Archive for March 2016

Here’s Why This Is The Best Study On Readmissions To Date

  Love or hate readmission rates as an effective measure of institutional performance, the benchmark has become the coin of the realm for QI gurus, policy geeks, and stat crunchers.  As such, we see new journal releases every week--mostly data dives into large registries where the conclusions proffered are tentative at best.  Clinicians rarely get studies comprised of patient-level information whose findings may impact how to better organize their PI interventions and direct care.  That just changed (see excerpted table at bottom). Andrew Auerbach, MD MPH and colleagues just published, Preventability and Causes of Readmissions in a National Cohort of General Medicine Patients in JAMA IM, and the results merit a deeper look.  Andy was kind enough to answer some questions regarding his group's important paper for the blog. Q:  Andy, first off, you and your collaborators should be congratulated on releasing the most exhaustive study on readmission root causes to date. For readers, can…

One of our own gets the star treatment. Big Time.

  As is custom nowadays, if you read a profile about any prominent public servant, you finish the article and feel a tad icky. Sometimes, however, the stars line up, and a story renews our faith in who is doing ours, the people's business in DC. In this case, it's one of our own. Most of you know Patrick Conway, the chief medical officer at CMS--one of his many roles there--as a hospitalist and frequent speaker at SHM. He also happens to be a humble, soft-spoken and delightful guy. He sees patients, still, and also has the gift of observation and the power to listen to folks, a rare offerings nowadays. In my neck of the woods, we call that a mensch. (more…)

The Tale of The Black Knight: ABIM a Year in Review

I passed! Let me tell you I was nervous. Perhaps it isn’t the smartest thing in the world to announce publically on your blog  that you are up for recertification and preparing to sit for the secure examination. It was only after I did this that it occurred to me that it could be rather embarrassing if I didn’t pass. And then of course I outed my fellow blogger, Brad Flansbaum, as also sitting for the Focused Practice in Hospital Medicine exam. Luckily, we both passed, as did 85% of test-takers, so neither he nor I have to endure the pity of the readers. As I reflect on the tumultuous year past, not just in my own life, scrambling to fulfill the requirements of MOC and hours upon hours studying, but also in the very public spectacle of the ABIM and Rich Baron, the public face of the organization, taking blow…

Perioperative Care: Top of Mind & Topic for #Periop #JHMChat on April 4th

With great successes in hosting our first couple of Twitter chats over the last six months, we’re excited to bring you the third in our quarterly series, #JHMChat, where you ask Journal of Hospital Medicine (JHM) authors about their research and corresponding clinical implications for managing inpatient care. We invite you to join us for the next #JHMChat on Monday, April 4th at 9pm EDT, when we will discuss Dr. Kurt Pfeifer et al.’s article from JHM, “Updates in perioperative medicine”, which you can read here. Perioperative care is a critical skillset for today’s hospitalists. The article authored by Dr. Pfeifer and colleagues highlights key clinical pearls from recent research on best practices in perioperative medicine. As the patient population ages and cases become more medically complex, hospitalists are key providers in ensuring safe, quality care for patients before, during and after surgery. In keeping with our theme of promoting…

Not So Involuntary: Hospitalists and Psych Holds

by Dr. Atashi Mandal
by Dr. Atashi Mandal MD He sat on the gurney, with averted eyes and contorted posture, as to avoid my encroaching examination. The usual jargon populated my assessment: psychomotor retardation, flat affect, poor vocalization… I glanced at his intake form and noted that he had been admitted to the emergency treatment unit for suicidal ideation, removed from a family with a history of incarceration, drug use and neglect. At my coaxing to face forward, I glimpsed at the tapestry of well healed linear scars from previous cutting attempts. I now needed to medically clear him so that he could receive his next placement in the “most appropriate setting”.  But I wondered if checking off boxes and signing a form was the most I could do for him. Sadly, as hospitalists, this scenario is one most, if not all, of us have encountered. We have also grown accustomed to separating medical…
Dr. Atashi Mandal is a practicing adult and pediatric hospitalist in Los Angeles and Orange County areas. She is also a member of SHM’s Public Policy Committee.