Hospital Medicine 19

A project to improve how hospitalists address inpatient delirium, which has led to reductions in length of stay and cost, took center stage on Tuesday morning at HM19 in the Best of RIV plenary session.

The project, conducted at the University of California, San Francisco (UCSF), was presented alongside projects on alcohol detox at the Cleveland Veterans Affairs Medical Center and on medication reconciliation at Brigham and Women’s Hospital in Boston.

“The plenary is the top three of the 1,000 that are out there – so, impressive work,” said Benji Mathews, MD, SFHM, the chair of the Research, Innovations and Vignettes competition.

At UCSF, the project was meant to tackle the huge problem of delirium in the hospital, said Catherine Lau, MD, SFHM, associate professor of medicine there. Each year delirium affects more than 7 million people who are hospitalized, and hospital-acquired delirium is linked with prolonged stays and more emergency department visits and hospital readmissions. But research has found that as many as a third of these hospital-acquired cases can be prevented, Dr. Lau said.

New admissions and transfers – a total of more than 2,800 patients – were assessed for delirium risk, and those deemed high risk were entered into a delirium care plan, aimed at prevention with nonpharmacologic steps such as maximizing their mobility and helping them sleep at night.

All patients also were screened on every nursing shift for delirium, and those diagnosed with the disorder were placed in the delirium care plan, with notification of the patient’s team for treatment.

The average length of stay decreased by 0.8 days (P less than .001), with a decrease of 1.9 days in patients with delirium, compared with outcomes for nearly 2,600 patients before the intervention was implemented, Dr. Lau said. Researchers also found a decrease in $850 spent per patient (P less than .001), with a direct savings to the hospital of a total of $997,000, she said. The 30-day readmission rate also fell significantly, from 18.9% to 15.9% (P = .03).

The screening itself seemed to be the most important factor in the project, Dr. Lau said.

“Just the recognition that their patient was at risk for delirium or actually had delirium really raised awareness,” she said.

The project on alcohol detox used careful risk assessments at emergency department discharge, e-consults, protocols to limit benzodiazepine prescribing, and telephone follow-up to reduce hospital admissions and 30-day readmissions, as well as length of stay.

Researchers used scores on CIWA – a 10-question measurement of the severity of someone’s alcohol withdrawal – and history of complicated alcohol-use withdrawal to determine whether ED patients should be admitted to the floor or sent home with or without prescriptions for gabapentin and lorazepam, said Robert Patrick, MD, a hospitalist at the Cleveland VA.

Perhaps the most innovative feature of the program was using systolic blood pressure and heart rate in addition to CIWA to determine whether someone should receive a benzodiazepine, he said. Someone with a CIWA of 9-12, for instance, would be prescribed one of these drugs only if their vitals were elevated, Dr. Patrick said.

He encouraged other hospitalists to try a similar program at their centers.

“You don’t have to be at a VA to do this,” he said. “And most importantly, you don’t have to have a cooperative ED to do this. You can do this just within your hospitalist group.”

In another presentation, Jeffrey Schnipper, MD, MPH, FHM, associate professor of medicine at Harvard Medical School, Boston, described the results from a project in which SHM’s MARQUIS program – an evidence-based “toolkit” on medication reconciliation – was implemented at 18 hospitals. The kit offers a plan to get the best possible medication history, give medication counseling on discharge, and identify patients at risk for medication discrepancies. The 18 sites were coached, with areas of improvement identified.

By months 13-18 of the study period, the number of medication discrepancies had fallen to 0.93 per patient for those who’d received at least one form of intervention, compared with 2.69 per patient among those who’d received none.

“The MARQUIS interventions, including the toolkit and mentored implementation,” Dr. Schnipper said, “are associated with a marked reduction in medication discrepancies.”

A project to improve how hospitalists address inpatient delirium, which has led to reductions in length of stay and cost, took center stage on Tuesday morning at HM19 in the Best of RIV plenary session.

The project, conducted at the University of California, San Francisco (UCSF), was presented alongside projects on alcohol detox at the Cleveland Veterans Affairs Medical Center and on medication reconciliation at Brigham and Women’s Hospital in Boston.

“The plenary is the top three of the 1,000 that are out there – so, impressive work,” said Benji Mathews, MD, SFHM, the chair of the Research, Innovations and Vignettes competition.

At UCSF, the project was meant to tackle the huge problem of delirium in the hospital, said Catherine Lau, MD, SFHM, associate professor of medicine there. Each year delirium affects more than 7 million people who are hospitalized, and hospital-acquired delirium is linked with prolonged stays and more emergency department visits and hospital readmissions. But research has found that as many as a third of these hospital-acquired cases can be prevented, Dr. Lau said.

New admissions and transfers – a total of more than 2,800 patients – were assessed for delirium risk, and those deemed high risk were entered into a delirium care plan, aimed at prevention with nonpharmacologic steps such as maximizing their mobility and helping them sleep at night.

All patients also were screened on every nursing shift for delirium, and those diagnosed with the disorder were placed in the delirium care plan, with notification of the patient’s team for treatment.

The average length of stay decreased by 0.8 days (P less than .001), with a decrease of 1.9 days in patients with delirium, compared with outcomes for nearly 2,600 patients before the intervention was implemented, Dr. Lau said. Researchers also found a decrease in $850 spent per patient (P less than .001), with a direct savings to the hospital of a total of $997,000, she said. The 30-day readmission rate also fell significantly, from 18.9% to 15.9% (P = .03).

The screening itself seemed to be the most important factor in the project, Dr. Lau said.

“Just the recognition that their patient was at risk for delirium or actually had delirium really raised awareness,” she said.

The project on alcohol detox used careful risk assessments at emergency department discharge, e-consults, protocols to limit benzodiazepine prescribing, and telephone follow-up to reduce hospital admissions and 30-day readmissions, as well as length of stay.

Researchers used scores on CIWA – a 10-question measurement of the severity of someone’s alcohol withdrawal – and history of complicated alcohol-use withdrawal to determine whether ED patients should be admitted to the floor or sent home with or without prescriptions for gabapentin and lorazepam, said Robert Patrick, MD, a hospitalist at the Cleveland VA.

Perhaps the most innovative feature of the program was using systolic blood pressure and heart rate in addition to CIWA to determine whether someone should receive a benzodiazepine, he said. Someone with a CIWA of 9-12, for instance, would be prescribed one of these drugs only if their vitals were elevated, Dr. Patrick said.

He encouraged other hospitalists to try a similar program at their centers.

“You don’t have to be at a VA to do this,” he said. “And most importantly, you don’t have to have a cooperative ED to do this. You can do this just within your hospitalist group.”

In another presentation, Jeffrey Schnipper, MD, MPH, FHM, associate professor of medicine at Harvard Medical School, Boston, described the results from a project in which SHM’s MARQUIS program – an evidence-based “toolkit” on medication reconciliation – was implemented at 18 hospitals. The kit offers a plan to get the best possible medication history, give medication counseling on discharge, and identify patients at risk for medication discrepancies. The 18 sites were coached, with areas of improvement identified.

By months 13-18 of the study period, the number of medication discrepancies had fallen to 0.93 per patient for those who’d received at least one form of intervention, compared with 2.69 per patient among those who’d received none.

“The MARQUIS interventions, including the toolkit and mentored implementation,” Dr. Schnipper said, “are associated with a marked reduction in medication discrepancies.”

A project to improve how hospitalists address inpatient delirium, which has led to reductions in length of stay and cost, took center stage on Tuesday morning at HM19 in the Best of RIV plenary session.

The project, conducted at the University of California, San Francisco (UCSF), was presented alongside projects on alcohol detox at the Cleveland Veterans Affairs Medical Center and on medication reconciliation at Brigham and Women’s Hospital in Boston.

“The plenary is the top three of the 1,000 that are out there – so, impressive work,” said Benji Mathews, MD, SFHM, the chair of the Research, Innovations and Vignettes competition.

At UCSF, the project was meant to tackle the huge problem of delirium in the hospital, said Catherine Lau, MD, SFHM, associate professor of medicine there. Each year delirium affects more than 7 million people who are hospitalized, and hospital-acquired delirium is linked with prolonged stays and more emergency department visits and hospital readmissions. But research has found that as many as a third of these hospital-acquired cases can be prevented, Dr. Lau said.

New admissions and transfers – a total of more than 2,800 patients – were assessed for delirium risk, and those deemed high risk were entered into a delirium care plan, aimed at prevention with nonpharmacologic steps such as maximizing their mobility and helping them sleep at night.

All patients also were screened on every nursing shift for delirium, and those diagnosed with the disorder were placed in the delirium care plan, with notification of the patient’s team for treatment.

The average length of stay decreased by 0.8 days (P less than .001), with a decrease of 1.9 days in patients with delirium, compared with outcomes for nearly 2,600 patients before the intervention was implemented, Dr. Lau said. Researchers also found a decrease in $850 spent per patient (P less than .001), with a direct savings to the hospital of a total of $997,000, she said. The 30-day readmission rate also fell significantly, from 18.9% to 15.9% (P = .03).

The screening itself seemed to be the most important factor in the project, Dr. Lau said.

“Just the recognition that their patient was at risk for delirium or actually had delirium really raised awareness,” she said.

The project on alcohol detox used careful risk assessments at emergency department discharge, e-consults, protocols to limit benzodiazepine prescribing, and telephone follow-up to reduce hospital admissions and 30-day readmissions, as well as length of stay.

Researchers used scores on CIWA – a 10-question measurement of the severity of someone’s alcohol withdrawal – and history of complicated alcohol-use withdrawal to determine whether ED patients should be admitted to the floor or sent home with or without prescriptions for gabapentin and lorazepam, said Robert Patrick, MD, a hospitalist at the Cleveland VA.

Perhaps the most innovative feature of the program was using systolic blood pressure and heart rate in addition to CIWA to determine whether someone should receive a benzodiazepine, he said. Someone with a CIWA of 9-12, for instance, would be prescribed one of these drugs only if their vitals were elevated, Dr. Patrick said.

He encouraged other hospitalists to try a similar program at their centers.

“You don’t have to be at a VA to do this,” he said. “And most importantly, you don’t have to have a cooperative ED to do this. You can do this just within your hospitalist group.”

In another presentation, Jeffrey Schnipper, MD, MPH, FHM, associate professor of medicine at Harvard Medical School, Boston, described the results from a project in which SHM’s MARQUIS program – an evidence-based “toolkit” on medication reconciliation – was implemented at 18 hospitals. The kit offers a plan to get the best possible medication history, give medication counseling on discharge, and identify patients at risk for medication discrepancies. The 18 sites were coached, with areas of improvement identified.

By months 13-18 of the study period, the number of medication discrepancies had fallen to 0.93 per patient for those who’d received at least one form of intervention, compared with 2.69 per patient among those who’d received none.

“The MARQUIS interventions, including the toolkit and mentored implementation,” Dr. Schnipper said, “are associated with a marked reduction in medication discrepancies.”

