enjoy doing that in the hospital setting. I think that there’s great satisfaction from taking care of a patient from admission to discharge.… I enjoyed every aspect of internal medicine, and when I graduated, I thought I could choose a subspecialty, but I felt that my skills and my expertise was really in taking care of the hospitalized patient.

Q: You have sought out extra training in palliative care and pain management. How has that impacted your career?

A: It’s not something that I necessarily started out thinking that I would specialize in, but the more I took care of hospitalized patients, the more I realized that we actually take care of a fair number of patients who have really complex symptom needs, and also really have a lot of needs with regard to recognizing when their prognosis is poor and understanding what their options are, if they’re even amenable to a palliative approach. I really felt that that was a skill that I needed to fine-tune. So I ended up gaining enough clinical experience and participating with hospice patients to the point where that’s really supplemented my hospitalist career, because what I found is that it’s made me a better hospitalist, and being a hospitalist has made me a better palliative-care doc.

Q: Working in academia, there’s no way to escape talk of the duty-hour rules recently put in place. What’s your view on the issue?

A: My view is that the work hours are here to stay. I think that there are some definite benefits that we’ve gained from having work hours. I’d say first and foremost of those gains is public trust. I think most physicians will tell you that they don’t want a physician who’s in the 36th hour of their day taking care of them when we know that studies actually can demonstrate that when you’ve been awake that long, that your cognitive abilities decline.

Q: But?

A: I think we have a lot of challenges, though, because a lot of things require creative solutions. And I think the first on that list is education, because that’s the first thing that I think has the potential to drop to the bottom of the list.

Q: In terms of HM’s growth, as you see residents coming through your program, how popular do you think the model is going to be with them moving forward?

A: I do, actually, because as an academic hospitalist, I’ve had several medical students and residents tell me, “Watching you, I think that I want to go into this field.” Or they’ll say, “What do you think about doing this for a year or two?” Or, “What do you think about subspecializing, and then being a hospitalist?” And my answer to all of them is it’s a dynamic specialty, and if you’re up for creating change and being a leader, it’s a good field, because we need people in a lot of different buckets, so to speak. We need people who have done other things in their career to contribute to our field.

Q: How do you prepare trainees for all the challenges coming down the pike?

A: A lot of the people who are doing work in medical education are starting to look to other fields to see if there are other models that we can adapt, or that we can somehow absorb into our practice. I think that there are some parts of our education which are not really formalized early on, but I think we have a lot to learn from organizational behavior circles, and systems that actually look at teams and leadership.

Q: What do the next five to 10 years hold for you?

A: All physician leaders have to stay somewhat in the clinical world. I think if you lose sight of that, you can’t be a very effective leader, or a very effective agent for change. Because part of my work is with palliative care, and I really feel that it’s affected my work as a hospitalist in a positive way, I don’t think I ever see myself leaving the clinical world completely. But I do see myself becoming, ideally, more involved with leadership and more involved with helping to train the next set of leaders.

Q: What do you see as SHM’s role specific to academic HM?

A: HM is changing the way healthcare is delivered in the U.S., and I think having an organization to represent us is vital to our success in other arenas of change—including healthcare policy and innovative care models. I see SHM as a large umbrella group, of which academic HM is one part. Academic hospitalists are increasingly involved in the education of future generations of physicians, and are uniquely poised for facilitating cascading leadership. The traditional, hierarchical model of attending-fellow-resident-medical student is shifting, and academic hospitalists are well-suited to study and explore this leadership structure and how it affects patient care, feedback, and mentoring.

Richard Quinn is a freelance writer based in New Jersey.

Chithra Perumalswami, MD, knew early on what she wanted to do with her life. As a teenager, she volunteered in an ED and with a hospice group, volunteerism that continued throughout her education. When she graduated from high school, she was tapped for Brown University’s Program in Liberal Medical Education, which calls itself the only baccalaureate-MD program in the Ivy League. And though she eventually turned down the offer, she pursued dual majors in cellular and molecular biology and English at the University of Michigan, where she earned her medical degree in 2004 and completed her residency.

