Q&A


Do you know your core competencies?

Satyen Nichani, MD, ACP Member, explains the Society of Hospital Medicine's recently updated Core Competencies in Hospital Medicine.

What happens when patients call their own rapid response?

A hospital finds surprising results from safety initiative.

Physician-rating websites lack star power

Reviews aren't numerous enough to provide meaningful information.

Critical illness events on wards may be ‘contagious'

Does focusing on one patient who's very, very sick have an impact on other patients on the same ward?

Teaching high-value care

An assistant dean for health care value discusses a new track in care transformation for residents.

Textbook reflects evolution of hospitalists

More robust coverage of consultation medicine, rehabilitation medicine, oncology, palliative care, and transitions of care is included

The future is now

Revisiting 2007 predictions for hospital medicine with Robert Wachter, MD, FACP

Dispelling the ‘hot-spotter’ myth

Not all patients who accrue high costs are frequent utilizers of services

A shift in hospital-physician affiliations

Many more physicians now work directly for hospitals. What does this mean for them?

A shift in hospital-physician affiliations

Many more physicians now work directly for hospitals. What does this mean for them?

Assess stroke rehab needs sooner, better

New guidelines focus on rehabilitation and recovery

Explaining Sepsis-3

A physician involved in developing the Third International Consensus Definitions for Sepsis and Septic Shock outlines the reasoning behind the new changes in sepsis criteria

Focusing on acute MI in women

An expert offers insight on the American Heart Association's first scientific statement on the topic

Bullies in the hospital

The problem of bullies in school extends all the way through medical training, according to a recent study

A new cause to consider in falls: Infection

Coexisting systemic infections may need to be routinely considered in patients who present with a fall

How hospitalists can avoid diagnostic errors

A patient safety expert offers advice on improving diagnosis

Will ICUs become hospitalists' turf?

Expert considers new intensive care staffing models

‘The pause’ allows for moment of silence after a patient death

The RN who developed it sees it as "a means of honoring a patient after they pass away"

Mobile apps enter the hospital

An expert discusses which apps hospitalists should know about and how they can begin to prescribe them

Clinical reasoning now a ‘foundational basic science’ in medical education

Perhaps the most important aspect of medical training is developing the ability to come to the correct diagnosis

Panel picks appropriate uses for PICCs

An expert discusses new collaborative recommendations

What do PCPs wish hospitalists would do?

A survey looks at what PCPs want from their professional relationships with hospitalists

Quality over cost: New book focuses on physicians' role in improving value

The book's authors discuss the importance of high-value health care

Give them choice or give them guidance?

Study looks at patients' autonomy versus their best interest

One hospital finds better communication with patients thanks to EHRs

Patient satisfaction rates went up after EHR implementation

A card and a couple of minutes convey condolences

A study finds that clinicians express condolences to patients' families at inconsistent rates

Add a second question to the smoking conversation

Secondhand smoke exposure common among cardiac inpatients

You can keep your pants on

Most patients would like to wear pants during hospital stay

Hospitalists can help IOM fix dying process

A new report calls for improvements in end-of-life care

A hospital compares outcomes of teaching and hospitalist teams

Dr. Chin's study looked at length of stay, readmissions, and costs among 3 types of inpatient medicine teams.

Q&A: What future hospitalists are thinking now

Young docs talk about training experiences, expectations for their careers.

Q&A: The next step in sepsis care

Patients with severe sepsis and septic shock get the best care that hospitals have to offer: rapid, intensive, protocol-based treatment.

Search out the surrogates

Alexia M. Torke, MD, discusses her study on sharing decision making with elderly inpatients.

An unusual state of hospital finances

An independent commission sets hospital charges, with the same prices for all payers.

Signing up isn't enough

Only half of hospitals reported monitoring whether they gave discharge summaries to primary care physicians, study found.

Failing to prevent heart failure readmissions

Hospitalist use was associated with greater adherence to heart failure performance measures,

Lab oversight important even for waived testing

Physicians should take steps to improve the testing done in their hospitals and offices.

The question patients won't ask but want answered

Research indicates sexual problems and concerns are common after hospital discharge.

