Hospitalists are often reminded that the quality of an inpatient's transition of care affects how well he or she does after discharge. To improve this transition, hospitalists are encouraged to communicate with primary care physicians (PCPs), so that vital information can be passed along, follow-up appointments made, and discharge instructions adhered to. Likewise, PCPs can provide pertinent information about a patient's history at admission or during the hospitalization period. Yet resistance and inattention plague many PCP-hospitalist relationships. Our cover story looks at strategies some hospitalist practices have used to maintain a strong connection to their referring PCPs, and the benefit they and their patients have realized from investing in this important relationship.
Morbidity and mortality (M&M) conferences are getting an overhaul at many hospitals. No longer do their participants examine events in isolation to determine what went wrong and who was at fault. Now they are an opportunity to look at how whole hospital systems contribute to unfavorable outcomes, and ways those systems can be fixed. Writer Janet Colwell discusses different frameworks for reshaping M&M conferences that are used at places like Johns Hopkins and San Francisco General Hospital, and provides practical guidance on how your hospital can rework its own conferences.
Eight years after the launch of the Surviving Sepsis Campaign offered guidelines for managing this devastating illness, hospitals still struggle to recognize the condition in time. General hospital wards, in particular, fare poorly in spotting the warning signs until patients are quite ill. Our story offers a primer on the indications of sepsis, as well as tips to educate staff so they are vigilant about this stealthy disease. This month's Coding Corner column discusses proper documentation of sepsis, while our Test Yourself feature offers several clinical vignettes involving the illness.
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Editor, ACP Hospitalist