JHM Research Series

The JHM Research Series highlights some of the most recent and impactful research coming out of the Journal of Hospital Medicine, SHM’s peer-reviewed research journal. Read what contributors and primary investigators have to say about the latest hospital medicine research. Visit www.journalofhospitalmedicine.com for more.

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…

Frequency & Clinical Relevance of Inconsistent Code Status Documentation

I had the pleasure of interviewing Dana Edelson, a Hospitalist at the University of Chicago, about her team’s recent publication in the Journal of Hospital Medicine (JHM), Comparison of mental status scales for predicting mortality on the general wards. We know from previous literature that altered mental status is a strong predictor for inpatient mortality. But it is not clear which mental status assessment tool is best in detecting the risk of mortality. This study retrospectively compared the accuracy of 3 mental status scales [Glasgow coma scale (GCS), the Richmond Agitation and Sedation Scale (RASS) and Alert, responsive to Verbal stimuli, responsive to Painful stimuli, and Unresponsive (AVPU)] in predicting inpatient mortality. The authors found RASS to be the most predictive, followed by GCS, followed by AVPU. The combination of RASS + GCS was the most predictive, compared to any of the scales alone. What is your background and how…

New Research That Helps Us Detect Delirium Faster & Easier

Delirium is one of the most vexing of problems we face in hospitalized patients. It is hard to treat and just as hard to diagnose. In the next issue of the Journal of Hospital Medicine an original paper “Preliminary Development of an Ultra-Brief 2-Item Bedside Test for Delirium” is being published from Donna Fick, PhD, who led a team of researchers, including Sharon Inouye, MD, MPH and Ed Marcantonio, MD. As the paper points out only 12-35% of delirium cases are detected in routine care! This paper seeks to find a better and easier to use screening tool for delirium. The research team recently developed and published on a three minute test called the 3D-CAM. It has a 95% sensitivity and 94% specificity. A great result, but they recognized that even three minutes may be hard to accomplish in the busy atmosphere of a hospital. They then set out to…

Improving Patient Satisfaction through Education, Feedback & Incentives

[caption id="attachment_12537" align="alignright" width="221"] Chart couresty of Kaiser Health News.[/caption] Patient satisfaction survey performance is becoming increasingly important for hospitals, as the ratings are being used by payers in pay-for-performance programs more and more (including the CMS Value Based Purchasing program). CMS also recently released their “Five-Star Quality Rating System” for hospitals, which publicly grades hospitals on 1-5 stars based on their patient satisfaction scores. Unfortunately, there is little literature to guide physicians on exactly HOW to improve patient satisfaction scores for themselves or their groups. A recent publication in the Journal of Hospital Medicine (JHM) found a feasible and effective intervention to improve patient satisfaction scores among trainees, the methodology of which could easily be applied to hospitalists. Dr. Gaurav Banka, a former internal medicine resident (and current cardiology fellow) at UCLA Hospital, was interviewed about his team’s recent publication in the Journal of Hospital Medicine, “Improving patient satisfaction…