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The Resident and Student Luncheon exposes future hospitalists to professional possibilities

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The Resident and Student Luncheon provides future hospitalists the opportunity to meet current hospitalists and learn about various fields within hospital medicine.

“Trainees can ask hospitalists who are administrative leaders, QI gurus, medical educators, global health hospitalists, pediatricians, and researchers about their day-to-day life and what they love about their careers,” stated Darlene B. Tad-y, MD, SFHM, who is an associate professor and hospitalist at the University of Colorado Hospital, Denver. “It’s a great way for trainees to build their network in hospital medicine in addition to learning about the diverse careers available in our field.”

Dr. Darlene Tad-y, associate professor and hospitalist at the University of Colorado Hospital, Denver
Dr. Darlene Tad-y

The luncheon is structured in such a way to maximizes attendees’ exposure and interaction with experienced hospitalists. Brian Kwan, MD, FHM, an associate professor of health science at the University of California, San Diego, and a hospitalist, elaborated on the sessions design.

“Each round table features a speaker that will highlight a different topic, including but not limited to medical education, executive leadership, global and rural health, quality improvement, advocacy, and informatics,” said Dr. Kwan.

But the session is not limited to a one-way presentation. “Conversations are facilitated by members of the SHM Physicians in Training (PIT) Committee,” he said. To maximize their exposure, “attendees will have an opportunity to select one table for the main meal and a different one for dessert, so that they have the opportunity to hear from more than one speaker.”

Dr. Brian Kwan, associate professor of health science at University of California San Diego, and a hospitalist.
Dr. Brian Kwan

Dr. Kwan and Dr. Tad-y said they believe that this type of exposure is important in the professional development of medical students and residents.

“We believe it is critical for students and residents to be exposed to hospitalists working at the forefront of our field who inspire and can provide a glimpse at different HM career paths and practices. Invited speakers are selected by the PIT Committee, and the luncheon serves as a launching point for networking and potential mentorship. Engaging residents and students is critical to sustaining our pipeline for future hospitalist leaders,” Dr. Kwan said.

Dr. Tad-y stated that this could be a defining professional moment for many of the attendees. “The resident or student may even meet their next project or career mentor, as well as potential peers or project partners.”

Resident and Student Luncheon
April 9, Monday, 12-1 p.m.

New York/New Orleans Room

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The Resident and Student Luncheon provides future hospitalists the opportunity to meet current hospitalists and learn about various fields within hospital medicine.

“Trainees can ask hospitalists who are administrative leaders, QI gurus, medical educators, global health hospitalists, pediatricians, and researchers about their day-to-day life and what they love about their careers,” stated Darlene B. Tad-y, MD, SFHM, who is an associate professor and hospitalist at the University of Colorado Hospital, Denver. “It’s a great way for trainees to build their network in hospital medicine in addition to learning about the diverse careers available in our field.”

Dr. Darlene Tad-y, associate professor and hospitalist at the University of Colorado Hospital, Denver
Dr. Darlene Tad-y

The luncheon is structured in such a way to maximizes attendees’ exposure and interaction with experienced hospitalists. Brian Kwan, MD, FHM, an associate professor of health science at the University of California, San Diego, and a hospitalist, elaborated on the sessions design.

“Each round table features a speaker that will highlight a different topic, including but not limited to medical education, executive leadership, global and rural health, quality improvement, advocacy, and informatics,” said Dr. Kwan.

But the session is not limited to a one-way presentation. “Conversations are facilitated by members of the SHM Physicians in Training (PIT) Committee,” he said. To maximize their exposure, “attendees will have an opportunity to select one table for the main meal and a different one for dessert, so that they have the opportunity to hear from more than one speaker.”

Dr. Brian Kwan, associate professor of health science at University of California San Diego, and a hospitalist.
Dr. Brian Kwan

Dr. Kwan and Dr. Tad-y said they believe that this type of exposure is important in the professional development of medical students and residents.

“We believe it is critical for students and residents to be exposed to hospitalists working at the forefront of our field who inspire and can provide a glimpse at different HM career paths and practices. Invited speakers are selected by the PIT Committee, and the luncheon serves as a launching point for networking and potential mentorship. Engaging residents and students is critical to sustaining our pipeline for future hospitalist leaders,” Dr. Kwan said.

Dr. Tad-y stated that this could be a defining professional moment for many of the attendees. “The resident or student may even meet their next project or career mentor, as well as potential peers or project partners.”

Resident and Student Luncheon
April 9, Monday, 12-1 p.m.

New York/New Orleans Room

The Resident and Student Luncheon provides future hospitalists the opportunity to meet current hospitalists and learn about various fields within hospital medicine.

“Trainees can ask hospitalists who are administrative leaders, QI gurus, medical educators, global health hospitalists, pediatricians, and researchers about their day-to-day life and what they love about their careers,” stated Darlene B. Tad-y, MD, SFHM, who is an associate professor and hospitalist at the University of Colorado Hospital, Denver. “It’s a great way for trainees to build their network in hospital medicine in addition to learning about the diverse careers available in our field.”

Dr. Darlene Tad-y, associate professor and hospitalist at the University of Colorado Hospital, Denver
Dr. Darlene Tad-y

The luncheon is structured in such a way to maximizes attendees’ exposure and interaction with experienced hospitalists. Brian Kwan, MD, FHM, an associate professor of health science at the University of California, San Diego, and a hospitalist, elaborated on the sessions design.

“Each round table features a speaker that will highlight a different topic, including but not limited to medical education, executive leadership, global and rural health, quality improvement, advocacy, and informatics,” said Dr. Kwan.

But the session is not limited to a one-way presentation. “Conversations are facilitated by members of the SHM Physicians in Training (PIT) Committee,” he said. To maximize their exposure, “attendees will have an opportunity to select one table for the main meal and a different one for dessert, so that they have the opportunity to hear from more than one speaker.”

Dr. Brian Kwan, associate professor of health science at University of California San Diego, and a hospitalist.
Dr. Brian Kwan

Dr. Kwan and Dr. Tad-y said they believe that this type of exposure is important in the professional development of medical students and residents.

“We believe it is critical for students and residents to be exposed to hospitalists working at the forefront of our field who inspire and can provide a glimpse at different HM career paths and practices. Invited speakers are selected by the PIT Committee, and the luncheon serves as a launching point for networking and potential mentorship. Engaging residents and students is critical to sustaining our pipeline for future hospitalist leaders,” Dr. Kwan said.

Dr. Tad-y stated that this could be a defining professional moment for many of the attendees. “The resident or student may even meet their next project or career mentor, as well as potential peers or project partners.”

Resident and Student Luncheon
April 9, Monday, 12-1 p.m.

New York/New Orleans Room

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Fun in the Florida sun

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Chris Harrington knows that not all the benefits of attending the Society of Hospital Medicine’s annual meetings come from the lectures and courses; there is the formation of friendships that endure.

“I am very grateful to SHM for allowing me the opportunity to accompany Bob to their annual conferences and leadership academies over the years,” said Mrs. Harrington, spouse of former SHM president Robert Harrington Jr., MD, SFHM in an interview.

“It truly has been a rewarding experience for me both as a spouse to travel with my husband and spend time with our friends, and as a health care professional to witness the tremendous growth of SHM membership and the educational and networking opportunities it provides to its members. Watching SHM become even more innovative in universally improving patient care has been an amazing experience as well.


“It is through many SHM conferences that Bob and I have met some wonderful people and have formed many lasting friendships that we will be forever grateful for,” she said.

Mrs. Harrington has some suggestions for activities in Orlando, starting with the Walt Disney World Resort theme parks, which are convenient to the meeting headquarters at the Orlando World Center Marriott. Other popular spots for those with kids (or the young at heart) include SeaWorld Orlando, Legoland Florida, and Universal’s Islands of Adventure, notably the Harry Potter and the Forbidden Journey and the Jurassic Park River Adventure attractions.

Within the Orlando World Center Marriott, families can check out the pool complex with its waterslides and slide tower, as well as the kids’ activity center, interactive game room, and table tennis. The resort also offers full-day (10 a.m. to 5 p.m.) or half-day (10 a.m. to 1:30 p.m. or 1:30 p.m. to 5 p.m.) Kid’s World programs and evening Kid’s Night Out programs (6-10 p.m.) for children aged 4-12, so parents get some time to themselves.

For the fitness enthusiasts, “bring your golf clubs, tennis rackets, and running shoes,” Mrs. Harrington said. The resort offers eight tennis courts, volleyball courts, swimming pools for laps, and Hawk’s Landing, a championship golf course that includes a Jack Nicklaus Academy of Golf, should the urge for instruction strike.

