Pulmonary Risk Assessment and Optimization
Publication date: Available online 12 February 2016 Source:Hospital Medicine Clinics Author(s): Kurt J. Pfeifer, Gerald W. SmetanaTeaser Postoperative pulmonary complications (PPCs), such as pneumonia and respiratory failure, are common and are associated with increased mortality. Several patient-specific and procedure-specific risk factors for PPCs have been elucidated and allow identification of patients who may benefit from risk reduction interventions. Pulmonary risk may be mitigated using several strategies, including lung-protective ventilation, regional or neuraxial anesthesia, smoking cessation, and lung ex...
Source: Hospital Medicine Clinics - February 13, 2016 Category: Internal Medicine Source Type: research
Patient Experience
Publication date: January 2016 Source:Hospital Medicine Clinics, Volume 5, Issue 1 Author(s): Patrick P. KneelandTeaser Patient experience is an important element of high-value care. As such, health care stakeholders, including patients, payers, policy makers, and providers, are increasingly striving to optimize the way patients experience care. Hospitalists affect patient experience both directly (communication with patients) and indirectly (contribution to care-team cohesiveness and care improvement efforts). Having an understanding of patient experience in the context of high-value care and developing specific pat...
Source: Hospital Medicine Clinics - November 18, 2015 Category: Internal Medicine Source Type: research
Procedural Skills for Hospitalists
This article summarizes 4 bedside procedures that are commonly encountered by hospitalists: abdominal paracentesis, thoracentesis, lumbar puncture, and arthrocentesis. The article discusses the indications, contraindications, complications, ways to minimize complications, procedure technique, use of ultrasonography, and guidelines for billing. It serves as a general guide and quick reference for hospitalists performing any of these 4 bedside procedures. (Source: Hospital Medicine Clinics)
Source: Hospital Medicine Clinics - November 18, 2015 Category: Internal Medicine Source Type: research
Palliative Sedation Therapy
This article reviews the differences between, and the ethics involving, palliative sedation therapy, physician-assisted death, and euthanasia, as well as how to approach the procedure of palliative sedation therapy. (Source: Hospital Medicine Clinics)
Source: Hospital Medicine Clinics - November 18, 2015 Category: Internal Medicine Source Type: research
Chemotherapy Basics for Hospitalists
Publication date: January 2016 Source:Hospital Medicine Clinics, Volume 5, Issue 1 Author(s): Likheng Ngov, Dimitriy LevinTeaser Cancer is the second most common cause of death after heart disease in the United States and it is projected to be the leading cause of death by 2030. The American Society of Clinical Oncology anticipates a shortage of oncology providers in the near future. Hospitalists are increasingly likely to care for patients with cancer receiving treatment and therefore they need to be familiar with common cancer-directed therapies and their adverse effects. (Source: Hospital Medicine Clinics)
Source: Hospital Medicine Clinics - November 18, 2015 Category: Internal Medicine Source Type: research
Regional Anesthesia
Publication date: January 2016 Source:Hospital Medicine Clinics, Volume 5, Issue 1 Author(s): Chad M. Craig, Jemiel NejimTeaser An understanding of regional anesthesia techniques, benefits, and potential complications is an important component of perioperative care. Hospital-based physicians play a vital role in the treatment of such patients, and there is a clear need to be familiar with regional anesthetic modalities. Here, we present an outline of key concepts and evidence relating to the use of regional anesthesia, with an emphasis on the potential benefits of regional anesthesia over general anesthesia, and re...