As the legalization of medical cannabis becomes more widespread, more and more patients admitted to the hospital are taking it. But once a patient crosses the hospital threshold, how do you incorporate into your care a product that is still illegal at the federal level?

Charles Reznikoff, MD, a physician and addiction specialist who treats medically complex hospitalized patients, walked the audience through the complexities of use of medical cannabis in these patients in a session Tuesday here at HM19. Dr. Reznikoff, from the Hennepin County (Minn.) Medical Center (HCMC), in the Minneapolis area, also discussed medical cannabis indications and contraindications in hospitalized patients.

In 2014, Minnesota passed a law allowing the use of state-based medical cannabis program products in the hospital setting. Two hospitals in the state – HCMC and the Mayo Clinic, which began allowing its use at those centers 3 years ago – illustrate the divergent ways in which different centers manage and oversee the products’ use, as they are forced to navigate nuances particular to their settings.

At Mayo, the medical cannabis is centrally stored, maintained, and administered by hospital nurses, physicians, and pharmacists. At HCMC, the situation is very different.

“Our nursing union told us, ‘Don’t make us handle schedule I substances,’ ” Dr. Reznikoff said. In addition, the hospital’s security officers – who are often off-duty police officers – said that their only interaction with medical cannabis would be to destroy it because of its illegal federal status.

So, at HCMC, the hospital documents which patients have medical cannabis, and the patients let nurses know when they take it and administer it themselves, with that administration documented. Only edibles and tinctures are allowed for use in the hospital – vaping is prohibited.

Despite the departure from the normal use of the hospital’s own formulary and pharmacy, the procedures have worked out, he said.

“For HCMC, it has been pretty straightforward – patients are happy and it has been a piece of cake,” he said, adding that in a few instances patients have been unaware that they could use their medical cannabis, or staff has been confused about the protocol.

Physicians in these situations should be on the lookout for contraindications and potential side effects, Dr. Reznikoff said.

“Medical cannabis has not a ton, but some, important side effects worth knowing about,” he said. “It can cause falls, it can cause dizziness. It can cause a little bit of tachycardia ... If they stop it, people can have mild withdrawal.”

Contraindications include altered mental status such as delirium, having had falls or having a risk of falling, hypotension or hypovolemia, and psychosis.

“For our patients, it is mostly HIV/AIDS and cancer patients who have contraindications, and that comes in the form of infectious diseases and their complications,” he said in an interview.

In the realm of palliative care, cancer, AIDS, and end-of-life care, the use of medical cannabis is a potential tool and should hinge on what patients report back as helpful or not helpful, he said.

But some claims being made about cannabidiol oil, whether as immunotherapy for autoimmune diseases, as an antipsychotic for schizophrenia, or as a cure for heroin addiction, for example, stretch credibility, Dr. Reznikoff said. But the evidence in favor of its use for seizure-reduction, for example, is persuasive, he added.

Overall, medical cannabis for hospitalized patients is no simple matter, but it is worth the fuss for some patients, he said.

“There are a few niches for it – and I think they are niches, but they’re there,” he said. “I don’t love medical cannabis. I think there are a lot of issues with it. I think a lot of physicians are very frustrated with it. But I think also, when we’re talking about palliative care–type issues and seizure disorders not otherwise treated by conventional means ... it’s very reasonable to bring cannabis into the hospital.”

As the legalization of medical cannabis becomes more widespread, more and more patients admitted to the hospital are taking it. But once a patient crosses the hospital threshold, how do you incorporate into your care a product that is still illegal at the federal level?

Charles Reznikoff, MD, a physician and addiction specialist who treats medically complex hospitalized patients, walked the audience through the complexities of use of medical cannabis in these patients in a session Tuesday here at HM19. Dr. Reznikoff, from the Hennepin County (Minn.) Medical Center (HCMC), in the Minneapolis area, also discussed medical cannabis indications and contraindications in hospitalized patients.

In 2014, Minnesota passed a law allowing the use of state-based medical cannabis program products in the hospital setting. Two hospitals in the state – HCMC and the Mayo Clinic, which began allowing its use at those centers 3 years ago – illustrate the divergent ways in which different centers manage and oversee the products’ use, as they are forced to navigate nuances particular to their settings.

At Mayo, the medical cannabis is centrally stored, maintained, and administered by hospital nurses, physicians, and pharmacists. At HCMC, the situation is very different.

“Our nursing union told us, ‘Don’t make us handle schedule I substances,’ ” Dr. Reznikoff said. In addition, the hospital’s security officers – who are often off-duty police officers – said that their only interaction with medical cannabis would be to destroy it because of its illegal federal status.

So, at HCMC, the hospital documents which patients have medical cannabis, and the patients let nurses know when they take it and administer it themselves, with that administration documented. Only edibles and tinctures are allowed for use in the hospital – vaping is prohibited.

Despite the departure from the normal use of the hospital’s own formulary and pharmacy, the procedures have worked out, he said.

“For HCMC, it has been pretty straightforward – patients are happy and it has been a piece of cake,” he said, adding that in a few instances patients have been unaware that they could use their medical cannabis, or staff has been confused about the protocol.

Physicians in these situations should be on the lookout for contraindications and potential side effects, Dr. Reznikoff said.

“Medical cannabis has not a ton, but some, important side effects worth knowing about,” he said. “It can cause falls, it can cause dizziness. It can cause a little bit of tachycardia ... If they stop it, people can have mild withdrawal.”

Contraindications include altered mental status such as delirium, having had falls or having a risk of falling, hypotension or hypovolemia, and psychosis.

“For our patients, it is mostly HIV/AIDS and cancer patients who have contraindications, and that comes in the form of infectious diseases and their complications,” he said in an interview.

In the realm of palliative care, cancer, AIDS, and end-of-life care, the use of medical cannabis is a potential tool and should hinge on what patients report back as helpful or not helpful, he said.

But some claims being made about cannabidiol oil, whether as immunotherapy for autoimmune diseases, as an antipsychotic for schizophrenia, or as a cure for heroin addiction, for example, stretch credibility, Dr. Reznikoff said. But the evidence in favor of its use for seizure-reduction, for example, is persuasive, he added.

Overall, medical cannabis for hospitalized patients is no simple matter, but it is worth the fuss for some patients, he said.

“There are a few niches for it – and I think they are niches, but they’re there,” he said. “I don’t love medical cannabis. I think there are a lot of issues with it. I think a lot of physicians are very frustrated with it. But I think also, when we’re talking about palliative care–type issues and seizure disorders not otherwise treated by conventional means ... it’s very reasonable to bring cannabis into the hospital.”

As the legalization of medical cannabis becomes more widespread, more and more patients admitted to the hospital are taking it. But once a patient crosses the hospital threshold, how do you incorporate into your care a product that is still illegal at the federal level?

Charles Reznikoff, MD, a physician and addiction specialist who treats medically complex hospitalized patients, walked the audience through the complexities of use of medical cannabis in these patients in a session Tuesday here at HM19. Dr. Reznikoff, from the Hennepin County (Minn.) Medical Center (HCMC), in the Minneapolis area, also discussed medical cannabis indications and contraindications in hospitalized patients.

In 2014, Minnesota passed a law allowing the use of state-based medical cannabis program products in the hospital setting. Two hospitals in the state – HCMC and the Mayo Clinic, which began allowing its use at those centers 3 years ago – illustrate the divergent ways in which different centers manage and oversee the products’ use, as they are forced to navigate nuances particular to their settings.

At Mayo, the medical cannabis is centrally stored, maintained, and administered by hospital nurses, physicians, and pharmacists. At HCMC, the situation is very different.

“Our nursing union told us, ‘Don’t make us handle schedule I substances,’ ” Dr. Reznikoff said. In addition, the hospital’s security officers – who are often off-duty police officers – said that their only interaction with medical cannabis would be to destroy it because of its illegal federal status.

So, at HCMC, the hospital documents which patients have medical cannabis, and the patients let nurses know when they take it and administer it themselves, with that administration documented. Only edibles and tinctures are allowed for use in the hospital – vaping is prohibited.

Despite the departure from the normal use of the hospital’s own formulary and pharmacy, the procedures have worked out, he said.

“For HCMC, it has been pretty straightforward – patients are happy and it has been a piece of cake,” he said, adding that in a few instances patients have been unaware that they could use their medical cannabis, or staff has been confused about the protocol.

Physicians in these situations should be on the lookout for contraindications and potential side effects, Dr. Reznikoff said.

“Medical cannabis has not a ton, but some, important side effects worth knowing about,” he said. “It can cause falls, it can cause dizziness. It can cause a little bit of tachycardia ... If they stop it, people can have mild withdrawal.”

Contraindications include altered mental status such as delirium, having had falls or having a risk of falling, hypotension or hypovolemia, and psychosis.

“For our patients, it is mostly HIV/AIDS and cancer patients who have contraindications, and that comes in the form of infectious diseases and their complications,” he said in an interview.

In the realm of palliative care, cancer, AIDS, and end-of-life care, the use of medical cannabis is a potential tool and should hinge on what patients report back as helpful or not helpful, he said.

But some claims being made about cannabidiol oil, whether as immunotherapy for autoimmune diseases, as an antipsychotic for schizophrenia, or as a cure for heroin addiction, for example, stretch credibility, Dr. Reznikoff said. But the evidence in favor of its use for seizure-reduction, for example, is persuasive, he added.

Overall, medical cannabis for hospitalized patients is no simple matter, but it is worth the fuss for some patients, he said.

“There are a few niches for it – and I think they are niches, but they’re there,” he said. “I don’t love medical cannabis. I think there are a lot of issues with it. I think a lot of physicians are very frustrated with it. But I think also, when we’re talking about palliative care–type issues and seizure disorders not otherwise treated by conventional means ... it’s very reasonable to bring cannabis into the hospital.”

HM19 attendees explain what they learned at the meeting today.

Vidyard Video

 

HM19 attendees explain what they learned at the meeting today.

Vidyard Video

 

HM19 attendees explain what they learned at the meeting today.

Vidyard Video

 

Every year SHM’s Annual Conference Committee examines prior attendee surveys, reviews the content presented the preceding year, and asks itself what new areas of learning are needed by hospitalists, said Dustin Smith, MD, SFHM, associate professor of medicine at Emory University in Atlanta, and HM19 course director.

“The conference’s schedule-at-a-glance of content can be overwhelming, so we have tried to use distinct educational tracks to provide focus and clarity for conference attendees,” he said. “Every year there are a few areas where questions often come up about complex clinical situations in which established medical guidelines aren’t much help.”

As a result, for HM19 an educational mini-track called “Between the Guidelines” was developed to gather up several of these areas of clinical complexity where what’s available in established clinical practice guidelines doesn’t offer clear answers, Dr. Smith said. These include controversies around antithrombotic therapy in patients with major bleeds, and a debate on controversial aspects of guidelines to direct inpatient care.

A Wednesday session, “The History of Hospitals via Arts and Stories,” fits nicely into this mini-track.