In 2009, she participated in the Palliative Care Education and Practice Program at Harvard Medical School in Boston, a two-week post-graduate course aimed at professional development for physicians dedicated to careers in palliative-care education. “I really found that there were just so many aspects to caring for a patient as a palliative-care specialist and as a hospitalist that really strike at the heart of what being a doctor is,” says Dr. Perumalswami, assistant professor of medicine in the Division of Hospital Medicine at Northwestern Memorial Hospital in Chicago and one of four new members of Team Hospitalist. “I think it’s been an interest I’ve always had. During my residency training, I definitely experienced quite a few patient cases where I felt that we really needed to help patients and their families, and I didn’t necessarily have the best skill set to do that until I had more experience and more training.”

Dr. Perumalswami now wants to get better at her craft.

“As an academic hospitalist, it’s not just about doing research and writing papers and seeing papers,” she says, “but it’s also developing those leadership skills and helping that become an integral part of the educational experience.”

Question: What drew you to a career in HM?

Answer: I chose a career in academic hospital medicine primarily because I enjoy taking care of acutely ill, hospitalized, adult patients. I also really enjoy teaching medical students, residents, and fellows, and I enjoy doing that in the hospital setting. I think that there’s great satisfaction from taking care of a patient from admission to discharge.… I enjoyed every aspect of internal medicine, and when I graduated, I thought I could choose a subspecialty, but I felt that my skills and my expertise was really in taking care of the hospitalized patient.

Q: You have sought out extra training in palliative care and pain management. How has that impacted your career?

A: It’s not something that I necessarily started out thinking that I would specialize in, but the more I took care of hospitalized patients, the more I realized that we actually take care of a fair number of patients who have really complex symptom needs, and also really have a lot of needs with regard to recognizing when their prognosis is poor and understanding what their options are, if they’re even amenable to a palliative approach. I really felt that that was a skill that I needed to fine-tune. So I ended up gaining enough clinical experience and participating with hospice patients to the point where that’s really supplemented my hospitalist career, because what I found is that it’s made me a better hospitalist, and being a hospitalist has made me a better palliative-care doc.

Q: Working in academia, there’s no way to escape talk of the duty-hour rules recently put in place. What’s your view on the issue?

A: My view is that the work hours are here to stay. I think that there are some definite benefits that we’ve gained from having work hours. I’d say first and foremost of those gains is public trust. I think most physicians will tell you that they don’t want a physician who’s in the 36th hour of their day taking care of them when we know that studies actually can demonstrate that when you’ve been awake that long, that your cognitive abilities decline.

Q: But?

A: I think we have a lot of challenges, though, because a lot of things require creative solutions. And I think the first on that list is education, because that’s the first thing that I think has the potential to drop to the bottom of the list.

Q: In terms of HM’s growth, as you see residents coming through your program, how popular do you think the model is going to be with them moving forward?

A: I do, actually, because as an academic hospitalist, I’ve had several medical students and residents tell me, “Watching you, I think that I want to go into this field.” Or they’ll say, “What do you think about doing this for a year or two?” Or, “What do you think about subspecializing, and then being a hospitalist?” And my answer to all of them is it’s a dynamic specialty, and if you’re up for creating change and being a leader, it’s a good field, because we need people in a lot of different buckets, so to speak. We need people who have done other things in their career to contribute to our field.

Q: How do you prepare trainees for all the challenges coming down the pike?

A: A lot of the people who are doing work in medical education are starting to look to other fields to see if there are other models that we can adapt, or that we can somehow absorb into our practice. I think that there are some parts of our education which are not really formalized early on, but I think we have a lot to learn from organizational behavior circles, and systems that actually look at teams and leadership.

Q: What do the next five to 10 years hold for you?

A: All physician leaders have to stay somewhat in the clinical world. I think if you lose sight of that, you can’t be a very effective leader, or a very effective agent for change. Because part of my work is with palliative care, and I really feel that it’s affected my work as a hospitalist in a positive way, I don’t think I ever see myself leaving the clinical world completely. But I do see myself becoming, ideally, more involved with leadership and more involved with helping to train the next set of leaders.