 

 


Runners, set your alarms for the 5K SHM Fun Run at 6 a.m. on April 10. The Harringtons said they will sign up and be at the start line after a quick visit to the resort’s in-house Starbucks.

“If you want to unwind after a day of meetings and workshops or rejuvenate after a workout, make an appointment (as soon as possible) at the resort’s full service spa,” Mrs. Harrington advised. Spa services include manicures/pedicures, facials, and even couple’s massages, she noted.

Other activities for individuals and families include ZE Segway Tours, the nearby town of Celebration, and the Basilica of the National Shrine of Mary, Queen of the Universe.

Spouses seeking some shopping during meeting time may enjoy nearby outlet malls, the Florida Mall, and the high-end shops of the Mall at Millenia, Mrs Harrington said. One of her favorite “hidden gems” for out-of-town shopping is Park Avenue in Winter Park, which has many boutiques and restaurants. Mount Dora, a small town once known as the Antiques Capital of Florida, includes a wide variety of specialty shops, she noted, and foodies should explore the East End Market, an Orlando neighborhood market and cultural food hub inspired by Central Florida’s local farmers and food artisans.

When it’s time for dining out in Orlando, Mrs. Harrington recommended the Big Fin Seafood Kitchen, a family-owned upscale casual restaurant serving lobster, snow crabs, fresh raw oysters, sushi rolls, steaks, and pasta with an option for outdoor dining on a covered balcony. Christini’s Ristorante Italiano, the most-awarded fine dining Italian restaurant in Orlando for more than 30 years, is consistently popular, and Vines Grille and Wine Bar, “a gem on Orlando’s Restaurant Row,” Mrs. Harrington said, is a great choice for happy hour and features jazz and blues in the evenings starting about 7 p.m.

Finally, “I would recommend meeting some SHM staff members either at registration or between meetings,” Mrs. Harrington advised. “They have been so welcoming to me over the years and have been a great resource and support system. Also, be open to meeting other spouses at group outings, dinners, or networking events whenever you have the opportunity, as they might become a treasured friend,” she said.
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Chris Harrington knows that not all the benefits of attending the Society of Hospital Medicine’s annual meetings come from the lectures and courses; there is the formation of friendships that endure.

“I am very grateful to SHM for allowing me the opportunity to accompany Bob to their annual conferences and leadership academies over the years,” said Mrs. Harrington, spouse of former SHM president Robert Harrington Jr., MD, SFHM in an interview.

“It truly has been a rewarding experience for me both as a spouse to travel with my husband and spend time with our friends, and as a health care professional to witness the tremendous growth of SHM membership and the educational and networking opportunities it provides to its members. Watching SHM become even more innovative in universally improving patient care has been an amazing experience as well.


“It is through many SHM conferences that Bob and I have met some wonderful people and have formed many lasting friendships that we will be forever grateful for,” she said.

Mrs. Harrington has some suggestions for activities in Orlando, starting with the Walt Disney World Resort theme parks, which are convenient to the meeting headquarters at the Orlando World Center Marriott. Other popular spots for those with kids (or the young at heart) include SeaWorld Orlando, Legoland Florida, and Universal’s Islands of Adventure, notably the Harry Potter and the Forbidden Journey and the Jurassic Park River Adventure attractions.

Within the Orlando World Center Marriott, families can check out the pool complex with its waterslides and slide tower, as well as the kids’ activity center, interactive game room, and table tennis. The resort also offers full-day (10 a.m. to 5 p.m.) or half-day (10 a.m. to 1:30 p.m. or 1:30 p.m. to 5 p.m.) Kid’s World programs and evening Kid’s Night Out programs (6-10 p.m.) for children aged 4-12, so parents get some time to themselves.

For the fitness enthusiasts, “bring your golf clubs, tennis rackets, and running shoes,” Mrs. Harrington said. The resort offers eight tennis courts, volleyball courts, swimming pools for laps, and Hawk’s Landing, a championship golf course that includes a Jack Nicklaus Academy of Golf, should the urge for instruction strike.

 

 


Runners, set your alarms for the 5K SHM Fun Run at 6 a.m. on April 10. The Harringtons said they will sign up and be at the start line after a quick visit to the resort’s in-house Starbucks.

“If you want to unwind after a day of meetings and workshops or rejuvenate after a workout, make an appointment (as soon as possible) at the resort’s full service spa,” Mrs. Harrington advised. Spa services include manicures/pedicures, facials, and even couple’s massages, she noted.

Other activities for individuals and families include ZE Segway Tours, the nearby town of Celebration, and the Basilica of the National Shrine of Mary, Queen of the Universe.

Spouses seeking some shopping during meeting time may enjoy nearby outlet malls, the Florida Mall, and the high-end shops of the Mall at Millenia, Mrs Harrington said. One of her favorite “hidden gems” for out-of-town shopping is Park Avenue in Winter Park, which has many boutiques and restaurants. Mount Dora, a small town once known as the Antiques Capital of Florida, includes a wide variety of specialty shops, she noted, and foodies should explore the East End Market, an Orlando neighborhood market and cultural food hub inspired by Central Florida’s local farmers and food artisans.

When it’s time for dining out in Orlando, Mrs. Harrington recommended the Big Fin Seafood Kitchen, a family-owned upscale casual restaurant serving lobster, snow crabs, fresh raw oysters, sushi rolls, steaks, and pasta with an option for outdoor dining on a covered balcony. Christini’s Ristorante Italiano, the most-awarded fine dining Italian restaurant in Orlando for more than 30 years, is consistently popular, and Vines Grille and Wine Bar, “a gem on Orlando’s Restaurant Row,” Mrs. Harrington said, is a great choice for happy hour and features jazz and blues in the evenings starting about 7 p.m.

Finally, “I would recommend meeting some SHM staff members either at registration or between meetings,” Mrs. Harrington advised. “They have been so welcoming to me over the years and have been a great resource and support system. Also, be open to meeting other spouses at group outings, dinners, or networking events whenever you have the opportunity, as they might become a treasured friend,” she said.

 

Chris Harrington knows that not all the benefits of attending the Society of Hospital Medicine’s annual meetings come from the lectures and courses; there is the formation of friendships that endure.

“I am very grateful to SHM for allowing me the opportunity to accompany Bob to their annual conferences and leadership academies over the years,” said Mrs. Harrington, spouse of former SHM president Robert Harrington Jr., MD, SFHM in an interview.

“It truly has been a rewarding experience for me both as a spouse to travel with my husband and spend time with our friends, and as a health care professional to witness the tremendous growth of SHM membership and the educational and networking opportunities it provides to its members. Watching SHM become even more innovative in universally improving patient care has been an amazing experience as well.


“It is through many SHM conferences that Bob and I have met some wonderful people and have formed many lasting friendships that we will be forever grateful for,” she said.

Mrs. Harrington has some suggestions for activities in Orlando, starting with the Walt Disney World Resort theme parks, which are convenient to the meeting headquarters at the Orlando World Center Marriott. Other popular spots for those with kids (or the young at heart) include SeaWorld Orlando, Legoland Florida, and Universal’s Islands of Adventure, notably the Harry Potter and the Forbidden Journey and the Jurassic Park River Adventure attractions.

Within the Orlando World Center Marriott, families can check out the pool complex with its waterslides and slide tower, as well as the kids’ activity center, interactive game room, and table tennis. The resort also offers full-day (10 a.m. to 5 p.m.) or half-day (10 a.m. to 1:30 p.m. or 1:30 p.m. to 5 p.m.) Kid’s World programs and evening Kid’s Night Out programs (6-10 p.m.) for children aged 4-12, so parents get some time to themselves.

For the fitness enthusiasts, “bring your golf clubs, tennis rackets, and running shoes,” Mrs. Harrington said. The resort offers eight tennis courts, volleyball courts, swimming pools for laps, and Hawk’s Landing, a championship golf course that includes a Jack Nicklaus Academy of Golf, should the urge for instruction strike.

 

 


Runners, set your alarms for the 5K SHM Fun Run at 6 a.m. on April 10. The Harringtons said they will sign up and be at the start line after a quick visit to the resort’s in-house Starbucks.

“If you want to unwind after a day of meetings and workshops or rejuvenate after a workout, make an appointment (as soon as possible) at the resort’s full service spa,” Mrs. Harrington advised. Spa services include manicures/pedicures, facials, and even couple’s massages, she noted.

