Posts by Vineet Arora

Next on #JHMChat: Ideas from Residents to Root Out Routine Labs

While the saying goes, “you can’t teach an old dog new tricks”, I think we all assume you can teach a new dog new tricks… or at least all of us in medical education believe this! However, new research in the Journal of Hospital Medicine highlights that maybe the old dog is the key to the puzzle after all. In the case of routine labs, a practice that has already been called into question by the Society of Hospital Medicine’s Choosing Wisely list, the majority of medicine and surgery residents at University of Pennsylvania admitted that they engaged in unnecessary ordering of inpatient labs, with over a third of them occurring on a daily basis! Why is this so hard to change? Not surprisingly, one of the key culprits was it was hard-to-break habit. However, several of the top reasons were also related to the “old dog”, also known as…

Time to #TurnTheTide: No Doctor Should Be Excited about Prescribing Opioids

As a resident, I still remember the day I was so excited that I could prescribe narcotics on my own. I had taken my USMLE part 3 and paid for my DEA number so that I could moonlight at a local community hospital. As an added bonus, I was no longer reliant on an attending to write narcotics scripts. While this may sound trivial, word spread through our residency like wildfire. That week, I got paged daily by an intern whose attending physician had left for the day, and they had patients to discharge on narcotics. After all, it was not uncommon to send patients home with narcotics because they were “having pain” and they needed pain medications to give them the edge they needed to stay out of the hospital. I did not think much of this until 5 years ago, I saw a patient “RC” acutely suffering from…

Taking CME to the Next Level on Twitter with #JHMChat

What comes to mind when you think of getting CME? I bet most of you would say sitting in an auditorium, whether that be during your local grand rounds or at our professional society meeting, like Hospital Medicine 16 in sunny San Diego this past March. Hanging out in the Twitterverse? Probably not so much… until now! On Monday, July 11th, the Journal of Hospital Medicine will be hosting its 3rd Tweetchat. For those new to Twitter or to “tweetchats”, it is a block of time (typically an hour) on Twitter during which tweeters use a hashtag to engage in a dialogue about an issue. #JHMChat uses its one hour to engage in a dialogue about a particular article in the Journal of Hospital Medicine. We often choose an article that has implications for Costs of Care or Choosing Wisely and most importantly, could be practice-changing for hospitalists. While we…

VISTA: The Future of Hospital Medicine Is in Healthcare Delivery Sciences

Eleven years ago, I remember being a junior faculty member attending the first “Quality Fair” at the University of Chicago, and presenting my work among roughly 20 posters on how to measure quality for hospitalized older patients. While I am proud to say this poster actually won an award, I am also embarrassed to say that I did not improve anything. That is perhaps where the state of the science was; we were still talking about how to measure quality and where the safety problems were as opposed to the science of actually improving it. Fast forward, this past week, I attended the 11th annual University of Chicago Medicine’s Quality and Safety Symposium. Over 120 posters were presented on a wide range of innovations, including how to improve patient transport times, predict the next heart attack in the community, as well as proactively screen patients before they develop hospital-acquired infections.…

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…