Q: What do you see as SHM’s role specific to academic HM?

A: HM is changing the way healthcare is delivered in the U.S., and I think having an organization to represent us is vital to our success in other arenas of change—including healthcare policy and innovative care models. I see SHM as a large umbrella group, of which academic HM is one part. Academic hospitalists are increasingly involved in the education of future generations of physicians, and are uniquely poised for facilitating cascading leadership. The traditional, hierarchical model of attending-fellow-resident-medical student is shifting, and academic hospitalists are well-suited to study and explore this leadership structure and how it affects patient care, feedback, and mentoring.

Richard Quinn is a freelance writer based in New Jersey.

Chithra Perumalswami, MD, knew early on what she wanted to do with her life. As a teenager, she volunteered in an ED and with a hospice group, volunteerism that continued throughout her education. When she graduated from high school, she was tapped for Brown University’s Program in Liberal Medical Education, which calls itself the only baccalaureate-MD program in the Ivy League. And though she eventually turned down the offer, she pursued dual majors in cellular and molecular biology and English at the University of Michigan, where she earned her medical degree in 2004 and completed her residency.

In 2009, she participated in the Palliative Care Education and Practice Program at Harvard Medical School in Boston, a two-week post-graduate course aimed at professional development for physicians dedicated to careers in palliative-care education. “I really found that there were just so many aspects to caring for a patient as a palliative-care specialist and as a hospitalist that really strike at the heart of what being a doctor is,” says Dr. Perumalswami, assistant professor of medicine in the Division of Hospital Medicine at Northwestern Memorial Hospital in Chicago and one of four new members of Team Hospitalist. “I think it’s been an interest I’ve always had. During my residency training, I definitely experienced quite a few patient cases where I felt that we really needed to help patients and their families, and I didn’t necessarily have the best skill set to do that until I had more experience and more training.”

Dr. Perumalswami now wants to get better at her craft.

“As an academic hospitalist, it’s not just about doing research and writing papers and seeing papers,” she says, “but it’s also developing those leadership skills and helping that become an integral part of the educational experience.”

Question: What drew you to a career in HM?

Answer: I chose a career in academic hospital medicine primarily because I enjoy taking care of acutely ill, hospitalized, adult patients. I also really enjoy teaching medical students, residents, and fellows, and I enjoy doing that in the hospital setting. I think that there’s great satisfaction from taking care of a patient from admission to discharge.… I enjoyed every aspect of internal medicine, and when I graduated, I thought I could choose a subspecialty, but I felt that my skills and my expertise was really in taking care of the hospitalized patient.

Q: You have sought out extra training in palliative care and pain management. How has that impacted your career?

A: It’s not something that I necessarily started out thinking that I would specialize in, but the more I took care of hospitalized patients, the more I realized that we actually take care of a fair number of patients who have really complex symptom needs, and also really have a lot of needs with regard to recognizing when their prognosis is poor and understanding what their options are, if they’re even amenable to a palliative approach. I really felt that that was a skill that I needed to fine-tune. So I ended up gaining enough clinical experience and participating with hospice patients to the point where that’s really supplemented my hospitalist career, because what I found is that it’s made me a better hospitalist, and being a hospitalist has made me a better palliative-care doc.

Q: Working in academia, there’s no way to escape talk of the duty-hour rules recently put in place. What’s your view on the issue?

A: My view is that the work hours are here to stay. I think that there are some definite benefits that we’ve gained from having work hours. I’d say first and foremost of those gains is public trust. I think most physicians will tell you that they don’t want a physician who’s in the 36th hour of their day taking care of them when we know that studies actually can demonstrate that when you’ve been awake that long, that your cognitive abilities decline.

Q: But?

A: I think we have a lot of challenges, though, because a lot of things require creative solutions. And I think the first on that list is education, because that’s the first thing that I think has the potential to drop to the bottom of the list.

