Abstract:
:The objective of this study was to measure internal medicine resident engagement with an electronic medical record-based dashboard providing feedback on their use of routine laboratory tests relative to service averages. From January 2016 to June 2016, residents were e-mailed a snapshot of their personalized dashboard, a link to the online dashboard, and text summarizing the resident and service utilization averages. We measured resident engagement using e-mail read-receipts and web-based tracking. We also conducted 3 hour-long focus groups with residents. Using grounded theory approach, the transcripts were analyzed for common themes focusing on barriers and facilitators of dashboard use. Among 80 residents, 74% opened the e-mail containing a link to the dashboard and 21% accessed the dashboard itself. We did not observe a statistically significant difference in routine laboratory ordering by dashboard use, although residents who opened the link to the dashboard ordered 0.26 fewer labs per doctor-patient-day than those who did not (95% confidence interval, -0.77 to 0.25;
journal_name
J Hosp Medjournal_title
Journal of hospital medicineauthors
Kurtzman G,Dine J,Epstein A,Gitelman Y,Leri D,Patel MS,Ryskina Kdoi
10.12788/jhm.2811subject
Has Abstractpub_date
2017-09-01 00:00:00pages
743-746issue
9eissn
1553-5592issn
1553-5606journal_volume
12pub_type
杂志文章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:BACKGROUND:In the hospitalized patient, nephrotoxin exposure is one potentially modifiable risk factor for acute kidney injury (AKI). Clinical decision support based on nephrotoxin ordering was developed at our hospital to assist inpatient providers with the prevention or mitigation of nephrotoxin-related AKI. The init...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.3196
更新日期:2019-08-01 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::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:BACKGROUND:Approaches of trainees to diagnosis in teaching hospitals are poorly understood. Identifying cognitive and system-based barriers and facilitators to diagnosis may improve diagnosis in these settings. METHODS:We conducted a focused ethnography of trainees at 2 academic medical centers to understand the barri...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.2966
更新日期:2018-10-01 00:00:00
abstract:BACKGROUND:Hospitalized patients with diabetes have experienced a disproportionate reduction in mortality over the past decade. OBJECTIVE:To examine whether this differential decrease affected all patients with diabetes, and to identify explanatory factors. DESIGN:Serial, cross-sectional observational study. SETTING...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2321
更新日期:2015-04-01 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:Hospitalized patients are frequently treated with opioids for pain control, and receipt of opioids at hospital discharge may increase the risk of future chronic opioid use. OBJECTIVE:To compare inpatient analgesic prescribing patterns and patients' perception of pain control in the United States and non-US ...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,多中心研究
doi:10.12788/jhm.3256
更新日期:2019-12-01 00:00:00
abstract:BACKGROUND:Increasing use of testing among hospitalized patients has resulted in an increase in radiologic incidental findings (IFs), which challenge the provision of high-value care in the hospital setting. OBJECTIVE:To understand impact of radiologic incidental findings on resource utilization in patients hospitaliz...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.2722
更新日期:2017-05-01 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: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: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: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:The recent intense attention to hospital readmissions and their implications for quality, safety, and reimbursement necessitates understanding specific subsets of readmitted patients. Frequently admitted patients, defined as patients who are admitted 5 or more times within 1 year, may have some distinguishin...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2375
更新日期:2015-09-01 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: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: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: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
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: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:BACKGROUND:Access to hand-carried ultrasound technology for noncardiologists has increased significantly, yet development and evaluation of training programs are limited. OBJECTIVE:We studied a focused program to teach hospitalists image acquisition of inferior vena cava (IVC) diameter and IVC collapsibility index wit...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2103
更新日期:2013-12-01 00:00:00
abstract::Physical examination (PE) is a core clinical competency, and the internal medicine clerkship is a premiere venue for students to develop PE skills. However, clinical rotations often lack opportunities for real-time instruction. We sought to measure the frequency, content, and factors affecting PE instruction during th...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.2972
更新日期:2018-06-01 00:00:00
abstract:BACKGROUND:Patients with low-risk chest pain are frequently readmitted for evaluation of recurrent chest pain. It is unknown whether stress testing during the first admission for chest pain is a cost-effective means of reducing readmissions. METHODS:Using a hospital administrative database, we conducted a retrospectiv...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2081
更新日期:2013-10-01 00:00:00
abstract:BACKGROUND:In the Medicare population, measures of relative severity of illness (SOI) for hospitalized patents have been used in prospective payment models. Similar measures for pediatric populations have not been fully developed. OBJECTIVE:To develop hospitalization resource intensity scores for kids (H-RISK) using p...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.2948
更新日期:2018-09-01 00:00:00
abstract:BACKGROUND: OBJECTIVE: DESIGN, SETTING, PATIENTS: INTERVENTION: MEASUREMENTS: CONCLUSIONS: ...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.3102
更新日期:2019-02-01 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:Recent studies in the outpatient setting have demonstrated high rates of opioid prescribing and overdose-related deaths. Prescribing practices in hospitalized patients are unexamined. OBJECTIVE:To investigate patterns and predictors of opioid utilization in nonsurgical admissions to US hospitals, variation ...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2102
更新日期:2014-02-01 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::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: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