Letter from the Editor

This issue offers expert advice on using checklists, clinical pearls on preop pulmonary evaluation, and guidance for ethically challenging situations.

Hospitalists are frequently hit with information on the best way to do their jobs from professional societies, studies and publications (like this one). How to keep from getting overwhelmed? The answer may lie in checklists, as Stacey Butterfield explains in our cover story. Many doctors already use them for discharges and a handful of other clinical processes, but checklists can be applied to a wider range of settings and evidence-based practices than is often realized. Read on for expert advice on identifying practices that are ripe for a checklist, and creating one that works for—and is actually used by—you and your colleagues.

Our clinical spotlight this month is trained on the lungs. For surgical patients, pulmonary complications are more frequent than cardiac complications, yet the latter get more attention from researchers and the media. Our feature story looks at who and how to screen for potential pulmonary problems before surgery, and what to do if you detect someone at risk. “Technology Traps “ explores when to use noninvasive positive-pressure ventilation in the hospital, while “Test Yourself “ covers the diagnosis and management of conditions like asthma exacerbation and chest pain after childbirth.

Two articles in this issue examine decision making in ethically challenging situations. One feature talks about how physicians in states with assisted suicide laws must determine where they stand on the matter, and how they will care for patients who want to end their lives. Meanwhile, in a Q&A, we talk with the inventors of a mnemonic (CURVES) that helps physicians with the most important factors to consider when facing difficult decisions about care.

What's your process for making difficult decisions on the job? Tell us about it, or share your impressions of these stories, by writing to us.

Jessica Berthold
Editor, ACP Hospitalist