Q: In terms of HM’s growth, as you see residents coming through your program, how popular do you think the model is going to be with them moving forward?

A: I do, actually, because as an academic hospitalist, I’ve had several medical students and residents tell me, “Watching you, I think that I want to go into this field.” Or they’ll say, “What do you think about doing this for a year or two?” Or, “What do you think about subspecializing, and then being a hospitalist?” And my answer to all of them is it’s a dynamic specialty, and if you’re up for creating change and being a leader, it’s a good field, because we need people in a lot of different buckets, so to speak. We need people who have done other things in their career to contribute to our field.

Q: How do you prepare trainees for all the challenges coming down the pike?

A: A lot of the people who are doing work in medical education are starting to look to other fields to see if there are other models that we can adapt, or that we can somehow absorb into our practice. I think that there are some parts of our education which are not really formalized early on, but I think we have a lot to learn from organizational behavior circles, and systems that actually look at teams and leadership.

Q: What do the next five to 10 years hold for you?

A: All physician leaders have to stay somewhat in the clinical world. I think if you lose sight of that, you can’t be a very effective leader, or a very effective agent for change. Because part of my work is with palliative care, and I really feel that it’s affected my work as a hospitalist in a positive way, I don’t think I ever see myself leaving the clinical world completely. But I do see myself becoming, ideally, more involved with leadership and more involved with helping to train the next set of leaders.

Q: What do you see as SHM’s role specific to academic HM?

A: HM is changing the way healthcare is delivered in the U.S., and I think having an organization to represent us is vital to our success in other arenas of change—including healthcare policy and innovative care models. I see SHM as a large umbrella group, of which academic HM is one part. Academic hospitalists are increasingly involved in the education of future generations of physicians, and are uniquely poised for facilitating cascading leadership. The traditional, hierarchical model of attending-fellow-resident-medical student is shifting, and academic hospitalists are well-suited to study and explore this leadership structure and how it affects patient care, feedback, and mentoring.

Richard Quinn is a freelance writer based in New Jersey.

An interactive program to teach quality and leadership skills to internal-medicine residents at Mount Sinai School of Medicine in New York City—described in an Research, Innovations and Clinical Vignettes (RIV) poster presented at HM12 in San Diego—found that medical trainees are eager and willing to learn the skills that will be required from hospitalists in a reformed healthcare system.¹ Lead author Brian Markoff, MD, SFHM, associate chief of hospital medicine at Mount Sinai, says the Healthcare Leadership Track’s elective, one-month block in quality improvement (QI) and patient safety was established with four second-year residents in 2011-2012.

Along with didactic presentations, participants were offered novel structured learning exercises that included:

• Teaching a care-transitions module to interns;
• Proposing a new clinical pathway;
• Leading a conference on QI;
• Examining a hospital readmission for what went wrong;
• Pairing with a ward medical director;
• Conducting a mentored QI research project; and
• Participating in a book club.

All four participants from the first year “strongly agree that the block was highly relevant to their current and future careers,” Dr. Markoff says.

In their third year, the residents will have the opportunity to participate in one-month electives for leadership, teaching, and the business of medicine.

Six new second-year residents are joining the program, and longitudinal components span the program’s two years. “Most institutions that train residents have a lot of this activity going on,” he says. “Why not get house staff involved in experiential learning in these areas?”

Reference

1. Markoff B, Dunn A. Healthcare leadership track: a novel track to train leaders in inpatient medicine. Paper presented at: HM12, Society of Hospital Medicine annual meeting; April 1-4, 2012; San Diego.

An interactive program to teach quality and leadership skills to internal-medicine residents at Mount Sinai School of Medicine in New York City—described in an Research, Innovations and Clinical Vignettes (RIV) poster presented at HM12 in San Diego—found that medical trainees are eager and willing to learn the skills that will be required from hospitalists in a reformed healthcare system.¹ Lead author Brian Markoff, MD, SFHM, associate chief of hospital medicine at Mount Sinai, says the Healthcare Leadership Track’s elective, one-month block in quality improvement (QI) and patient safety was established with four second-year residents in 2011-2012.