“It’s a history lesson you can’t glean from medical guidelines, which maybe point us toward what to incorporate and what not to repeat from across the history of hospitals,” he said. “That could help us better appreciate the work hospitalists are doing today and into the future.”

Jordan Messler, MD, SFHM, a hospitalist with the Morton Plant Hospitalist group in Clearwater, Fla., will lead the session and thinks that modern physicians can learn a great deal from both the history of medicine and the evolution of hospitals, starting with the ancient Greek physician, Galen (129-200 AD), who directed the celebrated Asclepeion or hospital in Pergamon (present-day Bergama, Turkey). Dr. Messler said this ancient hospital’s treatment of disease also addressed the senses, the emotions, and the spirit – an early prototype for whole-person care – with an em-phasis on self-therapy through rest, relaxation, exercise, and the promotion of healthy lifestyles.
 

A different perspective on hospitals

“People used to travel to Pergamon for healing at the Asclepeion, next to the amphitheater, where plays and music were presented, and to be outdoors in the natural elements. Now we’re seeing hospitals being built with healing gardens, and a new emphasis on how artwork and music and environmental design can assist in healing,” Dr. Messler said.

Dr. Messler explained that his “History of Hospitals” presentation also will survey the advent of more recent hospitals in France in the 18th century, pioneering work done at Johns Hopkins Hospital in Baltimore and Bellevue Hospital in New York, and the influence of nursing pioneer Florence Nightingale (1820-1910) on the modern hospital. Dr. Messler said Ms. Nightingale helped improve hospitals in her day, which still influences their modern design, and fundamentally changed the role of nursing in hospitals, introducing professional training standards for nurses.

Part of the goal for “Between the Guidelines” is to take a break from more clinically focused presentations and to think about the hospital from a different perspective, Dr. Messler said. His session will emphasize the power of stories and storytelling to inform and inspire medical practice.

“This is not something that can be applied clinically the next day, but lessons from the past can inform the design of hospitals and how we manage patients,” he said. “We need to ask ourselves, ‘How can we analyze hospital history to inform what we do today?’ ”
 

Origins Not Forgotten: The History of Hospitals via Arts and Stories
Wednesday, 12:30-1:10 p.m.
Woodrow Wilson A

Every year SHM’s Annual Conference Committee examines prior attendee surveys, reviews the content presented the preceding year, and asks itself what new areas of learning are needed by hospitalists, said Dustin Smith, MD, SFHM, associate professor of medicine at Emory University in Atlanta, and HM19 course director.

“The conference’s schedule-at-a-glance of content can be overwhelming, so we have tried to use distinct educational tracks to provide focus and clarity for conference attendees,” he said. “Every year there are a few areas where questions often come up about complex clinical situations in which established medical guidelines aren’t much help.”

As a result, for HM19 an educational mini-track called “Between the Guidelines” was developed to gather up several of these areas of clinical complexity where what’s available in established clinical practice guidelines doesn’t offer clear answers, Dr. Smith said. These include controversies around antithrombotic therapy in patients with major bleeds, and a debate on controversial aspects of guidelines to direct inpatient care.

A Wednesday session, “The History of Hospitals via Arts and Stories,” fits nicely into this mini-track.

“It’s a history lesson you can’t glean from medical guidelines, which maybe point us toward what to incorporate and what not to repeat from across the history of hospitals,” he said. “That could help us better appreciate the work hospitalists are doing today and into the future.”

Jordan Messler, MD, SFHM, a hospitalist with the Morton Plant Hospitalist group in Clearwater, Fla., will lead the session and thinks that modern physicians can learn a great deal from both the history of medicine and the evolution of hospitals, starting with the ancient Greek physician, Galen (129-200 AD), who directed the celebrated Asclepeion or hospital in Pergamon (present-day Bergama, Turkey). Dr. Messler said this ancient hospital’s treatment of disease also addressed the senses, the emotions, and the spirit – an early prototype for whole-person care – with an em-phasis on self-therapy through rest, relaxation, exercise, and the promotion of healthy lifestyles.
 

A different perspective on hospitals

“People used to travel to Pergamon for healing at the Asclepeion, next to the amphitheater, where plays and music were presented, and to be outdoors in the natural elements. Now we’re seeing hospitals being built with healing gardens, and a new emphasis on how artwork and music and environmental design can assist in healing,” Dr. Messler said.

Dr. Messler explained that his “History of Hospitals” presentation also will survey the advent of more recent hospitals in France in the 18th century, pioneering work done at Johns Hopkins Hospital in Baltimore and Bellevue Hospital in New York, and the influence of nursing pioneer Florence Nightingale (1820-1910) on the modern hospital. Dr. Messler said Ms. Nightingale helped improve hospitals in her day, which still influences their modern design, and fundamentally changed the role of nursing in hospitals, introducing professional training standards for nurses.

Part of the goal for “Between the Guidelines” is to take a break from more clinically focused presentations and to think about the hospital from a different perspective, Dr. Messler said. His session will emphasize the power of stories and storytelling to inform and inspire medical practice.

“This is not something that can be applied clinically the next day, but lessons from the past can inform the design of hospitals and how we manage patients,” he said. “We need to ask ourselves, ‘How can we analyze hospital history to inform what we do today?’ ”
 

Origins Not Forgotten: The History of Hospitals via Arts and Stories
Wednesday, 12:30-1:10 p.m.
Woodrow Wilson A

Every year SHM’s Annual Conference Committee examines prior attendee surveys, reviews the content presented the preceding year, and asks itself what new areas of learning are needed by hospitalists, said Dustin Smith, MD, SFHM, associate professor of medicine at Emory University in Atlanta, and HM19 course director.

“The conference’s schedule-at-a-glance of content can be overwhelming, so we have tried to use distinct educational tracks to provide focus and clarity for conference attendees,” he said. “Every year there are a few areas where questions often come up about complex clinical situations in which established medical guidelines aren’t much help.”

As a result, for HM19 an educational mini-track called “Between the Guidelines” was developed to gather up several of these areas of clinical complexity where what’s available in established clinical practice guidelines doesn’t offer clear answers, Dr. Smith said. These include controversies around antithrombotic therapy in patients with major bleeds, and a debate on controversial aspects of guidelines to direct inpatient care.

A Wednesday session, “The History of Hospitals via Arts and Stories,” fits nicely into this mini-track.

“It’s a history lesson you can’t glean from medical guidelines, which maybe point us toward what to incorporate and what not to repeat from across the history of hospitals,” he said. “That could help us better appreciate the work hospitalists are doing today and into the future.”

Jordan Messler, MD, SFHM, a hospitalist with the Morton Plant Hospitalist group in Clearwater, Fla., will lead the session and thinks that modern physicians can learn a great deal from both the history of medicine and the evolution of hospitals, starting with the ancient Greek physician, Galen (129-200 AD), who directed the celebrated Asclepeion or hospital in Pergamon (present-day Bergama, Turkey). Dr. Messler said this ancient hospital’s treatment of disease also addressed the senses, the emotions, and the spirit – an early prototype for whole-person care – with an em-phasis on self-therapy through rest, relaxation, exercise, and the promotion of healthy lifestyles.
 

A different perspective on hospitals

“People used to travel to Pergamon for healing at the Asclepeion, next to the amphitheater, where plays and music were presented, and to be outdoors in the natural elements. Now we’re seeing hospitals being built with healing gardens, and a new emphasis on how artwork and music and environmental design can assist in healing,” Dr. Messler said.

Dr. Messler explained that his “History of Hospitals” presentation also will survey the advent of more recent hospitals in France in the 18th century, pioneering work done at Johns Hopkins Hospital in Baltimore and Bellevue Hospital in New York, and the influence of nursing pioneer Florence Nightingale (1820-1910) on the modern hospital. Dr. Messler said Ms. Nightingale helped improve hospitals in her day, which still influences their modern design, and fundamentally changed the role of nursing in hospitals, introducing professional training standards for nurses.

Part of the goal for “Between the Guidelines” is to take a break from more clinically focused presentations and to think about the hospital from a different perspective, Dr. Messler said. His session will emphasize the power of stories and storytelling to inform and inspire medical practice.

“This is not something that can be applied clinically the next day, but lessons from the past can inform the design of hospitals and how we manage patients,” he said. “We need to ask ourselves, ‘How can we analyze hospital history to inform what we do today?’ ”
 

Origins Not Forgotten: The History of Hospitals via Arts and Stories
Wednesday, 12:30-1:10 p.m.
Woodrow Wilson A

A program using “telehospitalists” to hasten and improve patient care won the top prize in the Innovations category of the RIV competition on Monday night at HM19. In the Research category, a study on workload to improve overnight cross-coverage care took the top prize.

Lou Ferraro, Park South Photography

Jeetinder Kaur Gujral, MD, a family medicine and palliative care physician at Northwell Health in Bay Shore, N.Y., said that the telehospitalist program at her institution uses a telehealth hub that is on call to consult with patients when the on-site hospitalist is unable to evaluate a patient in the emergency department within 30 minutes.

Dr. Gujral’s winning study – presented on Monday night and evaluated based on its novelty and the quality of the presentation and the poster – examined results at one of Northwell’s tertiary centers from January to October of 2018, where a telehospitalist works from 12 p.m. to 10 p.m.

Researchers found there was no significant difference in the severity of illness between the patients seen by the on-site hospitalist and the telehospitalist – if anything, the patients consulted by the telehospitalist were a bit sicker, Dr. Gujral said. But there was significantly less variation in the time it took for a telehospitalist to consult with a patient than the on-site physician.

“We are more predictable, because it’s a press of a button, and we are there,” Dr. Gujral said. “And the orders go in faster. I don’t have to leave to go down to the ED to see the patient. I’m seeing the patient right there.”

Kelly Sponsler, MD, assistant professor at Vanderbilt University Medical Center in Nashville, Tenn., who led the Innovations judging, said the project seems to be a brand-new idea: taking a concept built to cover long distances at rural centers and using it within a center’s own program to improve care.

“We really felt like this was something we had not seen before,” Dr. Sponsler said. “There was a clear problem that the team had identified, and it’s a common problem that I think can be scalable, or that other groups probably encounter.”

In the cross-coverage study that won in the Research category, an index developed by NASA to quantify perceived workload was used to assess the factors that boost workload during night shifts, said Ruth Bates, MD, an assistant professor at Mayo Clinic in Rochester, Minn.

The key finding was that it wasn’t the number of patients that boosts workload during these hours, but the number of pages, action items, and rapid-response team and ICU activations. The number of unnecessary pages that overnight hospitalists receive is the prime target as a way to reduce the workload.

The idea is to reduce “low-value communication,” Dr. Bates said. An example is a page about a lab value that is a “tiny bit off.”

“That’s just one example of really low-value communication that has interrupted somebody’s work flow and is not really increasing the quality of patient care.”