Other activities for individuals and families include ZE Segway Tours, the nearby town of Celebration, and the Basilica of the National Shrine of Mary, Queen of the Universe.

Spouses seeking some shopping during meeting time may enjoy nearby outlet malls, the Florida Mall, and the high-end shops of the Mall at Millenia, Mrs Harrington said. One of her favorite “hidden gems” for out-of-town shopping is Park Avenue in Winter Park, which has many boutiques and restaurants. Mount Dora, a small town once known as the Antiques Capital of Florida, includes a wide variety of specialty shops, she noted, and foodies should explore the East End Market, an Orlando neighborhood market and cultural food hub inspired by Central Florida’s local farmers and food artisans.

When it’s time for dining out in Orlando, Mrs. Harrington recommended the Big Fin Seafood Kitchen, a family-owned upscale casual restaurant serving lobster, snow crabs, fresh raw oysters, sushi rolls, steaks, and pasta with an option for outdoor dining on a covered balcony. Christini’s Ristorante Italiano, the most-awarded fine dining Italian restaurant in Orlando for more than 30 years, is consistently popular, and Vines Grille and Wine Bar, “a gem on Orlando’s Restaurant Row,” Mrs. Harrington said, is a great choice for happy hour and features jazz and blues in the evenings starting about 7 p.m.

Finally, “I would recommend meeting some SHM staff members either at registration or between meetings,” Mrs. Harrington advised. “They have been so welcoming to me over the years and have been a great resource and support system. Also, be open to meeting other spouses at group outings, dinners, or networking events whenever you have the opportunity, as they might become a treasured friend,” she said.
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How policy illustrates the value of SHM membership

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A force multiplier for the Society’s effect on policy decisions

 

Federal programs can be enormously complicated, and the Medicare value-based payment programs, such as the Physician Quality Reporting System, the physician value-based payment modifier, and the new Merit-Based Incentive Payment System, are no exception.

It can be a challenge to navigate the rules, to identify how and which measures to report, and to determine how to integrate those requirements into your practice. Furthermore, the feedback from these programs to providers can be difficult to read and interpret.

Part of the value of being a member of the Society of Hospital Medicine (SHM) is having another set of eyes – particularly those that spend a significant amount of time immersed in federal regulations – to parse the policy-practice nexus. SHM hears from members all over the country, many in different practice types and with different policy needs. This knowledge can be shared, both with other members and with policymakers. A recent example highlights the power of this relationship.

Your membership contributes directly to the advocacy efforts of SHM, and the engagement of members with SHM staff on policy issues is a force multiplier for the effect SHM can have on policy decisions. There is a lot of value for belonging to SHM, and sometimes, we can put an exact number on it.

A solo-practicing hospitalist called seeking perspective on why he received a letter indicating he would be receiving a penalty in 2018 for failing the requirements of Physician Quality Reporting System reporting. This hospitalist had successfully reported on as many measures as he possibly could, so he could not understand why he would be receiving a penalty.

All told, a different read of the feedback reports, and some strategic questions from SHM staff, helped this hospitalist understand why he was being penalized and how, in this case, he could ask Centers for Medicare & Medicaid Services for reconsideration. Upon second review by CMS, the penalties were overturned, and this provider should save nearly $30,000 in Medicare payments in 2018.

SHM helped the provider by being a sounding board and by sharing information learned from experiences other members had had with these programs. In turn, the knowledge gained from this interaction will be used to fine-tune SHM’s educational materials and outreach efforts about these programs. It has also already contributed to advocacy efforts with CMS policymakers regarding how they can improve the programs to be more transparent and equitable. The learning is shared in both directions.

 

 


Want to learn more about SHM’s advocacy efforts and how policy affects hospitalists? Stop by sessions at Hospital Medicine 2018 in Orlando; there will be one on pay-for-performance programs on Monday, April 9, at 3:15 p.m. and others on health policy throughout the day on Wednesday, April 11. Learn more at www.shmannualconference.org.
 

Mr. Lapps is the government relations manager at the Society of Hospital Medicine.

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A force multiplier for the Society’s effect on policy decisions
A force multiplier for the Society’s effect on policy decisions

 

Federal programs can be enormously complicated, and the Medicare value-based payment programs, such as the Physician Quality Reporting System, the physician value-based payment modifier, and the new Merit-Based Incentive Payment System, are no exception.

It can be a challenge to navigate the rules, to identify how and which measures to report, and to determine how to integrate those requirements into your practice. Furthermore, the feedback from these programs to providers can be difficult to read and interpret.

Part of the value of being a member of the Society of Hospital Medicine (SHM) is having another set of eyes – particularly those that spend a significant amount of time immersed in federal regulations – to parse the policy-practice nexus. SHM hears from members all over the country, many in different practice types and with different policy needs. This knowledge can be shared, both with other members and with policymakers. A recent example highlights the power of this relationship.

Your membership contributes directly to the advocacy efforts of SHM, and the engagement of members with SHM staff on policy issues is a force multiplier for the effect SHM can have on policy decisions. There is a lot of value for belonging to SHM, and sometimes, we can put an exact number on it.

A solo-practicing hospitalist called seeking perspective on why he received a letter indicating he would be receiving a penalty in 2018 for failing the requirements of Physician Quality Reporting System reporting. This hospitalist had successfully reported on as many measures as he possibly could, so he could not understand why he would be receiving a penalty.

All told, a different read of the feedback reports, and some strategic questions from SHM staff, helped this hospitalist understand why he was being penalized and how, in this case, he could ask Centers for Medicare & Medicaid Services for reconsideration. Upon second review by CMS, the penalties were overturned, and this provider should save nearly $30,000 in Medicare payments in 2018.

SHM helped the provider by being a sounding board and by sharing information learned from experiences other members had had with these programs. In turn, the knowledge gained from this interaction will be used to fine-tune SHM’s educational materials and outreach efforts about these programs. It has also already contributed to advocacy efforts with CMS policymakers regarding how they can improve the programs to be more transparent and equitable. The learning is shared in both directions.

 

 


Want to learn more about SHM’s advocacy efforts and how policy affects hospitalists? Stop by sessions at Hospital Medicine 2018 in Orlando; there will be one on pay-for-performance programs on Monday, April 9, at 3:15 p.m. and others on health policy throughout the day on Wednesday, April 11. Learn more at www.shmannualconference.org.
 

Mr. Lapps is the government relations manager at the Society of Hospital Medicine.

 

Federal programs can be enormously complicated, and the Medicare value-based payment programs, such as the Physician Quality Reporting System, the physician value-based payment modifier, and the new Merit-Based Incentive Payment System, are no exception.

It can be a challenge to navigate the rules, to identify how and which measures to report, and to determine how to integrate those requirements into your practice. Furthermore, the feedback from these programs to providers can be difficult to read and interpret.

Part of the value of being a member of the Society of Hospital Medicine (SHM) is having another set of eyes – particularly those that spend a significant amount of time immersed in federal regulations – to parse the policy-practice nexus. SHM hears from members all over the country, many in different practice types and with different policy needs. This knowledge can be shared, both with other members and with policymakers. A recent example highlights the power of this relationship.

Your membership contributes directly to the advocacy efforts of SHM, and the engagement of members with SHM staff on policy issues is a force multiplier for the effect SHM can have on policy decisions. There is a lot of value for belonging to SHM, and sometimes, we can put an exact number on it.

A solo-practicing hospitalist called seeking perspective on why he received a letter indicating he would be receiving a penalty in 2018 for failing the requirements of Physician Quality Reporting System reporting. This hospitalist had successfully reported on as many measures as he possibly could, so he could not understand why he would be receiving a penalty.

All told, a different read of the feedback reports, and some strategic questions from SHM staff, helped this hospitalist understand why he was being penalized and how, in this case, he could ask Centers for Medicare & Medicaid Services for reconsideration. Upon second review by CMS, the penalties were overturned, and this provider should save nearly $30,000 in Medicare payments in 2018.

SHM helped the provider by being a sounding board and by sharing information learned from experiences other members had had with these programs. In turn, the knowledge gained from this interaction will be used to fine-tune SHM’s educational materials and outreach efforts about these programs. It has also already contributed to advocacy efforts with CMS policymakers regarding how they can improve the programs to be more transparent and equitable. The learning is shared in both directions.

 

 


Want to learn more about SHM’s advocacy efforts and how policy affects hospitalists? Stop by sessions at Hospital Medicine 2018 in Orlando; there will be one on pay-for-performance programs on Monday, April 9, at 3:15 p.m. and others on health policy throughout the day on Wednesday, April 11. Learn more at www.shmannualconference.org.
 

