Letter from the Editor

This issue examines antibiotic stewardship programs, rapid response systems, pocket ultrasounds, and more.

You don't have to work at a large academic hospital or be an infectious disease expert to combat antibiotic resistance. In California, nearly half of community hospitals have antibiotic stewardship programs, and another 31% plan to start one. In addition to improving outcomes, such programs can lower prescribing costs and costs associated with antibiotic overuse (like treating Clostridium difficile), and be tailored to individual institutions. The only true requirement for creating a program is the desire to use antibiotics correctly, experts say. Stacey Butterfield's cover story will show you how to get started in devising a plan that fits your facility's needs, regardless of size, available funds and resources, or access to infectious disease specialists.

Speaking of improvement programs, many hospitals employ rapid response systems as a way to boost patient safety and cut costs. The research is still equivocal, however, as to whether these systems actually save lives. How are hospitals to know whether the effort is worth it? Janet Colwell's story shows how you can assess less dramatic but important results like number of patient codes and employee satisfaction. Experts also offer advice on tracking statistics, such as calls received, response times and transfers, to ensure your system is operating efficiently.

In addition to instituting programs, best practices entails adopting potentially useful technology. Our article looks at one such gadget: the handheld ultrasound. While increasing in popularity, its utility in the hospital is far from widely accepted. Some say the device is a big help in making quick diagnoses and treatment decisions in the absence of specialists, while others question its safety, efficacy and added cost. We take a look at the debate surrounding the use of these devices, which supporters say are poised to make their way into more hospitals in the coming years.

New technology is exciting, but it's just as important to revisit aspects of hospital medicine that have been around for a while, to ensure they are still working. Hospitalist Edward Ma, ACP Member, argues that it's time to retire the seven on/seven off schedule used by many hospitals, in favor of one that offers physicians a better quality of life. Dr. Ma is writing for our new Perspectives section, in which physician readers can offer expert views on issues of interest to them.

If you're interested in contributing to our new Perspectives section—or would like to give feedback on the magazine in general—please email us. As always, thanks for reading.

Jessica Berthold
Editor, ACP Hospitalist