Trainee winners were Cameron Locke, MD, a resident physician at the University of California, San Francisco, for a study on a multidisciplinary approach to reduce endoscopy delays, which won in the Innovations category. That study was presented by Molly Kantor, MD, assistant clinical professor at UCSF.

The Research category trainee winner was Monisha Bhatia, MD, JD, MPH, of Jackson Memorial Hospital in Miami for her work on using phenotypic data from electronic health records to predict discharge destination.

On Tuesday afternoon, Erin Frost, MD, a resident in internal medicine and pediatrics at Duke University, Durham, N.C., won the top prize in the Clinical Vignettes category, for her presentation of a case of a woman with acute digital ischemia after an injection of sublingual buprenorphine and naloxone.

The trainee winner in Clinical Vignettes was a case of C. difficile infection of a total hip arthroplasty, presented by Benjamin Claxton, MPH, a medical student at Penn State University, Hershey. The category’s pediatrics winner was Erin Finn, MD, a resident at the University of North Carolina, Chapel Hill, for her presentation of a case of myocarditis in a 14-year-old.

The oral presentation winner for the Innovations category was Nainesh Shah, MD, of UT Southwestern Medical Center, Dallas, for his abstract presentation "Alert: Structured Radiology Reports are Here." For the Research category, the oral presentation winner was David Meltzer, MD, PhD, section chief of hospital medicine at University of Chicago Medicine, for his abstract presentation "Effects of Comprehensive Care Physicians on Patient Experience, Outcomes and Hospitalization."

A program using “telehospitalists” to hasten and improve patient care won the top prize in the Innovations category of the RIV competition on Monday night at HM19. In the Research category, a study on workload to improve overnight cross-coverage care took the top prize.

Lou Ferraro, Park South Photography

Jeetinder Kaur Gujral, MD, a family medicine and palliative care physician at Northwell Health in Bay Shore, N.Y., said that the telehospitalist program at her institution uses a telehealth hub that is on call to consult with patients when the on-site hospitalist is unable to evaluate a patient in the emergency department within 30 minutes.

Dr. Gujral’s winning study – presented on Monday night and evaluated based on its novelty and the quality of the presentation and the poster – examined results at one of Northwell’s tertiary centers from January to October of 2018, where a telehospitalist works from 12 p.m. to 10 p.m.

Researchers found there was no significant difference in the severity of illness between the patients seen by the on-site hospitalist and the telehospitalist – if anything, the patients consulted by the telehospitalist were a bit sicker, Dr. Gujral said. But there was significantly less variation in the time it took for a telehospitalist to consult with a patient than the on-site physician.

“We are more predictable, because it’s a press of a button, and we are there,” Dr. Gujral said. “And the orders go in faster. I don’t have to leave to go down to the ED to see the patient. I’m seeing the patient right there.”

Kelly Sponsler, MD, assistant professor at Vanderbilt University Medical Center in Nashville, Tenn., who led the Innovations judging, said the project seems to be a brand-new idea: taking a concept built to cover long distances at rural centers and using it within a center’s own program to improve care.

“We really felt like this was something we had not seen before,” Dr. Sponsler said. “There was a clear problem that the team had identified, and it’s a common problem that I think can be scalable, or that other groups probably encounter.”

In the cross-coverage study that won in the Research category, an index developed by NASA to quantify perceived workload was used to assess the factors that boost workload during night shifts, said Ruth Bates, MD, an assistant professor at Mayo Clinic in Rochester, Minn.

The key finding was that it wasn’t the number of patients that boosts workload during these hours, but the number of pages, action items, and rapid-response team and ICU activations. The number of unnecessary pages that overnight hospitalists receive is the prime target as a way to reduce the workload.

The idea is to reduce “low-value communication,” Dr. Bates said. An example is a page about a lab value that is a “tiny bit off.”

“That’s just one example of really low-value communication that has interrupted somebody’s work flow and is not really increasing the quality of patient care.”

Trainee winners were Cameron Locke, MD, a resident physician at the University of California, San Francisco, for a study on a multidisciplinary approach to reduce endoscopy delays, which won in the Innovations category. That study was presented by Molly Kantor, MD, assistant clinical professor at UCSF.

The Research category trainee winner was Monisha Bhatia, MD, JD, MPH, of Jackson Memorial Hospital in Miami for her work on using phenotypic data from electronic health records to predict discharge destination.

On Tuesday afternoon, Erin Frost, MD, a resident in internal medicine and pediatrics at Duke University, Durham, N.C., won the top prize in the Clinical Vignettes category, for her presentation of a case of a woman with acute digital ischemia after an injection of sublingual buprenorphine and naloxone.

The trainee winner in Clinical Vignettes was a case of C. difficile infection of a total hip arthroplasty, presented by Benjamin Claxton, MPH, a medical student at Penn State University, Hershey. The category’s pediatrics winner was Erin Finn, MD, a resident at the University of North Carolina, Chapel Hill, for her presentation of a case of myocarditis in a 14-year-old.

The oral presentation winner for the Innovations category was Nainesh Shah, MD, of UT Southwestern Medical Center, Dallas, for his abstract presentation "Alert: Structured Radiology Reports are Here." For the Research category, the oral presentation winner was David Meltzer, MD, PhD, section chief of hospital medicine at University of Chicago Medicine, for his abstract presentation "Effects of Comprehensive Care Physicians on Patient Experience, Outcomes and Hospitalization."

A program using “telehospitalists” to hasten and improve patient care won the top prize in the Innovations category of the RIV competition on Monday night at HM19. In the Research category, a study on workload to improve overnight cross-coverage care took the top prize.

Lou Ferraro, Park South Photography

Jeetinder Kaur Gujral, MD, a family medicine and palliative care physician at Northwell Health in Bay Shore, N.Y., said that the telehospitalist program at her institution uses a telehealth hub that is on call to consult with patients when the on-site hospitalist is unable to evaluate a patient in the emergency department within 30 minutes.

Dr. Gujral’s winning study – presented on Monday night and evaluated based on its novelty and the quality of the presentation and the poster – examined results at one of Northwell’s tertiary centers from January to October of 2018, where a telehospitalist works from 12 p.m. to 10 p.m.

Researchers found there was no significant difference in the severity of illness between the patients seen by the on-site hospitalist and the telehospitalist – if anything, the patients consulted by the telehospitalist were a bit sicker, Dr. Gujral said. But there was significantly less variation in the time it took for a telehospitalist to consult with a patient than the on-site physician.

“We are more predictable, because it’s a press of a button, and we are there,” Dr. Gujral said. “And the orders go in faster. I don’t have to leave to go down to the ED to see the patient. I’m seeing the patient right there.”

Kelly Sponsler, MD, assistant professor at Vanderbilt University Medical Center in Nashville, Tenn., who led the Innovations judging, said the project seems to be a brand-new idea: taking a concept built to cover long distances at rural centers and using it within a center’s own program to improve care.

“We really felt like this was something we had not seen before,” Dr. Sponsler said. “There was a clear problem that the team had identified, and it’s a common problem that I think can be scalable, or that other groups probably encounter.”

In the cross-coverage study that won in the Research category, an index developed by NASA to quantify perceived workload was used to assess the factors that boost workload during night shifts, said Ruth Bates, MD, an assistant professor at Mayo Clinic in Rochester, Minn.

The key finding was that it wasn’t the number of patients that boosts workload during these hours, but the number of pages, action items, and rapid-response team and ICU activations. The number of unnecessary pages that overnight hospitalists receive is the prime target as a way to reduce the workload.

The idea is to reduce “low-value communication,” Dr. Bates said. An example is a page about a lab value that is a “tiny bit off.”

“That’s just one example of really low-value communication that has interrupted somebody’s work flow and is not really increasing the quality of patient care.”

Trainee winners were Cameron Locke, MD, a resident physician at the University of California, San Francisco, for a study on a multidisciplinary approach to reduce endoscopy delays, which won in the Innovations category. That study was presented by Molly Kantor, MD, assistant clinical professor at UCSF.

The Research category trainee winner was Monisha Bhatia, MD, JD, MPH, of Jackson Memorial Hospital in Miami for her work on using phenotypic data from electronic health records to predict discharge destination.

On Tuesday afternoon, Erin Frost, MD, a resident in internal medicine and pediatrics at Duke University, Durham, N.C., won the top prize in the Clinical Vignettes category, for her presentation of a case of a woman with acute digital ischemia after an injection of sublingual buprenorphine and naloxone.

The trainee winner in Clinical Vignettes was a case of C. difficile infection of a total hip arthroplasty, presented by Benjamin Claxton, MPH, a medical student at Penn State University, Hershey. The category’s pediatrics winner was Erin Finn, MD, a resident at the University of North Carolina, Chapel Hill, for her presentation of a case of myocarditis in a 14-year-old.

The oral presentation winner for the Innovations category was Nainesh Shah, MD, of UT Southwestern Medical Center, Dallas, for his abstract presentation "Alert: Structured Radiology Reports are Here." For the Research category, the oral presentation winner was David Meltzer, MD, PhD, section chief of hospital medicine at University of Chicago Medicine, for his abstract presentation "Effects of Comprehensive Care Physicians on Patient Experience, Outcomes and Hospitalization."

Social media can be more than a tool to connect with friends and family, said Vineet Chopra, MD, MBBS, FHM, Charlie Wray, DO, and Vineet Arora, MD, MAPP, MHM, at Monday’s “Tweet Your Way to the Top? Social Media as a Career Development Tool in Hospital Medicine” session.

Online outreach can play crucial roles in everything from continuing education and research to networking and career advancement, but most of the conversations in medicine are really focused in the Twittersphere, the three hospitalists said.

“Social media has allowed me to connect with leaders in hospital medicine and many other medical communities,” said Dr. Wray, an assistant professor of medicine at the University of California, San Francisco. “It has allowed me to share my work and success with the hospitalist community in addition to highlighting my trainees’ and colleagues’ successes. My engagement has created opportunities to get involved with projects that I could never have previously imagined. And it has extended my networking circle and made annual gatherings like the SHM Annual Conference even more beneficial and high yield for my career.”

For session copresenter Dr. Chopra, associate professor and chief of the division of hospital medicine at the University of Michigan, Ann Arbor, social media “helps develop your brand and your identity. It is a wonderful way for people to know what you do, who you are, what you stand for, and your views and opinions on various topics.”

On the career front, social media “can connect you to leaders in the community so that they know who you are and what you are accomplishing. So when time comes for you to move on, people within this community will know who you are and what you’re known for at a national level,” said Dr. Wray, who is also deputy digital media editor for the Journal of Hospital Medicine.

Sharing on social media – and Twitter in particular – for the medical profession is focused mainly on dissemination of information, engaging in communities, and networking beyond your institution. The three presenters shared tips of the trade during the session, such as how to boost exposure to a tweet by including hashtags, posting photos, and sharing links. To overcome time commitment barriers, tie your Twitter contributions to something you are doing already, said Dr. Arora, associate chief medical officer-clinical learning environment at the University of Chicago.