Mr. Lapps is the government relations manager at the Society of Hospital Medicine.

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Hospital Medicine: An international specialty

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Hospitalist model growing globally

 

This past fall, I had the honor of being invited to speak at a hospitalist physician conference in Tokyo. The conference was hosted by the Japanese Society of Hospital General Medicine (JSHGM) and was attended by over 800 hospitalists, including some from other East Asian countries.

The JSHGM is 7 years old and has 1,400 members; its growth mirroring the growth of practicing hospitalists in Japan. They wanted me to speak about the evolution of the hospitalist model in the United States and to learn more about their efforts to grow the nascent specialty in Japan. We also jointly wanted to discuss the opportunity for the JSHGM and the Society of Hospital Medicine to work together to benefit the hospitalist model in both countries.

Dr. Ron Greeno, immediate past president of the Society of Hospital Medicine, and senior adviser for medical affairs, TeamHealth
Dr. Ron Greeno

This emerging partnership of the two societies is only the latest of a growing series of efforts on the part of SHM to support the growth of the hospitalist specialty internationally. It started with Canada in 2001, when a contingent of Canadian hospitalists requested to form their own chapter of SHM. They wanted to become the first international chapter and to join a group that has now grown to 56 state and regional chapters. Within a few years, the Canadian Chapter evolved to become its own independent and flourishing Canadian Society of Hospital Medicine.

More recently, SHM has helped develop chapters in Brazil and the Middle East, with more chapters being planned. The International Special Interest Forum at Hospital Medicine 2018 in Orlando in April expects attendees from Holland, Germany, Spain, Chile, Taiwan, China and more.

 

 


So why all of this activity by hospitalists in countries whose health systems are so different from ours and from each other’s? What is it about our specialty that has captured the interest of physicians, health systems, and governments from around the globe?

Talking to hospitalists from abroad, the answer is very consistent and very simple. It is the desire to lower cost and improve the quality of care. It turns out that the American health care system is not the only one that struggles with these issues. It seems that health care costs are too high everywhere and that the quest for higher quality, lower cost health care is a universal struggle. As Scottish-born health care economist Ian Morrison jokes, “Every health care system sucks in its own way.”

Let’s look at Japan. They have the longest average life expectancy in the world at 84 years, with about a quarter of their population over 65 years of age. On any given day, almost 14% of the population has a physician visit. Historically, they also have long hospital length of stays with current average length of stay anywhere between 14 and 21 days. This, of course, is very costly. … and in their single-payer system, the entire cost of this care falls on the Japanese government. And as birth rates in Japan have decreased, there are fewer taxpayers to bear the financial burden of the progressively aging and sicker population.

Canada has a different challenge. Also a single-payer system, their largest issue for the acutely ill is the availability of an open hospital bed. Although the system varies somewhat from province to province, it is typical that hospitals are given a total annual budget that must cover all expenses for the year, independent of the volume of patients. Since most hospitals are perpetually full, the discharge of a patient results in another new admission, which in turn actually costs the hospital more money. This perverse incentive keeps hospital beds full as patients wait for one to open (especially for any elective procedure). Adding to the problem, physicians are paid fee for service and therefore also have no incentive to discharge patients.

 

 


As Canadian citizens clamor for more access to care, the government looks for ways to lower excessively long length of stays. Wait times for elective surgeries are unacceptable with some patients coming to the United States for surgery that they must then pay for themselves. The result is mounting pressure to move to models of care that are more efficient and less wasteful.

It is no wonder that physicians and health care planners from Japan, Canada, and around the world have viewed with great interest what hospitalists have accomplished in the American health care system. They recognize the potential of this relatively new model to decrease hospital length of stays, lower health care costs, and improve outcomes. After all, this is what the hospitalist model was invented to accomplish – to create value not through high production, but by improving the efficiency of care delivery, overall quality of care, and contributing to improved hospital operations.

As unrelenting economic forces continue to put pressure on health care systems worldwide, it will be fascinating to follow and continue assessing the impact of the hospitalist model in nations where it is implemented. That includes, of course, in the United States, where the model is still very young and continually evolving.

In the meantime, SHM will continue to learn about and work with our international partners. This certainly will be the focus of a special “Hospital Medicine in Japan” session at Hospital Medicine 2018 along with the International Special Interest Forum. And for the first time, we will also have an International Lounge where our international members can meet with each other and our American members to share ideas and enthusiasm for the future of our specialty.

 

 

These are just the first steps to expanding the hospital medicine movement across the globe. SHM is optimistic about the future opportunities for international collaboration and is committed to supporting the growth of the specialty and its practitioners, not only in the United States, but worldwide.

Dr. Greeno is president of the Society of Hospital Medicine, and senior adviser for medical affairs, TeamHealth.

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Hospitalist model growing globally
Hospitalist model growing globally

 

This past fall, I had the honor of being invited to speak at a hospitalist physician conference in Tokyo. The conference was hosted by the Japanese Society of Hospital General Medicine (JSHGM) and was attended by over 800 hospitalists, including some from other East Asian countries.

The JSHGM is 7 years old and has 1,400 members; its growth mirroring the growth of practicing hospitalists in Japan. They wanted me to speak about the evolution of the hospitalist model in the United States and to learn more about their efforts to grow the nascent specialty in Japan. We also jointly wanted to discuss the opportunity for the JSHGM and the Society of Hospital Medicine to work together to benefit the hospitalist model in both countries.

Dr. Ron Greeno, immediate past president of the Society of Hospital Medicine, and senior adviser for medical affairs, TeamHealth
Dr. Ron Greeno

This emerging partnership of the two societies is only the latest of a growing series of efforts on the part of SHM to support the growth of the hospitalist specialty internationally. It started with Canada in 2001, when a contingent of Canadian hospitalists requested to form their own chapter of SHM. They wanted to become the first international chapter and to join a group that has now grown to 56 state and regional chapters. Within a few years, the Canadian Chapter evolved to become its own independent and flourishing Canadian Society of Hospital Medicine.

More recently, SHM has helped develop chapters in Brazil and the Middle East, with more chapters being planned. The International Special Interest Forum at Hospital Medicine 2018 in Orlando in April expects attendees from Holland, Germany, Spain, Chile, Taiwan, China and more.

 

 


So why all of this activity by hospitalists in countries whose health systems are so different from ours and from each other’s? What is it about our specialty that has captured the interest of physicians, health systems, and governments from around the globe?

Talking to hospitalists from abroad, the answer is very consistent and very simple. It is the desire to lower cost and improve the quality of care. It turns out that the American health care system is not the only one that struggles with these issues. It seems that health care costs are too high everywhere and that the quest for higher quality, lower cost health care is a universal struggle. As Scottish-born health care economist Ian Morrison jokes, “Every health care system sucks in its own way.”

Let’s look at Japan. They have the longest average life expectancy in the world at 84 years, with about a quarter of their population over 65 years of age. On any given day, almost 14% of the population has a physician visit. Historically, they also have long hospital length of stays with current average length of stay anywhere between 14 and 21 days. This, of course, is very costly. … and in their single-payer system, the entire cost of this care falls on the Japanese government. And as birth rates in Japan have decreased, there are fewer taxpayers to bear the financial burden of the progressively aging and sicker population.

Canada has a different challenge. Also a single-payer system, their largest issue for the acutely ill is the availability of an open hospital bed. Although the system varies somewhat from province to province, it is typical that hospitals are given a total annual budget that must cover all expenses for the year, independent of the volume of patients. Since most hospitals are perpetually full, the discharge of a patient results in another new admission, which in turn actually costs the hospital more money. This perverse incentive keeps hospital beds full as patients wait for one to open (especially for any elective procedure). Adding to the problem, physicians are paid fee for service and therefore also have no incentive to discharge patients.

 

 


As Canadian citizens clamor for more access to care, the government looks for ways to lower excessively long length of stays. Wait times for elective surgeries are unacceptable with some patients coming to the United States for surgery that they must then pay for themselves. The result is mounting pressure to move to models of care that are more efficient and less wasteful.

It is no wonder that physicians and health care planners from Japan, Canada, and around the world have viewed with great interest what hospitalists have accomplished in the American health care system. They recognize the potential of this relatively new model to decrease hospital length of stays, lower health care costs, and improve outcomes. After all, this is what the hospitalist model was invented to accomplish – to create value not through high production, but by improving the efficiency of care delivery, overall quality of care, and contributing to improved hospital operations.

