Letter from the Editor

This month's issue includes articles on caring for patients with intellectual and developmental disabilities, reducing readmissions, assessing capacity, and more.

There's a lot of misunderstanding about individuals with intellectual and developmental disabilities (IDD), and that includes in hospitals. Physicians receive little to no training on how to manage patients with IDD, and administrators may feel their staff encounter these patients too infrequently to merit training. Yet being unfamiliar with this population can carry a stiff price, as patients with IDD are more likely to come to the ED, have longer hospital stays, and be readmitted. As well, rates of diagnosed disabilities like autism are rising, and more patients with IDD are treated in community hospital settings than in the past. Our cover story looks at hospitals that have taken concrete steps to improve care of the patient population with IDD and outlines what you can do at your own hospital to ensure these patients are cared for respectfully and appropriately.

Speaking of the ED, our feature story examines lessons from a study that asked patients returning to the ED why they did so. High on the list were fears that their health was worsening, belief that care was quicker and easier in the ED, and dissatisfaction with the care received during the initial visit. The study's author and other experts discuss ways to ensure patients are more satisfied with their initial visit and more confident their health will not deteriorate once they are outside the hospital, and in doing so perhaps prevent some return ED visits.

In conference coverage, we offer recaps of sessions at Mayo Clinic's Managing Complex Patients meeting last October. Topics include how to manage the causes and complications of liver disease and how to assess decision-making capacity in inpatients. We also report on a session from IDWeek 2014 that outlined the latest innovations in Clostridium difficile, including frozen fecal capsules in lieu of fecal transplant.

What innovations are you excited about, in the world of research or within the walls of your own hospital? Tell us about them.

Jessica Berthold
Editor-in-Chief, ACP Hospitalist