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 how regionalization of medical teams and encouragement of bedside rounds affect participants on rounds and rounding time. DESIGN AND SETTING:We used pre-post analysis to study the effects of care redesign on teams' daily rounds on a general medicine service at an academic medical center. PARTICIPANTS:Four general medical teams were evaluated before the intervention and 5 teams afterward. INTERVENTIONS:General medical teams were regionalized to specific units, the admitting structure was changed to facilitate regionalization, and teams were encouraged to round bedside. MEASUREMENTS:Primary outcomes included proportion of time each team member was present on rounds and proportion of bedside rounding time. Secondary outcomes included round duration and non-patient time during rounds. RESULTS:Proportion of time the nurse was present on rounds increased from 24.1% to 67.8% (P ⟨ 0.001), and proportion of total bedside rounding time increased from 39.9% to 55.8% (P ⟨ 0.001). Mean total rounding time decreased from 3.0 hours to 2.4 hours (P = 0.01), despite a higher patient census. CONCLUSIONS:Creating regionalized care teams and encouraging interdisciplinary bedside rounds increased the proportion of bedside rounding time and the presence of nurses on rounds while decreasing total rounding time. Journal of Hospital Medicine 2017;12:150-156.
journal_name
J Hosp Medjournal_title
Journal of hospital medicineauthors
Huang KT,Minahan J,Brita-Rossi P,Aylward P,Katz JT,Roy C,Schnipper JL,Boxer Rdoi
10.12788/jhm.2696subject
Has Abstractpub_date
2017-03-01 00:00:00pages
150-156issue
3eissn
1553-5592issn
1553-5606journal_volume
12pub_type
杂志文章abstract:BACKGROUND:Little is known about management of hyperglycemia in inpatients. OBJECTIVE:To gain insight into caring for hospitalized patients with hyperglycemia. DESIGN:Retrospective analysis. SETTING:Teaching hospital. PATIENTS:Data on all patients discharged between January 1, 2001, and December 31, 2004 with a dia...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.188
更新日期:2007-07-01 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:OBJECTIVE:To explore why it is permissible for surgeons to "unilaterally withhold" surgery, whereas it is not commonplace (in the United States) to unilaterally withhold cardiopulmonary resuscitation (CPR) for clinical situations with similar degrees of uncertainty and prognosis. DATA SOURCES:The medical literature wa...
journal_title:Journal of hospital medicine
pub_type: 社论
doi:10.1002/jhm.986
更新日期:2012-03-01 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:Problems experienced after hospital discharge can result in rehospitalizations and unscheduled urgent and emergent care. OBJECTIVE:To identify opportunities for improving discharge processes by examining calls to an advice line (AL). DESIGN:Prospective cohort. SETTING:A 500-bed, university-affiliated hosp...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2252
更新日期:2014-11-01 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: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: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: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:No national policy requires health care providers to discuss with hospitalized patients whether the latter would want cardiopulmonary resuscitation (CPR) or mechanical ventilation (MV) in the event of cardiopulmonary failure. OBJECTIVE:To determine whether hospitalized patients are willing to discuss end-of...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,随机对照试验
doi:10.1002/jhm.78
更新日期:2006-05-01 00:00:00
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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:Superficial wound cultures are routinely used to guide therapy, despite a lack of clear supporting evidence. PURPOSE:To conduct a systematic review of the correlation between superficial wound cultures and the etiology of skin and soft tissue infections. DATA SOURCES:Medline, EMBASE, CINAHL, Scopus. STUDY...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,meta分析,评审
doi:10.1002/jhm.688
更新日期:2010-09-01 00:00:00
abstract::Posttraumatic stress disorder (PTSD) is common in the United States, with a prevalence of nearly 8% in the general population and between 10% and 30% in veterans. Despite how common PTSD is, inpatient providers may not be familiar with its manifestations or feel comfortable taking care of patients who may exhibit symp...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,评审
doi:10.12788/jhm.3409
更新日期:2021-01-01 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: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: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::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:Readmission to a different hospital than the original discharge hospital may result in breakdowns in continuity of care. In different-hospital readmissions (DHRs), continuity can be maintained when hospitals are connected through health information exchange (HIE) systems. OBJECTIVE:To examine whether length...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2535
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: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:BACKGROUND:Gender earnings disparities among physicians exist even after considering differences in specialty, part-time status, and practice type. Little is known about the role of job satisfaction priorities on earnings differences. OBJECTIVE:To examine gender differences in work characteristics and job satisfaction...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2400
更新日期:2015-08-01 00:00:00
abstract::Dysphagia is associated with aspiration, pneumonia, and malnutrition, but remains challenging to identify at the bedside. A variety of exam protocols and maneuvers are commonly used, but the efficacy of these maneuvers is highly variable. We conducted a comprehensive search of 7 databases, including MEDLINE, Embase, a...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,评审
doi:10.1002/jhm.2313
更新日期:2015-04-01 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: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
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journal_title:Journal of hospital medicine
pub_type: 杂志文章
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更新日期:2017-06-01 00:00:00
abstract:BACKGROUND:The economic burden of acute kidney injury (AKI) is not well understood. OBJECTIVE:To estimate the effects of AKI on hospitalization costs and length of stay (LOS). DESIGN:Using data from the 2012 National Inpatient Sample, we compared hospitalization costs and LOS with and without AKI. We used a generaliz...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.2683
更新日期:2017-02-01 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: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: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...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
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更新日期:2009-03-01 00:00:00
abstract::Women continue to be underrepresented as speakers at national conferences, and research has shown similar trends in hospital medicine. The Society of Hospital Medicine (SHM) Annual Meeting has historically had an open call peer review process for workshop speakers and, in 2019, expanded the process for didactic speake...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.3401
更新日期:2020-04-01 00:00:00