A presence on social media isn’t just a tool to boost your own profile, Dr. Wray said. It also helps you stay on top of medical news. “There is so much information and new data coming out nowadays, it can be hard to keep up,” he said. “A properly curated social media feed can help a busy clinician stay on top of what is really important. This is an invaluable skill for the modern hospitalist.”

But be careful how much you disclose on social media about yourself and, especially, other people. “A good rule of thumb is: Don’t put anything online that you wouldn’t want your mother to read,” Dr. Chopra said. “As well, sharing any personal or patient information without understanding your institution’s guidelines or obtaining explicit permission is a general no-no,” he said.

“Also, many employers look at social media profiles before they hire people. We certainly do so when we are looking at various individuals. We often call this a ‘Google biopsy.’ ”

Randy Dotinga contributed to this report.

Social media can be more than a tool to connect with friends and family, said Vineet Chopra, MD, MBBS, FHM, Charlie Wray, DO, and Vineet Arora, MD, MAPP, MHM, at Monday’s “Tweet Your Way to the Top? Social Media as a Career Development Tool in Hospital Medicine” session.

Online outreach can play crucial roles in everything from continuing education and research to networking and career advancement, but most of the conversations in medicine are really focused in the Twittersphere, the three hospitalists said.

“Social media has allowed me to connect with leaders in hospital medicine and many other medical communities,” said Dr. Wray, an assistant professor of medicine at the University of California, San Francisco. “It has allowed me to share my work and success with the hospitalist community in addition to highlighting my trainees’ and colleagues’ successes. My engagement has created opportunities to get involved with projects that I could never have previously imagined. And it has extended my networking circle and made annual gatherings like the SHM Annual Conference even more beneficial and high yield for my career.”

For session copresenter Dr. Chopra, associate professor and chief of the division of hospital medicine at the University of Michigan, Ann Arbor, social media “helps develop your brand and your identity. It is a wonderful way for people to know what you do, who you are, what you stand for, and your views and opinions on various topics.”

On the career front, social media “can connect you to leaders in the community so that they know who you are and what you are accomplishing. So when time comes for you to move on, people within this community will know who you are and what you’re known for at a national level,” said Dr. Wray, who is also deputy digital media editor for the Journal of Hospital Medicine.

Sharing on social media – and Twitter in particular – for the medical profession is focused mainly on dissemination of information, engaging in communities, and networking beyond your institution. The three presenters shared tips of the trade during the session, such as how to boost exposure to a tweet by including hashtags, posting photos, and sharing links. To overcome time commitment barriers, tie your Twitter contributions to something you are doing already, said Dr. Arora, associate chief medical officer-clinical learning environment at the University of Chicago.

A presence on social media isn’t just a tool to boost your own profile, Dr. Wray said. It also helps you stay on top of medical news. “There is so much information and new data coming out nowadays, it can be hard to keep up,” he said. “A properly curated social media feed can help a busy clinician stay on top of what is really important. This is an invaluable skill for the modern hospitalist.”

But be careful how much you disclose on social media about yourself and, especially, other people. “A good rule of thumb is: Don’t put anything online that you wouldn’t want your mother to read,” Dr. Chopra said. “As well, sharing any personal or patient information without understanding your institution’s guidelines or obtaining explicit permission is a general no-no,” he said.

“Also, many employers look at social media profiles before they hire people. We certainly do so when we are looking at various individuals. We often call this a ‘Google biopsy.’ ”

Randy Dotinga contributed to this report.

Social media can be more than a tool to connect with friends and family, said Vineet Chopra, MD, MBBS, FHM, Charlie Wray, DO, and Vineet Arora, MD, MAPP, MHM, at Monday’s “Tweet Your Way to the Top? Social Media as a Career Development Tool in Hospital Medicine” session.

Online outreach can play crucial roles in everything from continuing education and research to networking and career advancement, but most of the conversations in medicine are really focused in the Twittersphere, the three hospitalists said.

“Social media has allowed me to connect with leaders in hospital medicine and many other medical communities,” said Dr. Wray, an assistant professor of medicine at the University of California, San Francisco. “It has allowed me to share my work and success with the hospitalist community in addition to highlighting my trainees’ and colleagues’ successes. My engagement has created opportunities to get involved with projects that I could never have previously imagined. And it has extended my networking circle and made annual gatherings like the SHM Annual Conference even more beneficial and high yield for my career.”

For session copresenter Dr. Chopra, associate professor and chief of the division of hospital medicine at the University of Michigan, Ann Arbor, social media “helps develop your brand and your identity. It is a wonderful way for people to know what you do, who you are, what you stand for, and your views and opinions on various topics.”

On the career front, social media “can connect you to leaders in the community so that they know who you are and what you are accomplishing. So when time comes for you to move on, people within this community will know who you are and what you’re known for at a national level,” said Dr. Wray, who is also deputy digital media editor for the Journal of Hospital Medicine.

Sharing on social media – and Twitter in particular – for the medical profession is focused mainly on dissemination of information, engaging in communities, and networking beyond your institution. The three presenters shared tips of the trade during the session, such as how to boost exposure to a tweet by including hashtags, posting photos, and sharing links. To overcome time commitment barriers, tie your Twitter contributions to something you are doing already, said Dr. Arora, associate chief medical officer-clinical learning environment at the University of Chicago.

A presence on social media isn’t just a tool to boost your own profile, Dr. Wray said. It also helps you stay on top of medical news. “There is so much information and new data coming out nowadays, it can be hard to keep up,” he said. “A properly curated social media feed can help a busy clinician stay on top of what is really important. This is an invaluable skill for the modern hospitalist.”

But be careful how much you disclose on social media about yourself and, especially, other people. “A good rule of thumb is: Don’t put anything online that you wouldn’t want your mother to read,” Dr. Chopra said. “As well, sharing any personal or patient information without understanding your institution’s guidelines or obtaining explicit permission is a general no-no,” he said.

“Also, many employers look at social media profiles before they hire people. We certainly do so when we are looking at various individuals. We often call this a ‘Google biopsy.’ ”

Randy Dotinga contributed to this report.

Physicians have had diverse patients as long as there have been physicians (and patients). But diversity among health professionals remains elusive.

Can we do better? Absolutely, says a team of experts who will offer perspective to colleagues in a Wednesday morning session titled, “Best Practices and Tips for Developing Diversity in a Hospitalist Group.”

“The goals of our session are to review best practices for recruiting and retaining a diverse health care workforce, discuss strategies for dealing with implicit and explicit bias, and identify ways in which we can achieve common goals when working across cultures,” said hospitalist Amira del Pino-Jones, MD, assistant professor of medicine at the University of Colorado at Denver, Aurora, and director of the CU Hospitalist Scholars Program.

“Those who are interested in achieving excellence in hospital medicine through prioritizing diversity and equity efforts within their divisions, departments, and groups should attend,” said Dr. del Pino-Jones, who will be one of the speakers at the session.

Why is diversity important in hospital medicine? “Studies have shown that diversity enhances learning and work environments, promotes innovation, broadens research agendas, and improves the quality of care we provide for patients,” Dr. del Pino-Jones said. “In short, it is central to achieving excellence in hospital medicine.”

The session will focus on diverse groups, which have been historically underrepresented or discriminated against in medicine, including racial and ethnic minorities, women, LGBTQ+ individuals, and those with disabilities.

All speakers at the session are physicians, and each has seen or experienced challenges in diversifying their groups and divisions. “We hope to share our experiences, what we have learned, and ways to approach each of these issues. We also are hoping to hear from others and come up with new ways to approach these issues as a collective,” Dr. del Pino-Jones said.

Women and members of minority groups often have small numbers in their hospital medicine workplaces, especially in higher-level positions, and have trouble developing the critical mass to make progress on the diversity front, she said. Even when leaders recognize the importance of a diverse workforce, she said, “there is often a disconnect between motivation for increasing diversity and the ability to develop tangible, evidence-based methods that can be used to increase diversity.”

The session will tackle more than diversity at the workplace. Speakers also will discuss the relationship between medical professionals and patients.

“We will focus on the importance of inclusion and belonging, both of which are essential for creating a positive climate for all individuals,” Dr. del Pino-Jones said. “We will also discuss ways in which to cultivate cultural intelligence and enhance cross-cultural interactions between patients and providers. And we’ll look at ways to reduce and/or mitigate implicit and explicit bias in medicine.”

Dr. del Pino-Jones has no relevant disclosures.
 

Best Practices and Tips
for Developing Diversity in a Hospitalist Group
Wednesday, 10 - 11:30 a.m.
Potomac 4-6

Physicians have had diverse patients as long as there have been physicians (and patients). But diversity among health professionals remains elusive.

Can we do better? Absolutely, says a team of experts who will offer perspective to colleagues in a Wednesday morning session titled, “Best Practices and Tips for Developing Diversity in a Hospitalist Group.”

“The goals of our session are to review best practices for recruiting and retaining a diverse health care workforce, discuss strategies for dealing with implicit and explicit bias, and identify ways in which we can achieve common goals when working across cultures,” said hospitalist Amira del Pino-Jones, MD, assistant professor of medicine at the University of Colorado at Denver, Aurora, and director of the CU Hospitalist Scholars Program.

“Those who are interested in achieving excellence in hospital medicine through prioritizing diversity and equity efforts within their divisions, departments, and groups should attend,” said Dr. del Pino-Jones, who will be one of the speakers at the session.

Why is diversity important in hospital medicine? “Studies have shown that diversity enhances learning and work environments, promotes innovation, broadens research agendas, and improves the quality of care we provide for patients,” Dr. del Pino-Jones said. “In short, it is central to achieving excellence in hospital medicine.”

The session will focus on diverse groups, which have been historically underrepresented or discriminated against in medicine, including racial and ethnic minorities, women, LGBTQ+ individuals, and those with disabilities.

All speakers at the session are physicians, and each has seen or experienced challenges in diversifying their groups and divisions. “We hope to share our experiences, what we have learned, and ways to approach each of these issues. We also are hoping to hear from others and come up with new ways to approach these issues as a collective,” Dr. del Pino-Jones said.

Women and members of minority groups often have small numbers in their hospital medicine workplaces, especially in higher-level positions, and have trouble developing the critical mass to make progress on the diversity front, she said. Even when leaders recognize the importance of a diverse workforce, she said, “there is often a disconnect between motivation for increasing diversity and the ability to develop tangible, evidence-based methods that can be used to increase diversity.”

The session will tackle more than diversity at the workplace. Speakers also will discuss the relationship between medical professionals and patients.

“We will focus on the importance of inclusion and belonging, both of which are essential for creating a positive climate for all individuals,” Dr. del Pino-Jones said. “We will also discuss ways in which to cultivate cultural intelligence and enhance cross-cultural interactions between patients and providers. And we’ll look at ways to reduce and/or mitigate implicit and explicit bias in medicine.”

Dr. del Pino-Jones has no relevant disclosures.
 