As unrelenting economic forces continue to put pressure on health care systems worldwide, it will be fascinating to follow and continue assessing the impact of the hospitalist model in nations where it is implemented. That includes, of course, in the United States, where the model is still very young and continually evolving.

In the meantime, SHM will continue to learn about and work with our international partners. This certainly will be the focus of a special “Hospital Medicine in Japan” session at Hospital Medicine 2018 along with the International Special Interest Forum. And for the first time, we will also have an International Lounge where our international members can meet with each other and our American members to share ideas and enthusiasm for the future of our specialty.

 

 

These are just the first steps to expanding the hospital medicine movement across the globe. SHM is optimistic about the future opportunities for international collaboration and is committed to supporting the growth of the specialty and its practitioners, not only in the United States, but worldwide.

Dr. Greeno is president of the Society of Hospital Medicine, and senior adviser for medical affairs, TeamHealth.

 

This past fall, I had the honor of being invited to speak at a hospitalist physician conference in Tokyo. The conference was hosted by the Japanese Society of Hospital General Medicine (JSHGM) and was attended by over 800 hospitalists, including some from other East Asian countries.

The JSHGM is 7 years old and has 1,400 members; its growth mirroring the growth of practicing hospitalists in Japan. They wanted me to speak about the evolution of the hospitalist model in the United States and to learn more about their efforts to grow the nascent specialty in Japan. We also jointly wanted to discuss the opportunity for the JSHGM and the Society of Hospital Medicine to work together to benefit the hospitalist model in both countries.

Dr. Ron Greeno, immediate past president of the Society of Hospital Medicine, and senior adviser for medical affairs, TeamHealth
Dr. Ron Greeno

This emerging partnership of the two societies is only the latest of a growing series of efforts on the part of SHM to support the growth of the hospitalist specialty internationally. It started with Canada in 2001, when a contingent of Canadian hospitalists requested to form their own chapter of SHM. They wanted to become the first international chapter and to join a group that has now grown to 56 state and regional chapters. Within a few years, the Canadian Chapter evolved to become its own independent and flourishing Canadian Society of Hospital Medicine.

More recently, SHM has helped develop chapters in Brazil and the Middle East, with more chapters being planned. The International Special Interest Forum at Hospital Medicine 2018 in Orlando in April expects attendees from Holland, Germany, Spain, Chile, Taiwan, China and more.

 

 


So why all of this activity by hospitalists in countries whose health systems are so different from ours and from each other’s? What is it about our specialty that has captured the interest of physicians, health systems, and governments from around the globe?

Talking to hospitalists from abroad, the answer is very consistent and very simple. It is the desire to lower cost and improve the quality of care. It turns out that the American health care system is not the only one that struggles with these issues. It seems that health care costs are too high everywhere and that the quest for higher quality, lower cost health care is a universal struggle. As Scottish-born health care economist Ian Morrison jokes, “Every health care system sucks in its own way.”

Let’s look at Japan. They have the longest average life expectancy in the world at 84 years, with about a quarter of their population over 65 years of age. On any given day, almost 14% of the population has a physician visit. Historically, they also have long hospital length of stays with current average length of stay anywhere between 14 and 21 days. This, of course, is very costly. … and in their single-payer system, the entire cost of this care falls on the Japanese government. And as birth rates in Japan have decreased, there are fewer taxpayers to bear the financial burden of the progressively aging and sicker population.

Canada has a different challenge. Also a single-payer system, their largest issue for the acutely ill is the availability of an open hospital bed. Although the system varies somewhat from province to province, it is typical that hospitals are given a total annual budget that must cover all expenses for the year, independent of the volume of patients. Since most hospitals are perpetually full, the discharge of a patient results in another new admission, which in turn actually costs the hospital more money. This perverse incentive keeps hospital beds full as patients wait for one to open (especially for any elective procedure). Adding to the problem, physicians are paid fee for service and therefore also have no incentive to discharge patients.

 

 


As Canadian citizens clamor for more access to care, the government looks for ways to lower excessively long length of stays. Wait times for elective surgeries are unacceptable with some patients coming to the United States for surgery that they must then pay for themselves. The result is mounting pressure to move to models of care that are more efficient and less wasteful.

It is no wonder that physicians and health care planners from Japan, Canada, and around the world have viewed with great interest what hospitalists have accomplished in the American health care system. They recognize the potential of this relatively new model to decrease hospital length of stays, lower health care costs, and improve outcomes. After all, this is what the hospitalist model was invented to accomplish – to create value not through high production, but by improving the efficiency of care delivery, overall quality of care, and contributing to improved hospital operations.

As unrelenting economic forces continue to put pressure on health care systems worldwide, it will be fascinating to follow and continue assessing the impact of the hospitalist model in nations where it is implemented. That includes, of course, in the United States, where the model is still very young and continually evolving.

In the meantime, SHM will continue to learn about and work with our international partners. This certainly will be the focus of a special “Hospital Medicine in Japan” session at Hospital Medicine 2018 along with the International Special Interest Forum. And for the first time, we will also have an International Lounge where our international members can meet with each other and our American members to share ideas and enthusiasm for the future of our specialty.

 

 

These are just the first steps to expanding the hospital medicine movement across the globe. SHM is optimistic about the future opportunities for international collaboration and is committed to supporting the growth of the specialty and its practitioners, not only in the United States, but worldwide.

Dr. Greeno is president of the Society of Hospital Medicine, and senior adviser for medical affairs, TeamHealth.

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Career development: One of many new focal points at HM 2018

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Kathleen Finn, MD, FACP, FHM, shares advice on getting involved

 

Editor’s note: Each month, the Society of Hospital Medicine puts the spotlight on some of our most active members who are making substantial contributions to hospital medicine. Visit www.hospitalmedicine.org for more information on how you can lend your expertise to help SHM improve the care of hospitalized patients.

This month, The Hospitalist spotlights Kathleen Finn, MD, M. Phil, FACP, FHM, the inpatient associate program director of the internal medicine residency program at Massachusetts General Hospital and an assistant professor of medicine at Harvard Medical School, both in Boston. Dr. Finn has been a member of the Society of Hospital Medicine’s Annual Conference Committee for the past 8 years and is the course director for Hospital Medicine 2018 (HM18), to be held April 8-11 in Orlando.
 

When did you become a member of SHM, and how did you initially become involved with the Annual Conference Committee?

Dr. Kathleen Finn, a hospitalist at Massachusetts General, Boston
Dr. Kathleen Finn
I was a member of the National Association of Inpatient Physicians and then became a member of SHM when the name changed. Early on, I remember attending a hospitalist conference when it was just a precourse. It’s been amazing to see how hospital medicine has grown, with the national conference now 3 days long, with its own precourses, attracting more than 5,000 hospitalists.

 

 

I became involved with the Annual Conference Committee 8 years ago because of my interest in education. Being a founding member of the SHM Boston Chapter, I gained experience planning the quarterly local chapter meetings. As a clinical educator and hospitalist, I was involved in planning conferences for faculty at my hospital. I found I really enjoyed developing educational conferences and curriculum, so when I heard about the Annual Conference Committee, I thought it would be a perfect fit.


It’s been a great experience getting to know committee members from all over the country and hearing their thoughts about the annual conference. It’s always exciting to brainstorm topic ideas and think about what would interest conference attendees.

Describe your role as course director.

My job as course director is to challenge committee members to be as creative as possible and help focus the discussion around the needs of SHM members while keeping to a schedule. I led a team of 23 amazing committee members through the planning stages for HM18 this past summer. With the help of Brittany Evans, SHM’s Education and Meetings Project Manager, and Dustin Smith, MD, FHM, the cocourse director, the committee reviewed prior conference agendas and feedback from attendees and from other SHM committees. Using that information, we discussed, brainstormed, voted on, and planned this year’s clinical content talks, workshops, and many of the specialty tracks.

What are you most looking forward to at HM18?

I am looking forward to the entire meeting! First, the location is exciting since this is our first time in Orlando. I’m curious to see what the facility is like, and I am hoping attendees use the location as a reason to bring their families and visit the theme parks. In recognition of our Orlando location, the committee got creative with titles for the conference. For example, geriatrics became “The Tale as Old as Time.” I hope some of the titles put a smile on the attendees’ faces.

 

 

I am also eagerly anticipating the nationally recognized speakers. We invited the best speakers we know from both subspecialty backgrounds and fellow hospitalists, and given the Orlando location, we tried to feature the best speakers from the Southeast. Finally, I am looking forward to the diversity of topics. The committee really thought broadly about relevant topics to today’s practicing hospitalists.

