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 current contentment and importance to their morale. With exploratory factor analysis, a 28-item/7-factor instrument emerged. In May 2011, the refined scale was distributed to 108 hospitalists from 2 academic and 3 community hospitals. Confirmatory factor analysis (CFA) was used for internal validation and refinement of the Hospitalist Morale Index. Importance ratings and contentment assessments were used to generate item scores, which were then combined to generate factor scores and personal morale scores. Results were used to validate the instrument and evaluate the relationship between hospitalist morale and intent to leave due to unhappiness. RESULTS:The 2011 response rate was 86%. The final CFA resulted in a 5-factor and 5-stand-alone-item model. Personal morale scores were normally distributed (mean = 2.79, standard deviation = 0.58). For every categorical increase on a global question that assessed overall morale, personal morale scores rose 0.23 points (P < 0.001). Each 1-point increase in personal morale score was associated with an 85% decrease (odds ratio: 0.15, 95% confidence interval: 0.05-0.41, P < 0.001) in the odds of intending to leave because of unhappiness. CONCLUSION:The Hospitalist Morale Index is a validated instrument that evaluates hospitalist morale across multiple dimensions of morale. The Hospitalist Morale Index may help program leaders monitor morale and develop customized and effective retention strategies. Journal of Hospital Medicine 2016;11:425-431. © 2016 Society of Hospital Medicine.
journal_name
J Hosp Medjournal_title
Journal of hospital medicineauthors
Chandra S,Wright SM,Ghazarian S,Kargul GM,Howell EEdoi
10.1002/jhm.2543subject
Has Abstractpub_date
2016-06-01 00:00:00pages
425-31issue
6eissn
1553-5592issn
1553-5606journal_volume
11pub_type
杂志文章,评审abstract::Only 1 of 8 stroke patients is managed exclusively by a neurologist. Furthermore, many stroke patients harbor other vascular comorbidities and are also at risk for developing general medical complications that can lead to death following stroke. With the growing hospitalist system, it is quite clear that hospitalists ...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,评审
doi:10.1002/jhm.147
更新日期:2007-01-01 00:00:00
abstract:: ...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.3114
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:Serum folate levels are commonly ordered for multiple indications in the inpatient and emergency department settings. Since mandatory folic acid fortification in 1998, there has been a decreasing prevalence of folate deficiency in the United States. OBJECTIVE:Our objective was to determine the indications, ...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,随机对照试验
doi:10.1002/jhm.1994
更新日期:2013-02-01 00:00:00
abstract:BACKGROUND:Obese patients are thought to be at higher risk of postoperative medical complications. We determined whether body mass index (BMI) is associated with postoperative in-hospital noncardiac complications following urgent hip fracture repair. METHODS:We conducted a population-based study of Olmsted County, Min...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.527
更新日期:2009-10-01 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:Nearly two-thirds of hospitals in the United States are served by hospitalist physicians. How hospitalist work patterns and job satisfaction vary across various practice models is unknown. METHODS:We administered the Hospitalist Worklife Survey to a randomized stratified sample of 3105 potential hospitalist...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1002/jhm.1907
更新日期:2012-05-01 00:00:00
abstract:BACKGROUND:Predicting death risk in patients with diverse conditions is difficult. The Hospitalized-patient One-year Mortality Risk (HOMR) score accurately determines death risk in adults admitted to hospital using health administrative data unavailable to clinicians and most researchers. OBJECTIVE:Determine if HOMR i...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.2713
更新日期:2017-04-01 00:00:00
abstract:BACKGROUND:Interhospital transfer is an understudied area within transitions of care. The process by which hospitals accept and transfer patients is not well described. National trends and best practices are unclear. OBJECTIVE:To describe the demographics of large transfer centers, to identify common handoff practices...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2577
更新日期:2016-06-01 00:00:00
abstract:BACKGROUND:Computerized clinical knowledge mana-gement systems hold enormous potential for improving quality and efficiency. However, their impact on clinical practice is not well known. OBJECTIVE:To examine the impact of UpToDate on outcomes of care. DESIGN:Retrospective study. SETTING:National sample of US inpatie...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.944
更新日期:2012-02-01 00:00:00
abstract:BACKGROUND:A small proportion of patients accounts for a large proportion of hospitalizations. OBJECTIVE:To obtain patients' perspectives of factors associated with the onset and continuation of high hospital use. DESIGN:Qualitative research study where a research coordinator conducted one-on-one semi-structured inte...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.3175
更新日期:2019-03-20 00:00:00
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:A lack of cost-conscious medication use is a major contributor to excessive healthcare expenditures in the inpatient setting. Expensive medicines are often utilized when there are comparable alternatives available at a lower cost. Increasing prescriber awareness of medication cost at the time of ordering may...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.2779