Best Practices and Tips
for Developing Diversity in a Hospitalist Group
Wednesday, 10 - 11:30 a.m.
Potomac 4-6

Physicians have had diverse patients as long as there have been physicians (and patients). But diversity among health professionals remains elusive.

Can we do better? Absolutely, says a team of experts who will offer perspective to colleagues in a Wednesday morning session titled, “Best Practices and Tips for Developing Diversity in a Hospitalist Group.”

“The goals of our session are to review best practices for recruiting and retaining a diverse health care workforce, discuss strategies for dealing with implicit and explicit bias, and identify ways in which we can achieve common goals when working across cultures,” said hospitalist Amira del Pino-Jones, MD, assistant professor of medicine at the University of Colorado at Denver, Aurora, and director of the CU Hospitalist Scholars Program.

“Those who are interested in achieving excellence in hospital medicine through prioritizing diversity and equity efforts within their divisions, departments, and groups should attend,” said Dr. del Pino-Jones, who will be one of the speakers at the session.

Why is diversity important in hospital medicine? “Studies have shown that diversity enhances learning and work environments, promotes innovation, broadens research agendas, and improves the quality of care we provide for patients,” Dr. del Pino-Jones said. “In short, it is central to achieving excellence in hospital medicine.”

The session will focus on diverse groups, which have been historically underrepresented or discriminated against in medicine, including racial and ethnic minorities, women, LGBTQ+ individuals, and those with disabilities.

All speakers at the session are physicians, and each has seen or experienced challenges in diversifying their groups and divisions. “We hope to share our experiences, what we have learned, and ways to approach each of these issues. We also are hoping to hear from others and come up with new ways to approach these issues as a collective,” Dr. del Pino-Jones said.

Women and members of minority groups often have small numbers in their hospital medicine workplaces, especially in higher-level positions, and have trouble developing the critical mass to make progress on the diversity front, she said. Even when leaders recognize the importance of a diverse workforce, she said, “there is often a disconnect between motivation for increasing diversity and the ability to develop tangible, evidence-based methods that can be used to increase diversity.”

The session will tackle more than diversity at the workplace. Speakers also will discuss the relationship between medical professionals and patients.

“We will focus on the importance of inclusion and belonging, both of which are essential for creating a positive climate for all individuals,” Dr. del Pino-Jones said. “We will also discuss ways in which to cultivate cultural intelligence and enhance cross-cultural interactions between patients and providers. And we’ll look at ways to reduce and/or mitigate implicit and explicit bias in medicine.”

Dr. del Pino-Jones has no relevant disclosures.
 

Best Practices and Tips
for Developing Diversity in a Hospitalist Group
Wednesday, 10 - 11:30 a.m.
Potomac 4-6

A few lucky hospitalists had the chance to compete for dedicated consultation time from experienced hospital medicine mentors during the SHM Annual Conference’s first Research Shark Tank.

Lou Ferraro/Park South Photography

During the Monday afternoon session, four hospitalist projects were each presented in a 5-minute “pitch” to three senior quality and research leaders in hospital medicine who served as the “sharks.” These pitches were followed by 7 minutes of moderated questions and feedback from the sharks and the audience. Sharks then “bid” on the projects, offering up to 2 hours of one-on-one consultation during the conference or as needed.

The four projects included a study of the use of off-site scribes listening in to patient/hospitalist interactions to eliminate the need for the doctor to be glued to the computer screen, which was presented by Thea Dalfino, MD, chief of hospital medicine at Albany (N.Y.) Memorial Hospital; a rethinking of medical education to emphasize the role of hospitalists as mentors to individual student “apprentices,” presented by Amulya Nagarur, MD, of the department of medicine at Massachusetts General Hospital, Boston, and Christiana Renner, MD, of University of Texas Southwestern Medical Center, Dallas; and a redesign of patient hospital gowns to optimize, comfort, morale, and functionality, presented by Cheryl Dellasega, PhD, professor of medicine and humanities at Penn State University, Hershey.

The winning project was presented by Meera Udayakumar, MD, medical director at the University of North Carolina REX Healthcare in Raleigh. She discussed “The Equalizer,” a computerized tool to optimize patient distribution among hospitalists in order to balance workflow in a practice.

In discussing the thinking behind this unique session, Luci Leykum, MD, SFHM, chief of the division of general and hospital medicine at the University of Texas, San Antonio, who served as one of the sharks, stated that: “We’ve always tried to do things to promote the pipeline of research in hospital medicine and to raise the visibility of research activities at the annual conference. In the past, we have done one-on-one ‘speed dating’ with mentors, but the research committee thought this format would be more interactive and that audience members could benefit from hearing the discussion.”

The other participating sharks were Andrew Auerbach, MD, MPH, MHM, professor of medicine at the University of California, San Francisco, and former editor of the Journal of Hospital Medicine, and Hardeep Singh, MD, MPH, chief of the health policy, quality, and informatics program at the Center for Innovations in Quality, Effectiveness, and Safety at the Michael E. DeBakey Veterans Affairs Medical Center in Houston.

The selection process for those looking to pitch was rigorous. Projects submitted to the research committee had to focus on research, quality improvement, or medical education and be very specific to the practice of hospital medicine. In addition, the ideas needed to be relatively well developed, ideally with some pilot data. Applicants also needed to address a significant problem in hospital medicine, showcase an innovative approach, and make the case for how their solution would have short- and long-term effects.

Dr. Leykum said she was looking to see whether the pitched projects have clearly articulated questions that are important and interesting and whether the proposed methods would sufficiently answer those questions. She also considered what the implications were if the work was done.

Audience members had a chance to ask questions and, if they were interested, to potentially partner with presenters or adopt similar ideas at their own institutions. Attendees were exposed to innovative ways of solving problems that are common and ideas that have a big impact on the way problems are approached in hospital medicine.

“I think it was a fun, fast, interactive session, and it was interesting to see,” said Dr. Leykum. “Those of us who were the sharks know each other and each other’s work, so that was a fun dynamic.”

A few lucky hospitalists had the chance to compete for dedicated consultation time from experienced hospital medicine mentors during the SHM Annual Conference’s first Research Shark Tank.

Lou Ferraro/Park South Photography

During the Monday afternoon session, four hospitalist projects were each presented in a 5-minute “pitch” to three senior quality and research leaders in hospital medicine who served as the “sharks.” These pitches were followed by 7 minutes of moderated questions and feedback from the sharks and the audience. Sharks then “bid” on the projects, offering up to 2 hours of one-on-one consultation during the conference or as needed.

The four projects included a study of the use of off-site scribes listening in to patient/hospitalist interactions to eliminate the need for the doctor to be glued to the computer screen, which was presented by Thea Dalfino, MD, chief of hospital medicine at Albany (N.Y.) Memorial Hospital; a rethinking of medical education to emphasize the role of hospitalists as mentors to individual student “apprentices,” presented by Amulya Nagarur, MD, of the department of medicine at Massachusetts General Hospital, Boston, and Christiana Renner, MD, of University of Texas Southwestern Medical Center, Dallas; and a redesign of patient hospital gowns to optimize, comfort, morale, and functionality, presented by Cheryl Dellasega, PhD, professor of medicine and humanities at Penn State University, Hershey.

The winning project was presented by Meera Udayakumar, MD, medical director at the University of North Carolina REX Healthcare in Raleigh. She discussed “The Equalizer,” a computerized tool to optimize patient distribution among hospitalists in order to balance workflow in a practice.

In discussing the thinking behind this unique session, Luci Leykum, MD, SFHM, chief of the division of general and hospital medicine at the University of Texas, San Antonio, who served as one of the sharks, stated that: “We’ve always tried to do things to promote the pipeline of research in hospital medicine and to raise the visibility of research activities at the annual conference. In the past, we have done one-on-one ‘speed dating’ with mentors, but the research committee thought this format would be more interactive and that audience members could benefit from hearing the discussion.”

The other participating sharks were Andrew Auerbach, MD, MPH, MHM, professor of medicine at the University of California, San Francisco, and former editor of the Journal of Hospital Medicine, and Hardeep Singh, MD, MPH, chief of the health policy, quality, and informatics program at the Center for Innovations in Quality, Effectiveness, and Safety at the Michael E. DeBakey Veterans Affairs Medical Center in Houston.

The selection process for those looking to pitch was rigorous. Projects submitted to the research committee had to focus on research, quality improvement, or medical education and be very specific to the practice of hospital medicine. In addition, the ideas needed to be relatively well developed, ideally with some pilot data. Applicants also needed to address a significant problem in hospital medicine, showcase an innovative approach, and make the case for how their solution would have short- and long-term effects.

Dr. Leykum said she was looking to see whether the pitched projects have clearly articulated questions that are important and interesting and whether the proposed methods would sufficiently answer those questions. She also considered what the implications were if the work was done.

Audience members had a chance to ask questions and, if they were interested, to potentially partner with presenters or adopt similar ideas at their own institutions. Attendees were exposed to innovative ways of solving problems that are common and ideas that have a big impact on the way problems are approached in hospital medicine.

“I think it was a fun, fast, interactive session, and it was interesting to see,” said Dr. Leykum. “Those of us who were the sharks know each other and each other’s work, so that was a fun dynamic.”

A few lucky hospitalists had the chance to compete for dedicated consultation time from experienced hospital medicine mentors during the SHM Annual Conference’s first Research Shark Tank.

Lou Ferraro/Park South Photography

During the Monday afternoon session, four hospitalist projects were each presented in a 5-minute “pitch” to three senior quality and research leaders in hospital medicine who served as the “sharks.” These pitches were followed by 7 minutes of moderated questions and feedback from the sharks and the audience. Sharks then “bid” on the projects, offering up to 2 hours of one-on-one consultation during the conference or as needed.

The four projects included a study of the use of off-site scribes listening in to patient/hospitalist interactions to eliminate the need for the doctor to be glued to the computer screen, which was presented by Thea Dalfino, MD, chief of hospital medicine at Albany (N.Y.) Memorial Hospital; a rethinking of medical education to emphasize the role of hospitalists as mentors to individual student “apprentices,” presented by Amulya Nagarur, MD, of the department of medicine at Massachusetts General Hospital, Boston, and Christiana Renner, MD, of University of Texas Southwestern Medical Center, Dallas; and a redesign of patient hospital gowns to optimize, comfort, morale, and functionality, presented by Cheryl Dellasega, PhD, professor of medicine and humanities at Penn State University, Hershey.

The winning project was presented by Meera Udayakumar, MD, medical director at the University of North Carolina REX Healthcare in Raleigh. She discussed “The Equalizer,” a computerized tool to optimize patient distribution among hospitalists in order to balance workflow in a practice.

In discussing the thinking behind this unique session, Luci Leykum, MD, SFHM, chief of the division of general and hospital medicine at the University of Texas, San Antonio, who served as one of the sharks, stated that: “We’ve always tried to do things to promote the pipeline of research in hospital medicine and to raise the visibility of research activities at the annual conference. In the past, we have done one-on-one ‘speed dating’ with mentors, but the research committee thought this format would be more interactive and that audience members could benefit from hearing the discussion.”

