Hearts, shots, and PPIs

This month's issue looks at the division of responsibility for inpatient heart failure care, life after COVID-19 vaccination, and unnecessary proton-pump inhibitors, along with other topics.

Sometimes it's obvious which service should take a patient who is being admitted. But sometimes it's not. This month's main story looks how at this issue plays out for heart failure inpatients, who may be admitted to hospital medicine or cardiology. Research has shown a number of potentially problematic aspects of that dynamic, including patients of different races being sent to the two services at different rates and variation in outcomes by which service sees a heart failure patient. Experts offer their perspectives on how individual hospitalists and health systems can address these issues and optimize care.

A feature article in this issue focuses on the best news of the year—COVID-19 vaccination! Hospitalists discuss their feelings about being vaccinated (spoiler alert: they're all good) and whether hospital protocols will change as more of the country is too. Also on the subject of the pandemic, we have conference coverage from the Critical Care Congress. Three intensive care experts discussed the evolution of COVID-19 care from March 2020 to February 2021, when the conference was held online. A second conference coverage article offers 10 tips for keeping patients off the ventilator.

Getting patients off unnecessary proton-pump inhibitors (PPIs) has been a goal among many hospitalists for a while. An article in this issue discusses challenges to achieving this objective and offers an overview of the evidence so far on how PPI use might affect COVID-19 outcomes.

This issue includes one of our regular reader-written features: the Brief Case with cases from Oregon Health & Science University, Valleywise Health in Arizona, and Medical Center Bowling Green in Kentucky. We love when our readers write for or to us—get in touch anytime at acphospitalist@acponline.org.

Stacey Butterfield