What will be new and different for attendees at HM18 in comparison to previous annual conferences?

There are many new things this year. Given the field of hospital medicine is now more than 20 years old, the committee thought it was important to focus on career development – not just for new hospitalists, but midcareer hospitalists as well. How do you make hospital medicine a lifelong, enjoyable, and engaging career? To explore and answer these questions, the Annual Conference Committee created several new tracks for HM18.

We created a Seasoning Your Career track that offers ideas on how to change your role midcareer – how to advance to a leadership position, how to use emotional intelligence to achieve success, how to prevent burnout, and, best of all, how to consider and change your hospitalist group’s work schedule, which rules our lives and our families’ lives. We also added financial planning advice to help you prepare for retirement.

Another new track at HM18 is the Career Development Workshops track, which includes a diversity of workshops meant to help build leadership skills, develop presentation/communication skills, encourage peers to give each other feedback, promote women in hospital medicine, prevent burnout, and turn ideas into clinical research. The Medical Education track also has a session on how to break into educational roles, especially if you want to expand your career into a leadership position in medical education.

 

 


In addition to Seasoning Your Career and Career Development Workshops, we have three other new tracks: Palliative Care, NP/PA, and The Great Debate. The Great Debate track uses the popular format of the perioperative debate given every year at the annual conference to tackle topics in infectious disease and pulmonary medicine. We ask very talented, opinionated, and humorous speakers to debate with each other over clinical content; it will be a great “smack down!”


Other new things for HM18 include:

  • An interventional radiologist will speak about the latest procedures and when to refer your patients.
  • A few surgeons will talk about managing surgical patients on your service and about decubitus ulcers.
  • An oncologist will discuss the complications of the latest advanced agents on the wards.
  • A rheumatologist will discuss the complications of new biologic agents.
  • A rehab specialist will discuss the benefits and limitations of physical/occupational therapists and physiatrists.
  • A speaker will discussing vulnerable populations, focusing on the social determinants of health, which last year’s HM17 plenary speaker Karen DeSalvo, MD, MPH, MSc raised as an important issue.
  • There will be an “Updates in Addiction Medicine” lecture.
  • There will be a new cardiology precourse and an expanded infectious disease precourse, which will also focus on sepsis.
 

 

How has the committee worked to ensure the course content is refreshed and current?

The reason the Annual Conference Committee is large is to ensure that there is a diversity of voices and talents from all over the country. There are both academic and community hospitalists on the committee; its members represent internal medicine, family medicine, pediatrics, and subspecialists, as well as administrators and hospitalist leaders. The annual meetings are planned over 3-4 months via weekly calls. In between calls, committee members are encouraged to discuss topics with their colleagues at home for opinions and advice.

The best ideas from the committee come from the group discussion and brainstorming. Someone mentions a topic, which leads someone else to add to it, and so on. Within the hour, we have some fantastic suggestions that the committee can run with. We also rely on input from SHM members: For example, many of the workshops’ topics are chosen from hundreds of submissions from members; speaker and content suggestions are submitted by hospitalist leaders from around the country and thereby provide insight into current topics. Combined, these offer a richness of ideas, which allows the committee to stay up to date and refresh old ideas.
 

What advice can you offer to early career hospitalists looking to get involved with the Annual Conference Committee or other conference planning roles?

My advice for early career hospitalists is to start locally. Join your local SHM chapter, or start one. In trying to plan local conferences, you begin to figure out which content areas interest hospitalists and how they can best be delivered. You might offer to give a talk at your local chapter or at your hospital and develop presentation skills. Developing a network of fellow hospitalists through your local chapter is important. The more local hospitalists you connect with, the more likely it is that they will think of you when they are planning a conference. At the national level, consider submitting a workshop or submitting an idea for content. Workshops are a great way to get recognized at the national level.

 

 

The Annual Conference Committee takes applications every year. Once you have some experience planning conferences or coordinating speakers, it would definitely be worth applying. You may not be selected your first year, but do not let that discourage you! Demonstrating interest and perseverance goes a long way. There are also many other national SHM committees to join and other ways to get involved. Your willingness to provide some of your time makes the society – and the specialty – what it is.
 

Ms. Steele is the marketing communications specialist at the Society of Hospital Medicine.

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Kathleen Finn, MD, FACP, FHM, shares advice on getting involved
Kathleen Finn, MD, FACP, FHM, shares advice on getting involved

 

Editor’s note: Each month, the Society of Hospital Medicine puts the spotlight on some of our most active members who are making substantial contributions to hospital medicine. Visit www.hospitalmedicine.org for more information on how you can lend your expertise to help SHM improve the care of hospitalized patients.

This month, The Hospitalist spotlights Kathleen Finn, MD, M. Phil, FACP, FHM, the inpatient associate program director of the internal medicine residency program at Massachusetts General Hospital and an assistant professor of medicine at Harvard Medical School, both in Boston. Dr. Finn has been a member of the Society of Hospital Medicine’s Annual Conference Committee for the past 8 years and is the course director for Hospital Medicine 2018 (HM18), to be held April 8-11 in Orlando.
 

When did you become a member of SHM, and how did you initially become involved with the Annual Conference Committee?

Dr. Kathleen Finn, a hospitalist at Massachusetts General, Boston
Dr. Kathleen Finn
I was a member of the National Association of Inpatient Physicians and then became a member of SHM when the name changed. Early on, I remember attending a hospitalist conference when it was just a precourse. It’s been amazing to see how hospital medicine has grown, with the national conference now 3 days long, with its own precourses, attracting more than 5,000 hospitalists.

 

 

I became involved with the Annual Conference Committee 8 years ago because of my interest in education. Being a founding member of the SHM Boston Chapter, I gained experience planning the quarterly local chapter meetings. As a clinical educator and hospitalist, I was involved in planning conferences for faculty at my hospital. I found I really enjoyed developing educational conferences and curriculum, so when I heard about the Annual Conference Committee, I thought it would be a perfect fit.


It’s been a great experience getting to know committee members from all over the country and hearing their thoughts about the annual conference. It’s always exciting to brainstorm topic ideas and think about what would interest conference attendees.

Describe your role as course director.

My job as course director is to challenge committee members to be as creative as possible and help focus the discussion around the needs of SHM members while keeping to a schedule. I led a team of 23 amazing committee members through the planning stages for HM18 this past summer. With the help of Brittany Evans, SHM’s Education and Meetings Project Manager, and Dustin Smith, MD, FHM, the cocourse director, the committee reviewed prior conference agendas and feedback from attendees and from other SHM committees. Using that information, we discussed, brainstormed, voted on, and planned this year’s clinical content talks, workshops, and many of the specialty tracks.

What are you most looking forward to at HM18?

I am looking forward to the entire meeting! First, the location is exciting since this is our first time in Orlando. I’m curious to see what the facility is like, and I am hoping attendees use the location as a reason to bring their families and visit the theme parks. In recognition of our Orlando location, the committee got creative with titles for the conference. For example, geriatrics became “The Tale as Old as Time.” I hope some of the titles put a smile on the attendees’ faces.

 

 

I am also eagerly anticipating the nationally recognized speakers. We invited the best speakers we know from both subspecialty backgrounds and fellow hospitalists, and given the Orlando location, we tried to feature the best speakers from the Southeast. Finally, I am looking forward to the diversity of topics. The committee really thought broadly about relevant topics to today’s practicing hospitalists.

What will be new and different for attendees at HM18 in comparison to previous annual conferences?

There are many new things this year. Given the field of hospital medicine is now more than 20 years old, the committee thought it was important to focus on career development – not just for new hospitalists, but midcareer hospitalists as well. How do you make hospital medicine a lifelong, enjoyable, and engaging career? To explore and answer these questions, the Annual Conference Committee created several new tracks for HM18.

We created a Seasoning Your Career track that offers ideas on how to change your role midcareer – how to advance to a leadership position, how to use emotional intelligence to achieve success, how to prevent burnout, and, best of all, how to consider and change your hospitalist group’s work schedule, which rules our lives and our families’ lives. We also added financial planning advice to help you prepare for retirement.

Another new track at HM18 is the Career Development Workshops track, which includes a diversity of workshops meant to help build leadership skills, develop presentation/communication skills, encourage peers to give each other feedback, promote women in hospital medicine, prevent burnout, and turn ideas into clinical research. The Medical Education track also has a session on how to break into educational roles, especially if you want to expand your career into a leadership position in medical education.