The other participating sharks were Andrew Auerbach, MD, MPH, MHM, professor of medicine at the University of California, San Francisco, and former editor of the Journal of Hospital Medicine, and Hardeep Singh, MD, MPH, chief of the health policy, quality, and informatics program at the Center for Innovations in Quality, Effectiveness, and Safety at the Michael E. DeBakey Veterans Affairs Medical Center in Houston.

The selection process for those looking to pitch was rigorous. Projects submitted to the research committee had to focus on research, quality improvement, or medical education and be very specific to the practice of hospital medicine. In addition, the ideas needed to be relatively well developed, ideally with some pilot data. Applicants also needed to address a significant problem in hospital medicine, showcase an innovative approach, and make the case for how their solution would have short- and long-term effects.

Dr. Leykum said she was looking to see whether the pitched projects have clearly articulated questions that are important and interesting and whether the proposed methods would sufficiently answer those questions. She also considered what the implications were if the work was done.

Audience members had a chance to ask questions and, if they were interested, to potentially partner with presenters or adopt similar ideas at their own institutions. Attendees were exposed to innovative ways of solving problems that are common and ideas that have a big impact on the way problems are approached in hospital medicine.

“I think it was a fun, fast, interactive session, and it was interesting to see,” said Dr. Leykum. “Those of us who were the sharks know each other and each other’s work, so that was a fun dynamic.”

Chapter Excellence Awards

The Society of Hospital Medicine is proud to recognize its chapters for their hard work and dedication through Chapter Excellence Awards. Each year, chapters strive to demonstrate growth, sustainability, and innovation within their activities, which are then recognized at SHM’s annual conference.

Please join SHM in congratulating the following chapters on their year of success in 2018!

Platinum Chapters: Iowa; Knoxville; Maryland; Michigan; Minnesota; New Mexico; North Carolina Triangle; Pacific Northwest; Southwest Florida; Wiregrass.

Gold Chapters: Houston; NYC/Westchester; Piedmont Triad; San Francisco Bay Area

Silver Chapters: Boston/Eastern Massachusetts; Charlotte Metro Area; Gulf States; Hampton Roads; Kentucky; Maine; Nebraska; North Jersey; Rocky Mountain; South Central Pennsylvania; South Texas; St. Louis.
 

Outstanding Chapter of the Year

Michigan. The Outstanding Chapter of the Year Award goes to one chapter that exemplifies high performance, going above and beyond the basic chapter requirements. The recipient of the Outstanding Chapter of the Year Award for 2018 is the Michigan chapter of SHM.

The Michigan chapter continues to embrace the mission of our society and nurtures a vibrant, multidisciplinary membership. It is currently the largest chapter in the program, representing more than 750 SHM members.

Using a technology-enabled platform, the Michigan chapter has expanded its meetings to four different sites, leveraging expertise from across the state. The chapter recently held its largest meeting focused on provider burnout, with more than 100 attendees across four different sites. It featured a main speaker as well as a multidisciplinary panel of leaders from eight different health systems.

The chapter has successfully incorporated advocacy into its annual planning and actively responds to new legislation affecting hospital medicine. It continues to be an active and valued member of the Michigan medical community and the SHM chapter community at large.

In addition to the service to members, the chapter strives to serve the SHM chapter community at large by collaborating and sharing best practices.

The chapter’s level of originality is not only a benefit to the chapter, but also to SHM’s Chapter program as a whole. Congratulations to the Michigan chapter on being named the Outstanding Chapter of 2018.

Rising Star Chapter

Knoxville. The Rising Star Chapter Award goes to one chapter that has been active for 2 years or less and in the past 12 months has made improvements to its leadership, stability and growth, and membership.

The recipient of the Rising Star Chapter Award for 2018 is the Knoxville (Tenn.) Chapter of SHM, which has made significant strides since its launch in the spring of 2017. The chapter assembled a group of local hospitalists from Knoxville and the surrounding region to encourage participation and drive quality initiatives in area hospitals.

The Knoxville chapter developed a leadership framework, including officers and board members, and just completed its first formal chapter leadership election. In 2018, the chapter held four meetings, including an event steered toward residents and students. Membership in the chapter has grown by more than 20% since inception. The chapter has engaged in statewide quality initiatives with the Tennessee Hospital Association and has engaged with other chapters across the state.

The Knoxville’s Chapter is an active, enthusiastic organization that is rapidly growing and thriving. Congratulations to the Knoxville chapter on being named the Rising Star Chapter for 2018.
 

Student Hospitalist Scholar Grant recipients

SHM is proud to acknowledge the latest winners of its Student Hospitalist Scholar Grant. These medical students were awarded grants to complete scholarly work with an active SHM mentor in a project related to patient safety, quality improvement, or other areas relevant to the field of hospital medicine.

Sandeep Bala
University of Chicago Pritzker School of Medicine
Poster 382 – The impact of plain language open medical notes on patient activation
Location: Denver (Colo.) Health Hospital

Monisha Bhatia
Vanderbilt University School of Medicine
Poster 23 – Using electronic medical record phenotypic data to predict discharge destination
Location: Vanderbilt University Medical Center, Nashville, Tenn.

Maximilian Hemmrich
University of Chicago Pritzker School of Medicine
Oral presentation, 11:45 a.m. – Noon, Tuesday, March 26
Project: Derivation and validation of a COPD readmission risk prediction tool
Location: University of Chicago

Ilana Scandariato Lavina
Weill Cornell Medical College
Poster 424 – Understanding the experience of the long-term hospitalized patient with provider fragmentation: A qualitative study

Yun Li
Geisel School of Medicine at Dartmouth
Poster 320 – Developing and implementing clinical pathway(s) for hospitalized injection drug users due to injection-related infection sequelae
Location: Dartmouth-Hitchcock Medical Center, Lebanon, N.H.

Resident Travel Grant recipients

We would like to congratulate the latest winners of SHM’s Resident Travel Grant. To qualify for this award, residents submitted an abstract for consideration in the RIV session at HM19 as first authors. Each of them produced outstanding work worthy of recognition:

Daniel Choi, MD – New York Presbyterian Hospital–Weill Cornell
Poster 277 – Improving rates of appropriate ICD deactivation discussions in admitted patients made DNR and/or comfort care

Armond Esmaili, MD – University of California, San Francisco, and the San Francisco VA Medical Center
Poster 649 – Early isolated hypotension, a sepsis “Canary in the Coal Mine”: Timing of antibiotics according to hypotension identifies different sepsis subtypes at differing risks of treatment delay
Poster 8 – Who’s waiting? Predictors of antibiotic delays in hypotensive patients with sepsis

Geoffroy Fauchet, MD – University of Colorado at Denver, Aurora – Rocky Mountain Regional VA Medical Center
Poster 288 – Tackling opioid prescriptions through resident engagement

Nick Zessis, MD – Washington University School of Medicine, St. Louis Children’s Hospital
Poster 101 – Smartphone-based teaching app increases frequency of residents teaching medical students

David Sterken, MD – University of California, San Francisco
Poster 230 – Safety of antimotility agent use during treatment for Clostridioides difficile infection in malignant hepatology patients

James Anstey, MD – University of California, San Francisco
Poster 57 – The POCUS supervision safety gap: Attending physician knowledge in point-of-care ultrasound lags behind that of internal medicine residents
Poster 147 – Association of post paracentesis albumin dosage and acute kidney injury in hospitalized patients

Nicholas Iverson, MD – University of California, San Francisco
Poster 408 – Implications of using an alternative measure to assess opiate days supplied at discharge

Marwah Shahid, MD – Baylor College of Medicine, Houston
Poster 22 – Topic modeling to evaluate hospital Google reviews

Abhishek Chaturvedi, MD – Allegheny Health Network, Pittsburgh
Poster 152 – Association of socioeconomic and racial disparities with health care utilization and outcomes in opioid overdose–related hospitalizations in the United States: Insights from National Inpatient Sample from 2012 through 2014

Pratyusha Tirumanisetty, MD – Unity Hospital, Rochester (N.Y.) Regional Health
Poster 9 – Does hospital-onset Clostridium difficile infection increase the risk of hospital discharge to skilled nursing facilities? A retrospective case-control study from a community hospital.

Chapter Excellence Awards

The Society of Hospital Medicine is proud to recognize its chapters for their hard work and dedication through Chapter Excellence Awards. Each year, chapters strive to demonstrate growth, sustainability, and innovation within their activities, which are then recognized at SHM’s annual conference.

Please join SHM in congratulating the following chapters on their year of success in 2018!

Platinum Chapters: Iowa; Knoxville; Maryland; Michigan; Minnesota; New Mexico; North Carolina Triangle; Pacific Northwest; Southwest Florida; Wiregrass.

Gold Chapters: Houston; NYC/Westchester; Piedmont Triad; San Francisco Bay Area

Silver Chapters: Boston/Eastern Massachusetts; Charlotte Metro Area; Gulf States; Hampton Roads; Kentucky; Maine; Nebraska; North Jersey; Rocky Mountain; South Central Pennsylvania; South Texas; St. Louis.
 

Outstanding Chapter of the Year

Michigan. The Outstanding Chapter of the Year Award goes to one chapter that exemplifies high performance, going above and beyond the basic chapter requirements. The recipient of the Outstanding Chapter of the Year Award for 2018 is the Michigan chapter of SHM.

The Michigan chapter continues to embrace the mission of our society and nurtures a vibrant, multidisciplinary membership. It is currently the largest chapter in the program, representing more than 750 SHM members.

Using a technology-enabled platform, the Michigan chapter has expanded its meetings to four different sites, leveraging expertise from across the state. The chapter recently held its largest meeting focused on provider burnout, with more than 100 attendees across four different sites. It featured a main speaker as well as a multidisciplinary panel of leaders from eight different health systems.

The chapter has successfully incorporated advocacy into its annual planning and actively responds to new legislation affecting hospital medicine. It continues to be an active and valued member of the Michigan medical community and the SHM chapter community at large.

In addition to the service to members, the chapter strives to serve the SHM chapter community at large by collaborating and sharing best practices.

The chapter’s level of originality is not only a benefit to the chapter, but also to SHM’s Chapter program as a whole. Congratulations to the Michigan chapter on being named the Outstanding Chapter of 2018.

Rising Star Chapter

Knoxville. The Rising Star Chapter Award goes to one chapter that has been active for 2 years or less and in the past 12 months has made improvements to its leadership, stability and growth, and membership.

The recipient of the Rising Star Chapter Award for 2018 is the Knoxville (Tenn.) Chapter of SHM, which has made significant strides since its launch in the spring of 2017. The chapter assembled a group of local hospitalists from Knoxville and the surrounding region to encourage participation and drive quality initiatives in area hospitals.

