Abstract:
BACKGROUND:The Centers for Disease Control and Prevention recommends routinely offering HIV testing to inpatients at hospitals with an HIV seroprevalence rate of greater than 1% or an AIDS diagnosis rate of greater than 1.0 per 1000 discharges. This recommendation has not been widely adopted, perhaps because of one of several barriers: the cost of implementing a counseling and testing program; the logistics of HIV counseling and testing on a hospital ward particularly with respect to privacy; concern about the follow-up of HIV test results necessitating patients to return after discharge; and the cultural mindset of screening as an outpatient modality complicated by the fear of raising the possibility of HIV testing and therefore eliciting a negative reaction from a patient who has not requested it. PURPOSE:This article focuses on these barriers and some possible solutions, emphasizing the role of FDA-approved rapid HIV tests, which may decrease follow-up issues for HIV testing programs. It also considers hospitalists, given their frontline status and ability to coordinate the multidisciplinary services and system-wide approach required to implement such a program, as leaders in this area.
journal_name
J Hosp Medjournal_title
Journal of hospital medicineauthors
Greenwald JLdoi
10.1002/jhm.66subject
Has Abstractpub_date
2006-03-01 00:00:00pages
106-12issue
2eissn
1553-5592issn
1553-5606journal_volume
1pub_type
杂志文章,评审abstract:BACKGROUND:Efforts to curb healthcare spending have included interventions that target frequently hospitalized individuals. It is unclear the extent to which the most frequently hospitalized individuals also represent the costliest individuals. OBJECTIVE:To examine the relationship between 2 types of "high users" comm...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2096
更新日期:2013-12-01 00:00:00
abstract:BACKGROUND:Patient whiteboards can serve as a communication tool between hospital providers and as a mechanism to engage patients in their care, but little is known about their current use or best practices. METHODS:We surveyed bedside nurses, internal medicine housestaff, and hospitalists from the medical service at ...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.638
更新日期:2010-04-01 00:00:00
abstract:BACKGROUND:Few studies have examined alternative structures for inpatient clerkships. OBJECTIVE:Compare 2 inpatient clerkship structures using multiple outcome variables. DESIGN:Prospective, randomized controlled trial. SETTING:Tertiary-care, freestanding children's hospital. SUBJECTS:All medical students enrolled ...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,随机对照试验
doi:10.1002/jhm.250
更新日期:2007-11-01 00:00:00
abstract::Dr. Pham, a practicing general internist and health policy researcher, recalls her experience, as a granddaughter, of how patients, families, and physicians are often complicit in foiling the good coordination of care. ...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.410
更新日期:2009-04-01 00:00:00
abstract:BACKGROUND:Patient-centered care has been identified as 1 of the 6 aims for the 21st century healthcare system. The notepad is a simple tool for reminders and personal interactions. We introduced Dear Doctor (DD) notes, a bedside notepad designed to prompt patient questions and improve patient satisfaction. OBJECTIVE:...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2073
更新日期:2013-10-01 00:00:00
abstract:BACKGROUND:There are 250,000 cases of central line-associated blood stream infections in the United States annually, some of which may be prevented by the removal of lines that are no longer needed. OBJECTIVE:To test the performance of criteria to identify an idle line as a guideline to facilitate its removal. METHOD...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2573
更新日期:2016-07-01 00:00:00
abstract::Gallstone ileus is a rare etiology of small bowel obstruction, occurring typically in the elderly population. The delay in diagnosis often results in significant morbidity and mortality. Here, we describe a case of 67 year old woman who presented with non specific abdominal symptoms and on evaluation was found to have...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.582
更新日期:2010-02-01 00:00:00
abstract:BACKGROUND:Although interdisciplinary hospital quality improvement (QI) teams are both prevalent and associated with success of (QI) efforts, little is known about the behaviors of successful interdisciplinary QI teams. OBJECTIVE:We examined the specific behaviors of interdisciplinary QI teams in hospitals that succes...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.927
更新日期:2011-11-01 00:00:00
abstract::Nephrogenic systemic fibrosis (NSF) has now been linked to gadolinium-based contrast (GBC) exposure in those with compromised kidney function, particularly those with end-stage renal disease (ESRD). When ESRD is present, symptoms can be quite devastating for the patient including severe pain and immobility and even de...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.493
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:Health care-associated infections and antimicrobial resistance threaten the safety of hospitalized patients. New prevention strategies are necessary to address these problems. In response, the Society of Hospital Medicine (SHM) in collaboration with the Centers for Disease Control and Prevention developed an...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.223
更新日期:2007-07-01 00:00:00
abstract:BACKGROUND:High hospital occupancy is a challenge for quality of care and access, while low levels of occupancy may be inefficient in terms of resource utilization. Variability from scheduling decisions may affect occupancy and be amenable to alteration. OBJECTIVE:Describe variability in admission, discharge, and occu...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.819
更新日期:2011-02-01 00:00:00
abstract::The accountable care organization (ACO) concept is advocated as a promising value-based payment model that could successfully realign the current payment system to financially reward improvements in quality and efficiency. Focusing on the care of hospitalized patients and controlling a substantive portion of variable ...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.2965
更新日期:2018-04-01 00:00:00
abstract::The Centers for Medicare and Medicaid Services awarded Hospital Medicine a Medicare specialty code, "C6", in 2016. We examined the early uptake of C6 code using the 2017 Medicare Part B utilization data. We also compared the actual C6 specialty code usage against estimated rates of overall hospitalist billing using th...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.3303
更新日期:2020-02-01 00:00:00