 

 


In addition to Seasoning Your Career and Career Development Workshops, we have three other new tracks: Palliative Care, NP/PA, and The Great Debate. The Great Debate track uses the popular format of the perioperative debate given every year at the annual conference to tackle topics in infectious disease and pulmonary medicine. We ask very talented, opinionated, and humorous speakers to debate with each other over clinical content; it will be a great “smack down!”


Other new things for HM18 include:

  • An interventional radiologist will speak about the latest procedures and when to refer your patients.
  • A few surgeons will talk about managing surgical patients on your service and about decubitus ulcers.
  • An oncologist will discuss the complications of the latest advanced agents on the wards.
  • A rheumatologist will discuss the complications of new biologic agents.
  • A rehab specialist will discuss the benefits and limitations of physical/occupational therapists and physiatrists.
  • A speaker will discussing vulnerable populations, focusing on the social determinants of health, which last year’s HM17 plenary speaker Karen DeSalvo, MD, MPH, MSc raised as an important issue.
  • There will be an “Updates in Addiction Medicine” lecture.
  • There will be a new cardiology precourse and an expanded infectious disease precourse, which will also focus on sepsis.
 

 

How has the committee worked to ensure the course content is refreshed and current?

The reason the Annual Conference Committee is large is to ensure that there is a diversity of voices and talents from all over the country. There are both academic and community hospitalists on the committee; its members represent internal medicine, family medicine, pediatrics, and subspecialists, as well as administrators and hospitalist leaders. The annual meetings are planned over 3-4 months via weekly calls. In between calls, committee members are encouraged to discuss topics with their colleagues at home for opinions and advice.

The best ideas from the committee come from the group discussion and brainstorming. Someone mentions a topic, which leads someone else to add to it, and so on. Within the hour, we have some fantastic suggestions that the committee can run with. We also rely on input from SHM members: For example, many of the workshops’ topics are chosen from hundreds of submissions from members; speaker and content suggestions are submitted by hospitalist leaders from around the country and thereby provide insight into current topics. Combined, these offer a richness of ideas, which allows the committee to stay up to date and refresh old ideas.
 

What advice can you offer to early career hospitalists looking to get involved with the Annual Conference Committee or other conference planning roles?

My advice for early career hospitalists is to start locally. Join your local SHM chapter, or start one. In trying to plan local conferences, you begin to figure out which content areas interest hospitalists and how they can best be delivered. You might offer to give a talk at your local chapter or at your hospital and develop presentation skills. Developing a network of fellow hospitalists through your local chapter is important. The more local hospitalists you connect with, the more likely it is that they will think of you when they are planning a conference. At the national level, consider submitting a workshop or submitting an idea for content. Workshops are a great way to get recognized at the national level.

 

 

The Annual Conference Committee takes applications every year. Once you have some experience planning conferences or coordinating speakers, it would definitely be worth applying. You may not be selected your first year, but do not let that discourage you! Demonstrating interest and perseverance goes a long way. There are also many other national SHM committees to join and other ways to get involved. Your willingness to provide some of your time makes the society – and the specialty – what it is.
 

Ms. Steele is the marketing communications specialist at the Society of Hospital Medicine.

 

Editor’s note: Each month, the Society of Hospital Medicine puts the spotlight on some of our most active members who are making substantial contributions to hospital medicine. Visit www.hospitalmedicine.org for more information on how you can lend your expertise to help SHM improve the care of hospitalized patients.

This month, The Hospitalist spotlights Kathleen Finn, MD, M. Phil, FACP, FHM, the inpatient associate program director of the internal medicine residency program at Massachusetts General Hospital and an assistant professor of medicine at Harvard Medical School, both in Boston. Dr. Finn has been a member of the Society of Hospital Medicine’s Annual Conference Committee for the past 8 years and is the course director for Hospital Medicine 2018 (HM18), to be held April 8-11 in Orlando.
 

When did you become a member of SHM, and how did you initially become involved with the Annual Conference Committee?

Dr. Kathleen Finn, a hospitalist at Massachusetts General, Boston
Dr. Kathleen Finn
I was a member of the National Association of Inpatient Physicians and then became a member of SHM when the name changed. Early on, I remember attending a hospitalist conference when it was just a precourse. It’s been amazing to see how hospital medicine has grown, with the national conference now 3 days long, with its own precourses, attracting more than 5,000 hospitalists.

 

 

I became involved with the Annual Conference Committee 8 years ago because of my interest in education. Being a founding member of the SHM Boston Chapter, I gained experience planning the quarterly local chapter meetings. As a clinical educator and hospitalist, I was involved in planning conferences for faculty at my hospital. I found I really enjoyed developing educational conferences and curriculum, so when I heard about the Annual Conference Committee, I thought it would be a perfect fit.


It’s been a great experience getting to know committee members from all over the country and hearing their thoughts about the annual conference. It’s always exciting to brainstorm topic ideas and think about what would interest conference attendees.

Describe your role as course director.

My job as course director is to challenge committee members to be as creative as possible and help focus the discussion around the needs of SHM members while keeping to a schedule. I led a team of 23 amazing committee members through the planning stages for HM18 this past summer. With the help of Brittany Evans, SHM’s Education and Meetings Project Manager, and Dustin Smith, MD, FHM, the cocourse director, the committee reviewed prior conference agendas and feedback from attendees and from other SHM committees. Using that information, we discussed, brainstormed, voted on, and planned this year’s clinical content talks, workshops, and many of the specialty tracks.

What are you most looking forward to at HM18?

I am looking forward to the entire meeting! First, the location is exciting since this is our first time in Orlando. I’m curious to see what the facility is like, and I am hoping attendees use the location as a reason to bring their families and visit the theme parks. In recognition of our Orlando location, the committee got creative with titles for the conference. For example, geriatrics became “The Tale as Old as Time.” I hope some of the titles put a smile on the attendees’ faces.

 

 

I am also eagerly anticipating the nationally recognized speakers. We invited the best speakers we know from both subspecialty backgrounds and fellow hospitalists, and given the Orlando location, we tried to feature the best speakers from the Southeast. Finally, I am looking forward to the diversity of topics. The committee really thought broadly about relevant topics to today’s practicing hospitalists.

What will be new and different for attendees at HM18 in comparison to previous annual conferences?

There are many new things this year. Given the field of hospital medicine is now more than 20 years old, the committee thought it was important to focus on career development – not just for new hospitalists, but midcareer hospitalists as well. How do you make hospital medicine a lifelong, enjoyable, and engaging career? To explore and answer these questions, the Annual Conference Committee created several new tracks for HM18.

We created a Seasoning Your Career track that offers ideas on how to change your role midcareer – how to advance to a leadership position, how to use emotional intelligence to achieve success, how to prevent burnout, and, best of all, how to consider and change your hospitalist group’s work schedule, which rules our lives and our families’ lives. We also added financial planning advice to help you prepare for retirement.

Another new track at HM18 is the Career Development Workshops track, which includes a diversity of workshops meant to help build leadership skills, develop presentation/communication skills, encourage peers to give each other feedback, promote women in hospital medicine, prevent burnout, and turn ideas into clinical research. The Medical Education track also has a session on how to break into educational roles, especially if you want to expand your career into a leadership position in medical education.

 

 


In addition to Seasoning Your Career and Career Development Workshops, we have three other new tracks: Palliative Care, NP/PA, and The Great Debate. The Great Debate track uses the popular format of the perioperative debate given every year at the annual conference to tackle topics in infectious disease and pulmonary medicine. We ask very talented, opinionated, and humorous speakers to debate with each other over clinical content; it will be a great “smack down!”


Other new things for HM18 include:

  • An interventional radiologist will speak about the latest procedures and when to refer your patients.
  • A few surgeons will talk about managing surgical patients on your service and about decubitus ulcers.
  • An oncologist will discuss the complications of the latest advanced agents on the wards.
  • A rheumatologist will discuss the complications of new biologic agents.
  • A rehab specialist will discuss the benefits and limitations of physical/occupational therapists and physiatrists.
  • A speaker will discussing vulnerable populations, focusing on the social determinants of health, which last year’s HM17 plenary speaker Karen DeSalvo, MD, MPH, MSc raised as an important issue.
  • There will be an “Updates in Addiction Medicine” lecture.
  • There will be a new cardiology precourse and an expanded infectious disease precourse, which will also focus on sepsis.
 

 

How has the committee worked to ensure the course content is refreshed and current?