The emotional life of doctors

When physicians get a handle on work-related emotions, it helps improve patient care as well as self-care.

Advice on the most difficult conversation

Hospitalists often find reasons to avoid asking patients about goals of care.

Concerns, not ignorance, inhibit stroke med adherence

Physicians should work with patients to develop solutions to medication concerns.

Where does the day go?

Time with patients is sacrificed for time spent documenting care and talking with other clinicians.

How does your handoff rate?

Learning how to receive a handoff is as important as learning to how to send one.

CRE rates creeping up

Here's what hospitalists can do to protect patients from carbapenem-resistant Enterobacteriaceae.

Little conversations about big decisions

Understanding where colleagues are coming from could help improve communication.

Time to teach

Everybody believes somebody should do it, but nobody has the time to figure out whose job it is. Such is the problematic status of patient discharge education.

The dark side of doctoring

Physicians who commit suicide appear to differ from nonphysicians in several ways.

Time to curb the curbside?

They are quick, convenient and help out colleagues and patients. What could be wrong with curbside consults? Quite a lot.

Be smart about smartphone use

A study suggests that hospitals develop a policy about when and how to use smartphones at work.

A patient-centered home on the range

A three-year patient-centered medical home pilot reduced ED visits and hospital admissions.

Septic sadness

A recent study found a substantial prevalence of depression among spouses of sepsis survivors.

Optimizing Tx of med students

Medical student mistreatment appears to be more common than one might think.

You are a role model

When academic hospitalists observe their peers behaving unprofessionally, chances are residents and students are seeing the same thing.

What's your malpractice risk?

A research letter uncovers how often physicians face malpractice claims, and which are more likely to do so.

Writing and wishing

Understanding patients' and families' perspectives plays a big part in successful end-of-life care.

Losing a patient—and the family, too?

People were more likely to have an MI shortly after a significant death than in the six months prior.

A vision of the future

The chairman and CEO of IPC discusses current trends and future possibilities.

HAI but POA

A study indicates that public reporting of hospital infection rates should note which were present on admission.

Can't always get what you want, but hospitalists come close

A recent survey aimed to gain some perspective on job satisfaction for hospitalists.

Projecting the future of inpatient dementia

A recent analysis concluded that by 2050, the annual number of dementia-associated hospitalizations of patients older than 85 could surpass seven million.

Embracing the spiritual

Most patients don't want their physicians to play God, but discussing God is another matter.

How to volunteer overseas

An experienced volunteer discusses what's required to get involved.

Lost in transit

Even when errors didn't occur, communication patterns appeared less than ideal.

The challenge of predicting readmissions

It would be convenient if, along with their white coats, hospitalists were issued crystal balls.

Assess before anticoagulating

Three new evidence-based recommendations from ACP point out that VTE prophylaxis is not as simple as some might think.Three new evidence-based recommendations from ACP point out that VTE prophylaxis is not as simple as some might think.

Fall prevention falls short on evidence base

A review of existing fall prevention methods found little conclusive medical evidence to support them.

Not just another satisfaction survey

A survey asks patients what they didn't like about their hospital stays, and gets some interesting answers.

Learning from the best

Interviewing personnel at "best" and "worst" hospitals yielded some interesting findings.

ICU patients suffer symptoms silently

By the time a patient gets to the ICU, his symptoms aren't usually the focus of diagnostics or treatment. But that doesn't mean they aren't still bothering him.

Stay alert to patients' suicide risk

A recent Sentinel Event Alert aims to reduce suicide risk in hospitalized patients.

Hospitals with leverage get more from insurers

A new study shows that payment rates vary widely from private insurers to hospitals. The president of the Center for Studying Health System Change talks to ACP Hospitalist about possible causes and solutions.

ACP issues guideline on glucose management for hospitalized patients

ACP's director of clinical policy discusses a new guideline for intensive insulin therapy.

D2B: Saving time, but not lives?

Reducing delays for percutaneous coronary intervention didn't lower mortality, a study found.

