Abstract:
OBJECTIVE:To determine the range and frequency of experiences, clinical and nonclinical roles, training, work expectations, and career plans of practicing pediatric hospitalists. DESIGN:Mail survey study of a national sample of 530 pediatric hospitalists of whom 67% (N = 338) were from teaching hospitals, 71% (N = 374) were from children's hospitals, 43% (N = 230) were from freestanding children's hospitals, and 69% (N = 354) were from hospitals with >or=250 beds. RESULTS:The response rate was 84%. The majority (54%; N = 211) had been practicing as hospitalists for at least 3 years. Most reported that the pediatric inpatient unit (94%) and inpatient consultation service (51%) were a part of their regular clinical assignment. Most did not provide service in the normal newborn nursery (58%), subspecialty inpatient service (52%), transports (85%), outpatient clinics (66%), or as part of an emergency response team (53%). Many participated in quality improvement (QI) initiatives (84%) and practice guideline development (81%). CONCLUSIONS:This study provides the most comprehensive information available regarding the clinical and nonclinical roles, training, work expectations, and career plans of pediatric hospitalists. However, the field is currently a moving target; there is significant flux in the hospitalist workforce and variation in the roles of these professionals in their clinical and nonclinical work environment.
journal_name
J Hosp Medjournal_title
Journal of hospital medicineauthors
Freed GL,Dunham KM,Research Advisory Committee of the American Board of Pediatrics.doi
10.1002/jhm.458subject
Has Abstractpub_date
2009-03-01 00:00:00pages
179-86issue
3eissn
1553-5592issn
1553-5606journal_volume
4pub_type
杂志文章abstract:BACKGROUND:The affordability of prescription medications continues to be a major public health issue in the United States. Estimates of cost-related medication underuse come largely from surveys of ambulatory patients. Hospitalized patients may be vulnerable to cost-related underuse and its consequences, but have been ...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.948
更新日期:2012-02-01 00:00:00
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:Obtaining blood cultures (BCs) for patients hospitalized with community-acquired-pneumonia (CAP) has been recommended by experts and used as a measure of quality of care. However, BCs are infrequently positive in these patients and their effect on clinical management has been questioned. PURPOSE:We performe...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,评审
doi:10.1002/jhm.382
更新日期:2009-02-01 00:00:00
abstract:BACKGROUND:Experts and national regulatory bodies have deemed femoral vein catheterization (FVC) unsafe, and recommend avoiding it whenever possible. OBJECTIVE:To assess rates of catheter-related bloodstream infections (CRBI) and deep venous thrombosis (DVT) complicating FVC. DESIGN:Prospective observational cohort s...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.696
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:Attending rounds at academic medical centers are often disconnected from patients and team members who are not physicians. Regionalization of care teams may facilitate bedside rounding and more frequent interactions among doctors, nurses, and patients. OBJECTIVE:We used time-motion analysis to investigate h...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.2696
更新日期:2017-03-01 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:OBJECTIVES:Guidelines recommend pharmacologic prophylaxis for hospitalized medical patients at increased risk of thromboembolism. Despite recommendations, multiple studies demonstrate underutilization. Factors contributing to underutilization include uncertainty that prophylaxis reduces clinically relevant events, as w...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,meta分析
doi:10.1002/jhm.450
更新日期:2009-05-01 00:00:00
abstract:BACKGROUND:Warfarin reduces stroke in patients with atrial fibrillation. However, its narrow therapeutic index and need for chronic monitoring are barriers to its optimal utilization in many patients. The recent introduction of 3 novel oral anticoagulants (NOACs), as alternatives to warfarin, may change the eligibility...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,评审
doi:10.1002/jhm.2201
更新日期:2014-06-01 00:00:00
abstract:BACKGROUND:The "July phenomenon" refers to a purported worsening of outcomes in teaching-hospital patients with the arrival of new, inexperienced house-staff. Previous quantitative studies of new house-staff and increased mortality have been limited primarily by a focused patient population and the use of limited data ...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.917
更新日期:2011-09-01 00:00:00
abstract::Registry data indicate a gap between evidence-based guidelines and current management of patients with acute decompensated heart failure (ADHF). Bridging this gap is crucial given the frequency and cost of hospitalization for this disorder. Patients with ADHF require rapid assessment to determine appropriate treatment...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,评审
doi:10.1002/jhm.395
更新日期:2008-11-01 00:00:00
abstract::We examined whether placing a painting in the line of vision of a hospitalized patient improves patient outcomes and satisfaction and whether having patients choose their paintings offers greater benefit. From 2014 to 2016, we enrolled 186 inpatients with cancer diagnoses from Pennsylvania State University Cancer Inst...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,随机对照试验
doi:10.12788/jhm.2915
更新日期:2018-08-01 00:00:00