abstract:BACKGROUND:Peripheral intravenous catheter (PIVC) use in health care is common worldwide. Failure of PIVCs is also common, resulting in premature removal and replacement. OBJECTIVE:To investigate the characteristics, management practices, and outcomes of PIVCs internationally. DESIGN: SETTING/PATIENTS:Cross-sectiona...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.3039
更新日期:2018-05-30 00:00:00
abstract:BACKGROUND:Knowing the number of discharges that will occur is important for administrators when hospital occupancy is close to or exceeds 100%. This information will facilitate decision making such as whether to bring in extra staff, cancel planned surgery, or implement measures to increase the number of discharges. W...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.2802
更新日期:2018-03-01 00:00:00
abstract::As part of the Choosing Wisely Campaign, the Society of Hospital Medicine identified reducing inappropriate use of acid-suppressive medication for stress ulcer prophylaxis as 1 of 5 key opportunities to improve the value of care for hospitalized patients. We designed a computerized clinical decision support interventi...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2260
更新日期:2015-01-01 00:00:00
abstract::Current hospital readmission measures are part of the Centers for Medicare & Medicaid Services Five-Star Quality Rating System but are inadequate for reporting hospital quality. We review potential biases in the readmission measures and offer policy recommendations to address these biases. Hospital readmission rates a...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.2799
更新日期:2017-12-01 00:00:00
abstract:IMPORTANCE:Although intensive care unit (ICU) adaptations to the coronavirus disease of 2019 (COVID-19) pandemic have received substantial attention , most patients hospitalized with COVID-19 have been in general medical units. OBJECTIVE:To characterize inpatient adaptations to care for non-ICU COVID-19 patients. DES...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.3476
更新日期:2020-08-01 00:00:00
abstract:: ...
journal_title:Journal of hospital medicine
pub_type: 评论,社论
doi:10.12788/jhm.3116
更新日期:2018-12-01 00:00:00
abstract::As the field of hospital medicine expands, internal medicine residency programs can play a role in preparing future hospitalists. To date, little is known of the prevalence and characteristics of hospitalist-focused resident rotations. We surveyed the largest 100 Internal Medicine Residency Programs to better understa...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.2952
更新日期:2018-09-01 00:00:00
abstract:BACKGROUND:Best practice alerts (BPAs) provide clinical decision support (CDS) at the point of care to reduce unnecessary blood product transfusions, yet substantial transfusions continue outside of recommended guidelines. OBJECTIVE:To understand why providers order blood transfusions outside of recommended guidelines...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2236
更新日期:2015-01-01 00:00:00
abstract::Efforts to improve the patient experience are increasingly focusing on engaging patients and their "care partners" by using patient portals. The Acute Care Patient Portal Task Force was supported by the Gordon and Betty Moore Foundation to convene a national meeting of an interdisciplinary group of stakeholders, inclu...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.2860
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:Patients with suspected thiamine deficiency should receive treatment with parenteral thiamine to achieve the high serum thiamine levels necessary to reverse the effects of deficiency and to circumvent problems with absorption common in the medically ill. OBJECTIVE:To quantify rates of parenteral administrat...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,多中心研究
doi:10.1002/jhm.2324
更新日期:2015-04-01 00:00:00
abstract::Every year, nearly 5 million adults with cancer are hospitalized. Limited evidence suggests that hospitalization of the cancer patient is associated with adverse morbidity and mortality. Hospitalization of the patient with advanced cancer allows for an intense examination of health status in the face of terminal illne...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,评审
doi:10.1002/jhm.2511
更新日期:2016-04-01 00:00:00
abstract:BACKGROUND:Unplanned (unexpected) transfers to the intensive care unit (ICU) are typically preceded by physiologic instability. However, trends toward instability may be subtle and not accurately reflected by changes in vital signs. The shock index (SI) (heart rate/systolic blood pressure as an indicator of left ventri...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.779
更新日期:2010-10-01 00:00:00
abstract::Non-housestaff medicine services are growing rapidly in academic medical centers (AMCs), partly driven by efforts to comply with resident duty hour restrictions. Hospitalists have emerged as a solution to providing these services given their commitment to delivering efficient and high-quality care and the field's rapi...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.311
更新日期:2008-05-01 00:00:00
abstract:BACKGROUND:Approximately 83% of hospitalist groups around the country utilize advanced practice providers; however, the demand for hospitalists continues to exceed the supply, and this has led to increased utilization of advanced practice providers in hospital medicine. Advanced practice providers receive very limited ...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.3183
更新日期:2019-06-01 00:00:00
abstract:OBJECTIVE:There is growing demand for safe and effective procedural sedation in pediatric facilities nationally. Currently, these needs are being met by a variety of providers and sedation techniques, including anesthesiologists, pediatric intensivists, emergency medicine physicians, and pediatric hospitalists. There i...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.979
更新日期:2012-04-01 00:00:00
abstract:BACKGROUND:Care coordination is critical in settings characterized by high levels of uncertainty, time constraints, and interdependent work processes. The effects of provider characteristics on coordination in comanaged teams has never been examined. OBJECTIVE:To characterize individual providers based on their contri...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.797
更新日期:2010-11-01 00:00:00
abstract:BACKGROUND:High-flow nasal cannula (HFNC) is increasingly used to treat children hospitalized with bronchiolitis; however, the best practices for feeding during HFNC and the impact of feeding on time to discharge and adverse events are unknown. The study objective was to assess whether feeding exposure during HFNC was ...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.3306
更新日期:2019-09-18 00:00:00