Diaries share, and help resolve, secrets of the ICU

Daily logs may help lower incidence of post-traumatic stress disorder.

When hospitalists stay longer, patients leave sooner

A study indicates that fragmentation of care negatively affects length of stay. The lead author talks about his findings.

Evidence that's not what it seems

The determination of whether a treatment would be futile is one of the toughest decisions a hospitalist can face.

Patient safety vs. physician frustration: Finding a balance for medication alerts

Warnings in a computerized provider order entry system help alert prescribers to risky drugs for the elderly.

Guidelines getting tougher on industry, but physicians are not

A survey found that physicians were comfortable accepting industry-sponsored gifts despite prohibitions against them.

Six letters that can help with difficult decisions

Two physicians describe their mnemonic for determine patients' decision-making capacity.

Core competencies peripheral in practice

The Society of Hospital Medicine considers nine procedures to be "core competencies" for hospitalists, yet many perform them so rarely it would be difficult to maintain competency.

ICU patients need to be seen as well as heard

Determining the floor plan of a hospital is usually the responsibility of an architect, but a recent study shows doctors should care about design, too.

Putting MRSA to the test

Screening patients may keep infection from taking hold.

Q&A: Answering before the surgeon calls

Did seeing high-risk surgical patients early reduce complications and length of stay?

There is a doctor in the ‘House’

Lisa Sanders, ACP Member, is a technical adviser on the T.V. show "House, M.D."

Improving patient sleep by shaking up routines

Melissa Bartick, ACP Member, found that simple changes can reduce patients' requests for sedatives.

I-MOVE gets elderly patients on the move

The I-MOVE sounds like a state-of-the-art electronic gadget, but it's actually the simplest of medical tools. Developed by clinicians at Mercy Hospital of Pittsburgh and the Mayo Clinic in Minnesota, the Independent Mobility Validation Examination, or I-MOVE, is a 12-point scale that could help hospitalists assess their patients' mobility.

Treating trauma—not as scary as you think

A unique service makes hospitalists the primary physicians for certain trauma inpatients.

A sideline that grew outside the lines

Hospitalist Stephen Bekanich, MD, talks about starting a successful palliative care program.

Preventing heart disease by targeting patients' loved ones

Lori Mosca, ACP Member, explains how hospitalists can help reduce risk that runs in the family.

ACP program introduces leadership skills to young members

ACP's LEAD program (Leadership Enhancement and Development) grew out of the realization that training physicians in leadership skills would benefit both physicians and the College. ACP Hospitalist talked to Erik Wallace, FACP, who led the inaugural LEAD precourse at Internal Medicine 2008.

Finding an algorithm for heart failure

The OPTIMIZE-HF study showed which symptoms predicted likelihood of in-hospital mortality from decompensated congestive heart failure and what were the most important predictive factors. Now, there's an algorithm for stratifying patients.

A legal primer for international medical graduates and their employers

Carl Shusterman, JD, answers FAQs about how immigration law applies to doctors

No signouts? No problem

A hospitalist program uses an innovative scheduling system to reduce handoffs

New end-of-life guidelines help physicians fill gap in patient care

Donald E. Casey Jr., FACP, discusses new end-of-life guidelines

A new Rx for crowded hospitals: Math

Operations management expert brings queuing theory to health care

Q&A: Nurturing the human side of medical care

Nearly 20 years ago, Arnold P. Gold, MD, a pediatric neurologist, and his wife, Sandra O. Gold, EdD, a psychologist, created the Arnold P.

In the eye of the storm

Medical residents train amidst Hurricane Katrina's aftermath

Deciding when patients can't

End-of-life considerations for incapacitated patients without surrogates

Assessing unhealthy alcohol use in hospitalized patients

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) estimates that 3 in 10 Americans drink enough to put them at risk for health problems.

Improving door-to-balloon time for acute MI

The decisions made by hospital staff in the first few minutes following an acute myocardial infarction (MI) often determine whether a patient lives or dies.

One-way lung valves may offer hope to patients with severe emphysema

Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death in the U.S. and resulted in 638,000 hospital discharges in 2004, according to the National Center for Health Statistics.