abstract::Esophageal variceal bleeding (EVB) is a frequent complication in cirrhotic patients resulting in considerable mortality and morbidity. The aim of this study was to investigate the occurrence, impact, and trends of EVB in hospitalized cirrhotic patients on a nationwide level in the United States. We interrogated data f...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2360
更新日期:2015-07-01 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:Hospital care on weekends has been associated with reduced quality and poor clinical outcomes, suggesting that decreases in overall intensity of care may have important clinical effects. We describe a new measure of hospital intensity of care based on utilization of the electronic health record (EHR). METHO...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2068
更新日期:2013-09-01 00:00:00
abstract:OBJECTIVE:To develop a valid instrument to assess morale and explore the relationship between morale and intent to leave employment due to unhappiness. PATIENTS AND METHODS:An expert panel identified 46 drivers of hospitalist morale. In May 2009, responders of our single-site pilot survey rated each driver in terms of...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,评审
doi:10.1002/jhm.2543
更新日期:2016-06-01 00:00:00
abstract:BACKGROUND:Communication between clinicians is hampered by the frequent difficulty in reaching the most responsible physician for a patient as well as the use of outdated methods such as numeric paging. The aim of this study was to evaluate the use of smartphones to improve communication on internal medicine wards. ME...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.775
更新日期:2010-11-01 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::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:Cognitive errors in the course of clinical decision-making are prevalent in many cases of medical injury. We used information on verdict's judgment from closed claims files to determine the important cognitive factors associated with cases of medical injury. METHODS:Data were collected from claims closed be...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.820
更新日期:2011-03-01 00:00:00
abstract::Hyponatremia is relatively common in patients admitted with pneumonia, and it is associated with higher disease severity. The precise mechanism is incompletely understood, but the syndrome of inappropriate antidiuretic hormone secretion is felt to play a significant role. Traditional options to manage hyponatremia in ...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,评审
doi:10.1002/jhm.1933
更新日期:2012-04-01 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:OBJECTIVE:To examine the association of health literacy with the number and type of transitional care needs (TCN) among patients being discharged to home. DESIGN, SETTING, PARTICIPANTS:A cross-sectional analysis of patients admitted to an academic medical center. MEASUREMENTS:Nurses administered the Brief Health Lite...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.2841
更新日期:2017-11-01 00:00:00
abstract::Patients who deteriorate outside the intensive care unit (ICU) are known to have elevated mortality and morbidity. Rapid response teams (RRTs) were developed to address such deterioration. It has not been possible to establish that RRTs employing manual detection methods have definitively improved hospital outcomes. B...
journal_title:Journal of hospital medicine
pub_type:
doi:10.1002/jhm.2653
更新日期:2016-11-01 00:00:00
abstract:BACKGROUND:Asymptomatic blood pressure elevation is common in the inpatient setting. National guidelines recommend treating with oral agents to slowly decrease blood pressure; however, many clinicians use intravenous antihypertensive medications, which can lead to unpredictable changes in blood pressure. OBJECTIVE:To ...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.3190
更新日期:2019-03-01 00:00:00
abstract:BACKGROUND:Increased recognition of ionizing radiation risks has placed an emphasis on the appropriate use of myocardial perfusion imaging (MPI). Hospitalists frequently order MPI in the evaluation of chest pain and are thus at the forefront of its inpatient utilization. METHODS:We collected baseline figures for a gro...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2288
更新日期:2015-03-01 00:00:00
abstract:BACKGROUND:Angiotensin-converting enzyme inhibitors (ACE-Is) are a widely used class of cardiovascular medication. However, limited data exist on the risks of postoperative nonresumption of an ACE-I. OBJECTIVE:To evaluate the factors and 30-day mortality risks associated with the postoperative nonresumption of an ACE-...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2182
更新日期:2014-05-01 00:00:00
abstract:BACKGROUND:Hip fractures typically occur in frail elderly patients. Preoperative specialty consults, in addition to hospitalist comanagement, are often requested for preoperative risk assessment. OBJECTIVE:Determine if preoperative specialty consults meaningfully influence management and outcomes in hip fracture patie...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.3264
更新日期:2020-01-01 00:00:00
abstract::For more than 20 years, the Agency for Healthcare Research and Quality (AHRQ) Evidence-based Practice Center (EPC) Program has been identifying and synthesizing evidence to inform evidence-based healthcare. Recognizing that many healthcare settings continue to face challenges in disseminating and implementing evidence...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.3157
更新日期:2019-05-01 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:BACKGROUND:More than half of the hospitalized older adults discharged to skilled nursing facilities (SNFs) have more than 3 geriatric syndromes. Pharmacotherapy may be contributing to geriatric syndromes in this population. OBJECTIVES:Develop a list of medications associated with geriatric syndromes and describe their...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2614
更新日期:2016-10-01 00:00:00