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 into practice, AHRQ's EPC program has also embarked on initiatives to facilitate the translation of evidence into practice and to measure and monitor how practice changes impact health outcomes. The program has structured its efforts around the three phases of the Learning Healthcare System cycle: knowledge, practice, and data. Here, we use a topic relevant to the field of hospital medicine-Clostridium difficile colitis prevention and treatment-as an exemplar of how the EPC program has used this framework to move evidence into practice and develop systems to facilitate continuous learning in healthcare systems.
journal_name
J Hosp Medjournal_title
Journal of hospital medicineauthors
Borsky AE,Flores EJ,Berliner E,Chang C,Umscheid CA,Chang SMdoi
10.12788/jhm.3157subject
Has Abstractpub_date
2019-05-01 00:00:00pages
311-314issue
5eissn
1553-5592issn
1553-5606pii
jhm.3157journal_volume
14pub_type
杂志文章abstract:BACKGROUND:Hospital leaders have had mixed success reducing readmissions Little is known about the readmitted patient's perspective. METHODS:A cross-sectional 36-item survey was administered to 1084 readmitted inpatients of The Hospital of the University of Pennsylvania (an urban academic medical center) and Penn Pres...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.1966
更新日期:2012-11-01 00:00:00
abstract::Over the past 10 years, postdischarge clinics have been introduced in response to various health system pressures, including the focus on rehospitalizations and the challenges of primary care access. Often ignored in the discussion are questions of the effect of postdischarge physician visits on readmissions. In addit...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,评审
doi:10.12788/jhm.2750
更新日期:2017-06-01 00:00:00
abstract::Value-based payment systems have been widely implemented in healthcare in an effort to improve the quality of care. However, these programs have not broadly improved quality, and some evidence suggests that they may increase inequities in care. No Child Left Behind is a parallel effort in education to address uneven a...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2483
更新日期:2016-01-01 00:00:00
abstract::Improving early discharges may improve patient flow and increase hospital capacity. We conducted a national survey of academic medical centers addressing the prevalence, importance, and effectiveness of early-discharge initiatives. We assembled a list of hospitalist and general internal medicine leaders at 115 US-base...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.2885
更新日期:2018-06-01 00:00:00
abstract:BACKGROUND:Patient safety indicators (PSI) were developed for hospitals to screen for healthcare-associated adverse events. PSIs are believed to be preventable and have become a part of major pay-for-performance programs. PSI-12 captures perioperative venous thromboembolism (VTE), which contributes to morbidity and mor...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.3298
更新日期:2019-11-20 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::Many hospitalists are routinely granted hospital privileges to perform invasive bedside procedures, but criteria for privileging are not well described. We conducted a survey of 21 hospitalist procedure experts from the Society of Hospital Medicine Point-of-Care Ultrasound Task Force to better understand current privi...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.2837
更新日期:2017-10-01 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::Clozapine was approved by the US Food and Drug Administration in 1989 for the management of treatment-resistant schizophrenia, and has since proven to reduce symptom burden and suicide risk, increase quality of life, and reduce substance use in individuals with psychotic disorders. Nevertheless, clozapine's psychiatri...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,评审
doi:10.1002/jhm.2345
更新日期:2015-08-01 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: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: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: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::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
abstract::Many children's hospitals are actively working to reduce readmissions to improve care and avoid financial penalties. We sought to determine if pediatric readmission rates have changed over time. We used data from 66 hospitals in the Inpatient Essentials Database including index hospitalizations from January, 2010 thro...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.3210
更新日期:2019-10-01 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: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::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: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: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 AND OBJECTIVE:Previous local quality improvement focused on discharging patients with inhaled corticosteroids (ICS) "in-hand" decreased healthcare reutilization after hospitalization for an asthma exacerbation. However, as a result of these new processes, some patients admitted for an asthma exacerbation rec...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.3275
更新日期:2020-01-01 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: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: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: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: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::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::The growth of hospital medicine has led to new challenges, and recent graduates may feel unprepared to meet the expanding clinical duties expected of hospitalists. At our institution, we created a resident-inspired hospitalist curriculum to address the training needs for the next generation of hospitalists. Our progra...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2590
更新日期:2016-09-01 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