Along with didactic presentations, participants were offered novel structured learning exercises that included:

• Teaching a care-transitions module to interns;
• Proposing a new clinical pathway;
• Leading a conference on QI;
• Examining a hospital readmission for what went wrong;
• Pairing with a ward medical director;
• Conducting a mentored QI research project; and
• Participating in a book club.

All four participants from the first year “strongly agree that the block was highly relevant to their current and future careers,” Dr. Markoff says.

In their third year, the residents will have the opportunity to participate in one-month electives for leadership, teaching, and the business of medicine.

Six new second-year residents are joining the program, and longitudinal components span the program’s two years. “Most institutions that train residents have a lot of this activity going on,” he says. “Why not get house staff involved in experiential learning in these areas?”

Reference

1. Markoff B, Dunn A. Healthcare leadership track: a novel track to train leaders in inpatient medicine. Paper presented at: HM12, Society of Hospital Medicine annual meeting; April 1-4, 2012; San Diego.

An interactive program to teach quality and leadership skills to internal-medicine residents at Mount Sinai School of Medicine in New York City—described in an Research, Innovations and Clinical Vignettes (RIV) poster presented at HM12 in San Diego—found that medical trainees are eager and willing to learn the skills that will be required from hospitalists in a reformed healthcare system.¹ Lead author Brian Markoff, MD, SFHM, associate chief of hospital medicine at Mount Sinai, says the Healthcare Leadership Track’s elective, one-month block in quality improvement (QI) and patient safety was established with four second-year residents in 2011-2012.

Along with didactic presentations, participants were offered novel structured learning exercises that included:

• Teaching a care-transitions module to interns;
• Proposing a new clinical pathway;
• Leading a conference on QI;
• Examining a hospital readmission for what went wrong;
• Pairing with a ward medical director;
• Conducting a mentored QI research project; and
• Participating in a book club.

All four participants from the first year “strongly agree that the block was highly relevant to their current and future careers,” Dr. Markoff says.

In their third year, the residents will have the opportunity to participate in one-month electives for leadership, teaching, and the business of medicine.

Six new second-year residents are joining the program, and longitudinal components span the program’s two years. “Most institutions that train residents have a lot of this activity going on,” he says. “Why not get house staff involved in experiential learning in these areas?”

Reference

1. Markoff B, Dunn A. Healthcare leadership track: a novel track to train leaders in inpatient medicine. Paper presented at: HM12, Society of Hospital Medicine annual meeting; April 1-4, 2012; San Diego.

Clinical question: Can a quality-improvement (QI) collaborative decrease patient identification (ID) band errors?

Background: ID band errors often result in medication errors and unsafe care. Consequently, correct patient identification, through the use of at least two identifiers, has been an ongoing Joint Commission National Patient Safety Goal. Although individual sites have demonstrated improvement in accuracy of patient identification, there have not been reports of dissemination of successful practices.

Study design: Collaborative quality-improvement initiative.

Setting: Six hospitals.

Synopsis: ID band audits in 11,377 patients were performed in the learning collaborative’s six participating hospitals.

The audits were organized primarily around monthly conference calls. The hospital settings were diverse: community hospitals, hospitals within an academic medical center, and freestanding children’s hospitals. The aim of the collaborative was to reduce ID band errors by 50% within a one-year time frame across the collective sites.

Key interventions included transparent data collection and reporting; engagement of staff, families and leadership; voluntary event reporting; and auditing of failures. The mean combined ID band failure rate decreased to 4% from 22% within 13 months, representing a 77% relative reduction (P<0.001).

QI collaboratives are not designed to specifically result in generalizable knowledge, yet they might produce widespread improvement, as this effort demonstrates. The careful documentation of iterative factors implemented across sites in this initiative provides a blueprint for hospitals looking to replicate this success. Additionally, the interventions represent feasible and logical concepts within the basic constructs of improvement science methodology.

