Sometimes all it takes to move forward on a problem is to reframe the way one thinks about it. That's why we were so struck by Harlan Krumholz's Jan. 10 piece in the New England Journal of Medicine. In it, he elegantly summarized recent research suggesting there is more to preventing readmissions than a good discharge and follow-up. The hospital experience itself may contribute to readmissions, he posited, and thus, improving the experience may help reduce readmissions. In our cover story, top leaders in the field offer their thoughts on this theory, which has widespread interest if not total acceptance. In a related sidebar, we recap a critical care conference session in which experts discussed measures for reducing post-intensive care syndrome.
For our feature story, we interviewed experts who have thought deeply and creatively about how to create the ideal ward team—one that both supports and learns from its members. Silly icebreakers and serious management strategies both play a role in helping disparate personalities to gel, the experts said. We continue our coding column series on how to document the complexity of medical decision making for E/M services. And our Success Story provides a snapshot of a simple, single-site intervention that got huge results in reducing patient identification errors.
Physician-authored guest columns this month include an Irish medical student telling of his first impressions of U.S. hospital medicine, and a hospitalist whose patient encounter caused her to rethink the definition of a “good outcome.” If you would like to write for us, there are many opportunities; drop us a line to learn more.
Editor, ACP Hospitalist