更新日期:2017-08-01 00:00:00
abstract:BACKGROUND:Multidisciplinary rounds (MDR) facilitate timely communication amongst the care team and with patients. We used Lean techniques to redesign MDR on the teaching general medicine service. OBJECTIVE:To examine if our Lean-based new model of MDR was associated with change in the primary outcome of length of sta...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.2908
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:Half of patients admitted to hospital for reasons unrelated to childbirth are age 65 years or older. Nonetheless, few hospital-based physicians have received training in geriatric medicine, and few geriatricians practice in the hospital. This paper describes the state of the science of hospital care for olde...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,评审
doi:10.1002/jhm.11
更新日期:2006-01-01 00:00:00
abstract::Successful secondary prevention of cardiovascular disease relies on medication therapy; thus, minimizing nonadherence is a focus for improving patient outcomes. Receipt of discharge medication counseling has been associated with improved drug knowledge and adherence. We evaluated the prevalence and predictors of postd...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2446
更新日期:2016-01-01 00:00:00
abstract::One emerging policy solution for deterring low-value care is to financially penalize physicians who prescribe it. However, physicians' willingness to support such policies may depend on whether they perceive that benefits accrue to patients or to insurers and hospitals. We surveyed physicians practicing hospital medic...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.2878
更新日期:2018-01-01 00:00:00
abstract::Physicians are notorious for poor hand hygiene (HH) compliance. We wondered if lower performance by physicians compared with other health professionals might reflect differences in the Hawthorne effect. We introduced covert HH observers to see if performance differences between physicians and nurses decreased and to g...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2632
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:The National Acute Medicine Programme (NAMP) was established to address the unsatisfactory management of acutely ill medical patients in Ireland. It aimed to improve quality of care and patient safety, streamline access to healthcare, and reduce cost through efficiency gains. METHOD:A model of care was deve...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2443
更新日期:2015-12-01 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:BACKGROUND:Sepsis, the most expensive cause of hospitalization in the United States, is associated with high morbidity and mortality. However, healthcare utilization patterns following sepsis are poorly understood. OBJECTIVE:To identify patient-level factors that contribute to postsepsis mortality and healthcare utili...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,多中心研究
doi:10.1002/jhm.2197
更新日期:2014-08-01 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
abstract:BACKGROUND:Emergency department (ED) ward admissions subsequently transferred to the intensive care unit (ICU) within 24 hours have higher mortality than direct ICU admissions. DESIGN, SETTING, PATIENTS:Describe risk factors for unplanned ICU transfer within 24 hours of ward arrival from the ED. METHODS:Evaluation of...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.1979
更新日期:2013-01-01 00:00:00
abstract::Outcomes for patients hospitalized on weekends are often worse for adults-the so-called "weekend effect." Less is known about the weekend effect for children. We examined 55,383 hospitalizations at a tertiary care children's hospital. We used logistic regression to examine the associations of weekend admission and wee...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2426
更新日期:2015-11-01 00:00:00
abstract:BACKGROUND:Hospital-acquired (HA) venous thromboembolism (VTE) is a common source of morbidity/mortality. Prophylactic measures are underutilized. Available risk assessment models/protocols are not prospectively validated. OBJECTIVES:Improve VTE prophylaxis, reduce HA VTE, and prospectively validate a VTE risk-assessm...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.562
更新日期:2010-01-01 00:00:00
abstract:OBJECTIVE:Mortality in hospitalized human immunodeficiency virus (HIV)-infected patients is not well described. We sought to characterize in-hospital deaths among HIV-infected patients in the antiretroviral (ART) era and identify factors associated with mortality. METHODS:We reviewed the medical records of hospitalize...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2409
更新日期:2015-09-01 00:00:00
abstract:BACKGROUND:Little is known about the state of research in academic hospital medicine (HM) despite the substantial growth of this specialty. METHODS:We used the Society of Hospital Medicine (SHM) membership database to identify research programs and their leadership. In addition, the members of the SHM Research Committ...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.3136
更新日期:2019-04-01 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::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:OBJECTIVE: DESIGN: SETTING: PATIENTS: MEASUREMENTS: RESULTS: CONCLUSIONS: ...
journal_title:Journal of hospital medicine
pub_type: 评论,信件
doi:10.12788/jhm.2992
更新日期:2018-11-01 00:00:00
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 ...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,评审
doi:10.1002/jhm.66
更新日期:2006-03-01 00:00:00