The Knoxville chapter developed a leadership framework, including officers and board members, and just completed its first formal chapter leadership election. In 2018, the chapter held four meetings, including an event steered toward residents and students. Membership in the chapter has grown by more than 20% since inception. The chapter has engaged in statewide quality initiatives with the Tennessee Hospital Association and has engaged with other chapters across the state.

The Knoxville’s Chapter is an active, enthusiastic organization that is rapidly growing and thriving. Congratulations to the Knoxville chapter on being named the Rising Star Chapter for 2018.
 

Student Hospitalist Scholar Grant recipients

SHM is proud to acknowledge the latest winners of its Student Hospitalist Scholar Grant. These medical students were awarded grants to complete scholarly work with an active SHM mentor in a project related to patient safety, quality improvement, or other areas relevant to the field of hospital medicine.

Sandeep Bala
University of Chicago Pritzker School of Medicine
Poster 382 – The impact of plain language open medical notes on patient activation
Location: Denver (Colo.) Health Hospital

Monisha Bhatia
Vanderbilt University School of Medicine
Poster 23 – Using electronic medical record phenotypic data to predict discharge destination
Location: Vanderbilt University Medical Center, Nashville, Tenn.

Maximilian Hemmrich
University of Chicago Pritzker School of Medicine
Oral presentation, 11:45 a.m. – Noon, Tuesday, March 26
Project: Derivation and validation of a COPD readmission risk prediction tool
Location: University of Chicago

Ilana Scandariato Lavina
Weill Cornell Medical College
Poster 424 – Understanding the experience of the long-term hospitalized patient with provider fragmentation: A qualitative study

Yun Li
Geisel School of Medicine at Dartmouth
Poster 320 – Developing and implementing clinical pathway(s) for hospitalized injection drug users due to injection-related infection sequelae
Location: Dartmouth-Hitchcock Medical Center, Lebanon, N.H.

Resident Travel Grant recipients

We would like to congratulate the latest winners of SHM’s Resident Travel Grant. To qualify for this award, residents submitted an abstract for consideration in the RIV session at HM19 as first authors. Each of them produced outstanding work worthy of recognition:

Daniel Choi, MD – New York Presbyterian Hospital–Weill Cornell
Poster 277 – Improving rates of appropriate ICD deactivation discussions in admitted patients made DNR and/or comfort care

Armond Esmaili, MD – University of California, San Francisco, and the San Francisco VA Medical Center
Poster 649 – Early isolated hypotension, a sepsis “Canary in the Coal Mine”: Timing of antibiotics according to hypotension identifies different sepsis subtypes at differing risks of treatment delay
Poster 8 – Who’s waiting? Predictors of antibiotic delays in hypotensive patients with sepsis

Geoffroy Fauchet, MD – University of Colorado at Denver, Aurora – Rocky Mountain Regional VA Medical Center
Poster 288 – Tackling opioid prescriptions through resident engagement

Nick Zessis, MD – Washington University School of Medicine, St. Louis Children’s Hospital
Poster 101 – Smartphone-based teaching app increases frequency of residents teaching medical students

David Sterken, MD – University of California, San Francisco
Poster 230 – Safety of antimotility agent use during treatment for Clostridioides difficile infection in malignant hepatology patients

James Anstey, MD – University of California, San Francisco
Poster 57 – The POCUS supervision safety gap: Attending physician knowledge in point-of-care ultrasound lags behind that of internal medicine residents
Poster 147 – Association of post paracentesis albumin dosage and acute kidney injury in hospitalized patients

Nicholas Iverson, MD – University of California, San Francisco
Poster 408 – Implications of using an alternative measure to assess opiate days supplied at discharge

Marwah Shahid, MD – Baylor College of Medicine, Houston
Poster 22 – Topic modeling to evaluate hospital Google reviews

Abhishek Chaturvedi, MD – Allegheny Health Network, Pittsburgh
Poster 152 – Association of socioeconomic and racial disparities with health care utilization and outcomes in opioid overdose–related hospitalizations in the United States: Insights from National Inpatient Sample from 2012 through 2014

Pratyusha Tirumanisetty, MD – Unity Hospital, Rochester (N.Y.) Regional Health
Poster 9 – Does hospital-onset Clostridium difficile infection increase the risk of hospital discharge to skilled nursing facilities? A retrospective case-control study from a community hospital.

Chapter Excellence Awards

The Society of Hospital Medicine is proud to recognize its chapters for their hard work and dedication through Chapter Excellence Awards. Each year, chapters strive to demonstrate growth, sustainability, and innovation within their activities, which are then recognized at SHM’s annual conference.

Please join SHM in congratulating the following chapters on their year of success in 2018!

Platinum Chapters: Iowa; Knoxville; Maryland; Michigan; Minnesota; New Mexico; North Carolina Triangle; Pacific Northwest; Southwest Florida; Wiregrass.

Gold Chapters: Houston; NYC/Westchester; Piedmont Triad; San Francisco Bay Area

Silver Chapters: Boston/Eastern Massachusetts; Charlotte Metro Area; Gulf States; Hampton Roads; Kentucky; Maine; Nebraska; North Jersey; Rocky Mountain; South Central Pennsylvania; South Texas; St. Louis.
 

Outstanding Chapter of the Year

Michigan. The Outstanding Chapter of the Year Award goes to one chapter that exemplifies high performance, going above and beyond the basic chapter requirements. The recipient of the Outstanding Chapter of the Year Award for 2018 is the Michigan chapter of SHM.

The Michigan chapter continues to embrace the mission of our society and nurtures a vibrant, multidisciplinary membership. It is currently the largest chapter in the program, representing more than 750 SHM members.

Using a technology-enabled platform, the Michigan chapter has expanded its meetings to four different sites, leveraging expertise from across the state. The chapter recently held its largest meeting focused on provider burnout, with more than 100 attendees across four different sites. It featured a main speaker as well as a multidisciplinary panel of leaders from eight different health systems.

The chapter has successfully incorporated advocacy into its annual planning and actively responds to new legislation affecting hospital medicine. It continues to be an active and valued member of the Michigan medical community and the SHM chapter community at large.

In addition to the service to members, the chapter strives to serve the SHM chapter community at large by collaborating and sharing best practices.

The chapter’s level of originality is not only a benefit to the chapter, but also to SHM’s Chapter program as a whole. Congratulations to the Michigan chapter on being named the Outstanding Chapter of 2018.

Rising Star Chapter

Knoxville. The Rising Star Chapter Award goes to one chapter that has been active for 2 years or less and in the past 12 months has made improvements to its leadership, stability and growth, and membership.

The recipient of the Rising Star Chapter Award for 2018 is the Knoxville (Tenn.) Chapter of SHM, which has made significant strides since its launch in the spring of 2017. The chapter assembled a group of local hospitalists from Knoxville and the surrounding region to encourage participation and drive quality initiatives in area hospitals.

The Knoxville chapter developed a leadership framework, including officers and board members, and just completed its first formal chapter leadership election. In 2018, the chapter held four meetings, including an event steered toward residents and students. Membership in the chapter has grown by more than 20% since inception. The chapter has engaged in statewide quality initiatives with the Tennessee Hospital Association and has engaged with other chapters across the state.

The Knoxville’s Chapter is an active, enthusiastic organization that is rapidly growing and thriving. Congratulations to the Knoxville chapter on being named the Rising Star Chapter for 2018.
 

Student Hospitalist Scholar Grant recipients

SHM is proud to acknowledge the latest winners of its Student Hospitalist Scholar Grant. These medical students were awarded grants to complete scholarly work with an active SHM mentor in a project related to patient safety, quality improvement, or other areas relevant to the field of hospital medicine.

Sandeep Bala
University of Chicago Pritzker School of Medicine
Poster 382 – The impact of plain language open medical notes on patient activation
Location: Denver (Colo.) Health Hospital

Monisha Bhatia
Vanderbilt University School of Medicine
Poster 23 – Using electronic medical record phenotypic data to predict discharge destination
Location: Vanderbilt University Medical Center, Nashville, Tenn.

Maximilian Hemmrich
University of Chicago Pritzker School of Medicine
Oral presentation, 11:45 a.m. – Noon, Tuesday, March 26
Project: Derivation and validation of a COPD readmission risk prediction tool
Location: University of Chicago

Ilana Scandariato Lavina
Weill Cornell Medical College
Poster 424 – Understanding the experience of the long-term hospitalized patient with provider fragmentation: A qualitative study

Yun Li
Geisel School of Medicine at Dartmouth
Poster 320 – Developing and implementing clinical pathway(s) for hospitalized injection drug users due to injection-related infection sequelae
Location: Dartmouth-Hitchcock Medical Center, Lebanon, N.H.

Resident Travel Grant recipients

We would like to congratulate the latest winners of SHM’s Resident Travel Grant. To qualify for this award, residents submitted an abstract for consideration in the RIV session at HM19 as first authors. Each of them produced outstanding work worthy of recognition:

Daniel Choi, MD – New York Presbyterian Hospital–Weill Cornell
Poster 277 – Improving rates of appropriate ICD deactivation discussions in admitted patients made DNR and/or comfort care

Armond Esmaili, MD – University of California, San Francisco, and the San Francisco VA Medical Center
Poster 649 – Early isolated hypotension, a sepsis “Canary in the Coal Mine”: Timing of antibiotics according to hypotension identifies different sepsis subtypes at differing risks of treatment delay
Poster 8 – Who’s waiting? Predictors of antibiotic delays in hypotensive patients with sepsis

Geoffroy Fauchet, MD – University of Colorado at Denver, Aurora – Rocky Mountain Regional VA Medical Center
Poster 288 – Tackling opioid prescriptions through resident engagement

Nick Zessis, MD – Washington University School of Medicine, St. Louis Children’s Hospital
Poster 101 – Smartphone-based teaching app increases frequency of residents teaching medical students

David Sterken, MD – University of California, San Francisco
Poster 230 – Safety of antimotility agent use during treatment for Clostridioides difficile infection in malignant hepatology patients

James Anstey, MD – University of California, San Francisco
Poster 57 – The POCUS supervision safety gap: Attending physician knowledge in point-of-care ultrasound lags behind that of internal medicine residents
Poster 147 – Association of post paracentesis albumin dosage and acute kidney injury in hospitalized patients

Nicholas Iverson, MD – University of California, San Francisco
Poster 408 – Implications of using an alternative measure to assess opiate days supplied at discharge

Marwah Shahid, MD – Baylor College of Medicine, Houston
Poster 22 – Topic modeling to evaluate hospital Google reviews

Abhishek Chaturvedi, MD – Allegheny Health Network, Pittsburgh
Poster 152 – Association of socioeconomic and racial disparities with health care utilization and outcomes in opioid overdose–related hospitalizations in the United States: Insights from National Inpatient Sample from 2012 through 2014

Pratyusha Tirumanisetty, MD – Unity Hospital, Rochester (N.Y.) Regional Health
Poster 9 – Does hospital-onset Clostridium difficile infection increase the risk of hospital discharge to skilled nursing facilities? A retrospective case-control study from a community hospital.