Source: Hospital Medicine Clinics - November 18, 2015 Category: Internal Medicine Source Type: research
Fecal Microbiota Transplant
This article discusses the history, evolution, pathophysiology, preparation, and delivery of fecal microbiota transplant. Also included is a summary of the evidence evaluating its use in the management of several diseases, primarily Clostridium difficile–associated diarrhea and inflammatory bowel disease, and its associated adverse effects. (Source: Hospital Medicine Clinics)
Source: Hospital Medicine Clinics - November 18, 2015 Category: Internal Medicine Source Type: research
Nephrolithiasis
Publication date: January 2016 Source:Hospital Medicine Clinics, Volume 5, Issue 1 Author(s): Anunta VirapongseTeaser Nephrolithiasis is a common disease that affects 8.8% of people in the United States, with associated costs of more than $5 billion each year. In this review article, the new and primary literature on the initial workup and management of these patients is summarized. The role of hospitalists in the management of these patients is also discussed. (Source: Hospital Medicine Clinics)
Source: Hospital Medicine Clinics - November 18, 2015 Category: Internal Medicine Source Type: research
Isolation Precautions in the Inpatient Setting
This article provides an overview of the use of standard and isolation precautions in the hospital setting, including droplet, airborne, and contact precautions. The article includes the indications for use, guidance for appropriate discontinuation of precautions, and the effect of precaution use on infection control measures, patient safety and experience, health care costs, and environmental outcomes. (Source: Hospital Medicine Clinics)
Source: Hospital Medicine Clinics - November 18, 2015 Category: Internal Medicine Source Type: research
Vascular Access in Hospitalized Patients
Publication date: January 2016 Source:Hospital Medicine Clinics, Volume 5, Issue 1 Author(s): Megan Faga, Brian WolfeTeaser Nearly every patient admitted to the hospital requires vascular access in order to manage fluid status, obtain diagnostic information, or administer therapeutic agents. Different types of vascular access devices exist to meet different indications, ranging from small peripherally placed intravenous catheters to surgically implanted subcutaneous ports. Although necessary, these devices place patients at increased risk for complications, notably infection, thrombosis, and bleeding. Therefore, it...
Source: Hospital Medicine Clinics - November 18, 2015 Category: Internal Medicine Source Type: research
A Hospital Away from Home
Publication date: January 2016 Source:Hospital Medicine Clinics, Volume 5, Issue 1 Author(s): Mary E. Anderson, Jeffrey J. Glasheen (Source: Hospital Medicine Clinics)
Source: Hospital Medicine Clinics - November 18, 2015 Category: Internal Medicine Source Type: research
Invasive Mechanical Ventilation
This article provides an overview of mechanical ventilation in adults, which is one of the Society of Hospital Medicine's common core bedside. The indications for mechanical ventilation and the procedure logistics including the different ventilator modes, the rationale for choosing a specific mode, and how to set the initial ventilator settings are discussed. The evidence for lung protective ventilation strategies, prone positioning, and weaning is reviewed. Approaches to common clinical scenarios are discussed including refractory hypoxemia, high pressure alarms, and auto – positive end-expiratory pressure. Finally, ven...
Source: Hospital Medicine Clinics - October 24, 2015 Category: Internal Medicine Source Type: research
Ethics of Physician Relationships with Industry
Publication date: October 2015 Source:Hospital Medicine Clinics, Volume 4, Issue 4 Author(s): Joseph L. Breault, Douglas Shenson, Lydia S. DugdaleTeaser Ethically sound actions in physician relationships with industry should be guided by professional standards, medical society guidelines, and local institutional policies. Even minor gifts can affect decision making. Income from industry (eg, gifts, research subsidies, consulting, speakers’ bureaus, advisory boards) and other nonfinancial relationships with industry should be disclosed. Providing cost-effective, high-quality care to patients without bias is crit...
Source: Hospital Medicine Clinics - September 28, 2015 Category: Internal Medicine Source Type: research
Emergency Department Evaluation and Management of Bradyarrhythmia
Publication date: Available online 17 July 2015 Source:Hospital Medicine Clinics Author(s): Vishal Demla, Anita RohraTeaser Bradycardia is defined as a heart rate that is approximately 2 standard deviations less than the mean of the population. Classically, in adults, bradycardia is defined as a heart rate less than 60 beats per minute. Bradycardia can be seen in healthy individuals and does not require evaluation or treatment in asymptomatic individuals, provided the rhythm emanates from the sinus node. Symptomatic patients often have nonspecific complaints, placing the burden on practitioners to determine whether...
Source: Hospital Medicine Clinics - July 18, 2015 Category: Internal Medicine Source Type: research
Lean Hospital(ist)s
Publication date: Available online 17 July 2015 Source:Hospital Medicine Clinics Author(s): Joseph Swartz, Deanna Davis, Mark GrabanTeaser Lean is an effective methodology for improving hospitalist processes, as shown by 9 ideas in practice that were successfully implemented, resulting in significant benefits. Hospitals and the hospitalists who choose to practice there have successfully identified, trialed, proved, and shared the ideas of geographic assignment and rounding, dashboards, work teams, hospitalist/hospital steering teams, pay-for-performance contracting, telemetry pack process improvements, nocturnist...
Source: Hospital Medicine Clinics - July 18, 2015 Category: Internal Medicine Source Type: research
