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 patients, while being comanaged by hospitalists DESIGN: Retrospective cohort study SETTING: Tertiary care hospital in Connecticut PATIENTS: 491 patients aged 50 years and older who underwent surgery for an isolated fragility hip fracture, defined as one occurring from a fall of a height of standing or less. INTERVENTION:Presence or absence of a preoperative specialty consult MEASUREMENTS: Time to surgery (TTS), length of hospital stay (LOS), and postoperative complications RESULTS: 177 patients had a preoperative specialty consult. Patients with consults were older and had more comorbidities. Most consult recommendations were minor (72.8%); there was a major recommendation only for eight patients (4.5%). Multivariate analysis demonstrates that consults are more likely to be associated with a TTS beyond 24 hours (Odds Ratio [OR] 4.28 [2.79-6.56]) and 48 hours (OR 2.59 [1.52-4.43]), an extended LOS (OR 2.67 [1.78-4.03]), and a higher 30-day readmission rate (OR 2.11 [1.09-4.08]). A similar 30-day mortality rate was noted in both consult and no-consult groups. CONCLUSIONS:The majority of preoperative specialty consults did not meaningfully influence management and may have potentially increased morbidity by delaying surgery. Our data suggest that unless a hip fracture patient is unstable and likely to require active management by a consultant, such consults offer limited benefit when weighed against the negative impact of surgical delay.
journal_name
J Hosp Medjournal_title
Journal of hospital medicineauthors
Bellas N,Stohler S,Staff I,Majk K,Lewis C,Davis S,Kumar Mdoi
10.12788/jhm.3264subject
Has Abstractpub_date
2020-01-01 00:00:00pages
16-21issue
1eissn
1553-5592issn
1553-5606pii
jhm.3264journal_volume
15pub_type
杂志文章abstract:OBJECTIVES:This study aimed to describe variation in imaging practices and examine the association between early imaging and outcomes in children hospitalized with cervical lymphadenitis. METHODS:This multicenter cross-sectional study included children between two months and 18 years hospitalized with cervical lymphad...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.3333
更新日期:2020-04-01 00:00:00
abstract::Physiotherapy delivered in a group setting has been shown to be effective in a variety of populations. However, little is known about the attitudes of older adults toward participating in group physiotherapy. The objectives of this study were to explore older inpatients' perceptions and experiences of group physiother...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,随机对照试验
doi:10.1002/jhm.2550
更新日期:2016-05-01 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:Initiation of enteral feeding is an important part of the best practice model for critically ill patients. Although nasogastric feeding is appropriate for the majority of patients requiring short-term nutrition support, certain patients benefit greatly from postpyloric feeding. OBJECTIVE:To determine which ...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2122
更新日期:2014-01-01 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: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:Dexmedetomidine is a potentially useful sedative for hospitalized children, but there is little published data regarding its safety, dosage, or efficacy. OBJECTIVE:To report our experience with dexmedetomidine for the sedation of hospitalized children. DESIGN:Retrospective case series. SETTING:Pediatric I...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.282
更新日期:2008-03-01 00:00:00
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: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:: ...
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: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::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:OBJECTIVE:There have been no recent studies describing the management and outcomes of patients with infective endocarditis (IE). PATIENTS AND METHODS:We conducted a retrospective cohort study of adult patients admitted to a tertiary medical center from 2007 to 2011 with a Duke criteria consistent discharge diagnosis o...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.2746
更新日期:2017-06-01 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::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::Acute decompensated heart failure (ADHF) is one of the most common conditions managed by hospitalists. Here we review the most recent evidence applicable to hospitalists for the diagnosis, risk stratification, and management of patients presenting with ADHF. By following a structured approach based on the patient's sy...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,评审
doi:10.1002/jhm.1919
更新日期:2012-05-01 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: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: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: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: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: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: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::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:OBJECTIVE:To examine the relationship between pediatric obesity and inpatient length of stay (LOS), resource utilization, readmission rates, and total billed charges for in-hospital status asthmaticus. DESIGN/METHODS:We conducted a cross-sectional study of patients 5 to 17 years old hospitalized with status asthmaticu...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2296
更新日期:2015-03-01 00:00:00
abstract::As the field of hospital medicine expands, internal medicine residency programs can play a role in preparing future hospitalists. To date, little is known of the prevalence and characteristics of hospitalist-focused resident rotations. We surveyed the largest 100 Internal Medicine Residency Programs to better understa...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.2952
更新日期:2018-09-01 00:00:00
abstract:BACKGROUND:Patient whiteboards can serve as a communication tool between hospital providers and as a mechanism to engage patients in their care, but little is known about their current use or best practices. METHODS:We surveyed bedside nurses, internal medicine housestaff, and hospitalists from the medical service at ...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.638
更新日期:2010-04-01 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:OBJECTIVE:We examined the impact of an aspart insulin protocol for treatment of hyperglycemia in the emergency department (ED) coupled with rapid initiation of a detemir-aspart insulin protocol for patients admitted to the hospital. RESEARCH DESIGN AND METHODS:ED patients with type 2 diabetes mellitus and a blood gluc...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,随机对照试验
doi:10.1002/jhm.866
更新日期:2011-05-01 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