Posts by Vineet Arora

An Army of One No More: Hospitalists Choosing Wisely with Nurses

Oftentimes that can be how hospitalists feel as they “battle” to provide high-value care (better care at lower cost) for their patients. But it does not need to be this way; there is a whole world all around us – doctors, nurses, pharmacists, and social workers – that can help combat the problems of overuse, inefficiencies, and patient safety lapses. While hospitalists often spend somewhere between a few minutes and an hour total each day at a patient’s bedside, nurses are there all day long. They see everyday pragmatic opportunities to prevent low-value care through the daily labs, specimens and cultures, x-rays, medications, electrocardiograms, and so on that are ordered for patients. And since nurses spend the most time at the point-of-care, they are essential to professionally communicating and collaborating with the inter-professional team when changes in patients’ conditions or plans of care occur. So, how do you incorporate nurses…

Lessons from the Wizard of Oz: Giving Thanks to Interprofessional Team Members

Tonight I happened to catch a few minutes of the Wizard of Oz- a great classic and our daughter was in delight watching the munchkins dance and sing for Dorothy. It also reminded me of the importance of a great team—Dorothy needed the Scarecrow, the Tin Man, and the Cowardly Lion to get to her final destination. Likewise, it takes a great team (and less singing and dancing ability fortunately) to take care of a patient in the hospital. We all know this, but if so, why is it sometimes so hard to work together in a team? Well, one reason is that doctors have not received formal training in how to interact with the multitude of team members that they will come into contact with while taking care of patients. That is now changing. The Association of American Medical Colleges now states that graduating medical students must be prepared…

A Social Media Success! First #JHMChat by the Numbers

First, thank you to everyone who joined us on October 12th for our first Journal of Hospital Medicine (@JHospMedicine) Twitter chat, known in the Twitterverse as #JHMChat. I was joined on Twitter by Chris Moriates (@chrismoriates) author of a recently published Choosing Wisely: Things We Do for No Reason paper entitled, “Nebulized bronchodilators instead of metered-dose inhalers for obstructive pulmonary symptoms” and we and others asked Dr. Moriates questions about his research and the paper. Interestingly, Chris and I were tweeting from my living room in Chicago, and for a split second, we looked at each other at 8pm CST and had that last minute feeling that it was going to be just us…but boy, were we wrong! Tweeters came out in droves to ask questions, share stories, and also discuss ways to get more people on board with inhalers instead of nebulizers. If you happened to miss it, don’t…

Tackling Costs of Care on Twitter: Join the First #JHMChat on October 12th

On October 12th at 9 PM EST I will be hosting the first #JHMChat, a twitter chat dedicated to talking about the newest research coming out of the Journal of Hospital Medicine (@JHospMedicine), SHM’s journal of peer reviewed research. If you are unfamiliar with what a Twitter Chat is, you can read more about it here. For this first #JHMChat we will be discussing Dr. Chris Moriates’ recent Things We Do for No Reason article, “Nebulized bronchodilators instead of meter-dose inhalers for obstructive pulmonary symptoms.” Why should you, a busy hospitalist with lots of demands on your time, do this? Well, for starters, this is a great opportunity for you to learn, ask questions about the research and interact with the author! More importantly, unlike other types of events, there is no guilt associated with being on a Twitter chat. After all, Twitter is like a cocktail conversation that you…

Tackling the “Elephant in the Room”: Improving Hospital Sleep through Nudges

The other week, when looking at PBS NewsHour, amid the discussion of the amazing bravery of a few heroes thwarting a train attack in France and concerns of the volatility of the stock market, one headline read: “Why won't hospitals let their patients sleep?” This was one of many news outlets that picked up this story and it just spread on Twitter with many doctors and patients alike tweeting about it. As someone who studies this area, I was actually surprised it was getting so much attention. I was asked to do an interview for a Salt Lake City radio station on our work defining the problem, and it was then that I realized why it was of such interest. As the banter continued between the hosts, it became apparent that the prevailing notion is that everyone who has ever been in a hospital knows that it's the last place…