Bottom line: A QI collaborative might result in rapid and significant reductions in ID band errors.

Citation: Phillips SC, Saysana M, Worley S, Hain PD. Reduction in pediatric identification band errors: a quality collaborative. Pediatrics. 2012;129(6):e1587-e1593.

Reviewed by Pediatric Editor Mark Shen, MD, SFHM, medical director of hospital medicine at Dell Children's Medical Center, Austin, Texas.

Clinical question: Can a quality-improvement (QI) collaborative decrease patient identification (ID) band errors?

Background: ID band errors often result in medication errors and unsafe care. Consequently, correct patient identification, through the use of at least two identifiers, has been an ongoing Joint Commission National Patient Safety Goal. Although individual sites have demonstrated improvement in accuracy of patient identification, there have not been reports of dissemination of successful practices.

Study design: Collaborative quality-improvement initiative.

Setting: Six hospitals.

Synopsis: ID band audits in 11,377 patients were performed in the learning collaborative’s six participating hospitals.

The audits were organized primarily around monthly conference calls. The hospital settings were diverse: community hospitals, hospitals within an academic medical center, and freestanding children’s hospitals. The aim of the collaborative was to reduce ID band errors by 50% within a one-year time frame across the collective sites.

Key interventions included transparent data collection and reporting; engagement of staff, families and leadership; voluntary event reporting; and auditing of failures. The mean combined ID band failure rate decreased to 4% from 22% within 13 months, representing a 77% relative reduction (P<0.001).

QI collaboratives are not designed to specifically result in generalizable knowledge, yet they might produce widespread improvement, as this effort demonstrates. The careful documentation of iterative factors implemented across sites in this initiative provides a blueprint for hospitals looking to replicate this success. Additionally, the interventions represent feasible and logical concepts within the basic constructs of improvement science methodology.

Bottom line: A QI collaborative might result in rapid and significant reductions in ID band errors.

Citation: Phillips SC, Saysana M, Worley S, Hain PD. Reduction in pediatric identification band errors: a quality collaborative. Pediatrics. 2012;129(6):e1587-e1593.

Reviewed by Pediatric Editor Mark Shen, MD, SFHM, medical director of hospital medicine at Dell Children's Medical Center, Austin, Texas.

Clinical question: Can a quality-improvement (QI) collaborative decrease patient identification (ID) band errors?

Background: ID band errors often result in medication errors and unsafe care. Consequently, correct patient identification, through the use of at least two identifiers, has been an ongoing Joint Commission National Patient Safety Goal. Although individual sites have demonstrated improvement in accuracy of patient identification, there have not been reports of dissemination of successful practices.

Study design: Collaborative quality-improvement initiative.

Setting: Six hospitals.

Synopsis: ID band audits in 11,377 patients were performed in the learning collaborative’s six participating hospitals.

The audits were organized primarily around monthly conference calls. The hospital settings were diverse: community hospitals, hospitals within an academic medical center, and freestanding children’s hospitals. The aim of the collaborative was to reduce ID band errors by 50% within a one-year time frame across the collective sites.

Key interventions included transparent data collection and reporting; engagement of staff, families and leadership; voluntary event reporting; and auditing of failures. The mean combined ID band failure rate decreased to 4% from 22% within 13 months, representing a 77% relative reduction (P<0.001).

QI collaboratives are not designed to specifically result in generalizable knowledge, yet they might produce widespread improvement, as this effort demonstrates. The careful documentation of iterative factors implemented across sites in this initiative provides a blueprint for hospitals looking to replicate this success. Additionally, the interventions represent feasible and logical concepts within the basic constructs of improvement science methodology.

Bottom line: A QI collaborative might result in rapid and significant reductions in ID band errors.

Citation: Phillips SC, Saysana M, Worley S, Hain PD. Reduction in pediatric identification band errors: a quality collaborative. Pediatrics. 2012;129(6):e1587-e1593.

Reviewed by Pediatric Editor Mark Shen, MD, SFHM, medical director of hospital medicine at Dell Children's Medical Center, Austin, Texas.