The reason the Annual Conference Committee is large is to ensure that there is a diversity of voices and talents from all over the country. There are both academic and community hospitalists on the committee; its members represent internal medicine, family medicine, pediatrics, and subspecialists, as well as administrators and hospitalist leaders. The annual meetings are planned over 3-4 months via weekly calls. In between calls, committee members are encouraged to discuss topics with their colleagues at home for opinions and advice.

The best ideas from the committee come from the group discussion and brainstorming. Someone mentions a topic, which leads someone else to add to it, and so on. Within the hour, we have some fantastic suggestions that the committee can run with. We also rely on input from SHM members: For example, many of the workshops’ topics are chosen from hundreds of submissions from members; speaker and content suggestions are submitted by hospitalist leaders from around the country and thereby provide insight into current topics. Combined, these offer a richness of ideas, which allows the committee to stay up to date and refresh old ideas.
 

What advice can you offer to early career hospitalists looking to get involved with the Annual Conference Committee or other conference planning roles?

My advice for early career hospitalists is to start locally. Join your local SHM chapter, or start one. In trying to plan local conferences, you begin to figure out which content areas interest hospitalists and how they can best be delivered. You might offer to give a talk at your local chapter or at your hospital and develop presentation skills. Developing a network of fellow hospitalists through your local chapter is important. The more local hospitalists you connect with, the more likely it is that they will think of you when they are planning a conference. At the national level, consider submitting a workshop or submitting an idea for content. Workshops are a great way to get recognized at the national level.

 

 

The Annual Conference Committee takes applications every year. Once you have some experience planning conferences or coordinating speakers, it would definitely be worth applying. You may not be selected your first year, but do not let that discourage you! Demonstrating interest and perseverance goes a long way. There are also many other national SHM committees to join and other ways to get involved. Your willingness to provide some of your time makes the society – and the specialty – what it is.
 

Ms. Steele is the marketing communications specialist at the Society of Hospital Medicine.

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RIV takes center stage at HM18

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Changed
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Popular event highlights cutting-edge research

 

If prior SHM annual meetings are any guide, a highlight of the upcoming HM18 conference will be the Scientific Abstract and Poster Competition. This event, also known as the Research, Innovations, and Clinical Vignettes (RIV), has become one of the annual meeting’s most popular events. Crowds of attendees cluster around posters to read abstracts summarizing some of the most exciting, cutting-edge research in hospital medicine.

Networking in that crowd is a major factor in the RIV’s popularity, says the HM18 Innovations chair, Benji K. Mathews, MD, FACP, SFHM, CLHM, section head of hospital medicine at Regions Hospital, St. Paul, Minn., which is part of HealthPartners, the largest consumer-governed, non-profit health care organization in the U.S.

Dr. Benji K. Mathews, assistant professor of medicine at the University of Minnesota, Minneapolis
Dr. Benji K. Mathews

“From my standpoint, the power of this Innovations RIV competition is the opportunity to network,” said Dr. Mathews, who is also assistant professor of medicine at the University of Minnesota, Minneapolis. “In addition to primary authors, often these posters have several different people involved, and then there’s the foot traffic: We’re expecting thousands of people to walk through. The hope is to create the opportunity to network, to collaborate intergenerationally and also cross-institutionally.”

The RIV competition features some 1,000 posters this year, Dr. Mathews said. Plenary and oral sessions are chosen from the pool of abstracts prior to the meeting, and their authors are invited to present on-site at HM18.

But in spirit, the RIV is not really a competition, said RIV chair Ethan Cumbler, MD, FACP, FHM, professor of medicine at the University of Colorado.

Dr. Ethan Cumbler, professor of medicine and medical director of the University of Colorado Acute Care Center for the Elderly
Dr. Ethan Cumbler


“It’s really about sharing the latest science and the cases and innovations that are going to change practice tomorrow. The RIV is about sharing with our colleagues and moving the science of hospital medicine forward,” he said.

“Hospitalists can share and discuss their work and exchange ideas in a nonthreatening, collegial manner,” Dr. Mathews added. “In the end, we understand it’s not all about winning. We try to make sure it’s an atmosphere where people can engage and collaborate with each other.”

As far as the competitive element goes, the judges’ decisions are driven by an abstract’s content, organization, and style, Dr. Mathews said. “When we look at abstracts, affecting patient care in the authors’ own hospital is a beautiful thing, but is there a potential in this abstract to reach the masses? Is it able to be implemented beyond their local microcosm to affect people regionally, nationally, internationally? If there’s potential for that, that’s usually a good abstract.”
 

What’s new in 2018

The more than 1,000 posters and oral presentations at HM18 is a new record, and it demonstrates the growth of hospital medicine as a scientific field, Dr. Cumbler said.

“We received a huge number of submissions,” he revealed. “We see that trend rise, year over year, and the quality has been going up as well.”

New this year is a Trainee Award category for resident and student authors. Another difference in 2018: The top 15 advances in Research and Innovations have been given a special track on day 2 of the conference, with oral presentations by the authors sharing their work.

The Vignettes are being featured in a new way as well. “We have so many incredible cases that we’re going to have a clinical vignette luncheon on two different days of the conference,” Dr. Cumbler said. “These are cases that we want to highlight, so that the experience of a hospitalist in one part of the country could help a hospitalist provide the right diagnosis for a patient on the other side of the country. There are lessons to be learned in clinical medicine, and our clinical vignettes is a fantastic way of sharing them.”

In making their selections in the different categories, the judges aimed to highlight some negative studies this year, Dr. Mathews said, which is a slight departure from previous years. “Sometimes you try something and it didn’t work, and it’s important to share that so we don’t just try the same thing over and over.”

This year, Research and Innovations abstracts will be grouped by theme, making it easier for attendees to navigate the posters. “If you’ve got a particular interest in a topic like transitions or communication, you’ll be able to find that portion of the poster session and talk to some of the people who are doing groundbreaking work in that topic,” Dr. Cumbler said. 

He also noted that he expects to see a strong expression of RIV content on social media from HM18, as judges encounter some of the best and most interesting work at RIV. Dr. Mathews is similarly enthusiastic about that amplification of the work.

“I love that the conversation continues into social media platforms such as Twitter,” he said. “People are engaging back and forth, saying, ‘Hey, take a look at this poster.’ Being in a room with countless people interested in research innovations for a field that’s still relatively young – I love that there’s movement toward that.”
 

 

 

Exciting research

By definition, the research on display at the RIV is the best of the best. “It’s difficult to get your work accepted at a national meeting, and it’s a high honor to be selected as a finalist. The poster abstracts or oral presentations that win are always remarkable pieces of work,” Dr. Cumbler said.

Some of this year’s most exciting projects examine prediction models and scoring systems for patients with infections such as sepsis or influenza, he said. “One of the most fascinating abstracts looked at deep learning, or machine learning, to create algorithms to predict sepsis and decompensation in ways that simplistic models might not. Many of our current prediction rules are designed around simple acronyms, because they’re easy to remember: the ABCD score, the CURB-65 score. But if you looked at the source code of the Google search algorithm – not that they’d let you – you’d discover that it doesn’t translate to a simple four-variable prediction model. It’s incredibly complex; it looks at interactions between variables.”

This research attempts to move medical prediction models in that direction, Dr. Cumbler said. “Examining deep learning models, or neural networks, to help clinicians make more accurate predictions and take better care of patients – we are getting a taste of the future of clinical medicine at HM18.”

Several research projects highlighted at RIV this year examine ways to make better use of the data in the electronic health record.

“One of the pieces of research I’m particularly excited to hear more about looks at how the vast data that exists within electronic health records is actually used,” Dr. Cumbler said. “With electronic health records, we have all of the information in a patient’s record at our fingertips, yet this creates incredible new challenges for the hospitalist needing to make decisions in real time, with the limitations of our organic neural networks.” Dr. Cumbler revealed that one of the research teams sharing their work at HM18 explored how hospitalists interact with the volume of information that exists within the health record at the time of admission. “The results are pretty amazing,” he said.

Another project Dr. Cumbler found fascinating examines the impact of delivery of real-time performance data to hospitalists on their phones, and how it affected practice across a number of different performance metrics.

“We will see a project using game theory to teach quality improvement and another sharing important quality improvement work occurring at the intersection of evidence-based medicine and patient experience – like looking at how to keep patients NPO for less unnecessary time,” he said. “It makes perfect sense that we don’t want to keep people hungry in the hospital longer than we need to. It’s really interesting seeing how one team worked to make that happen and what they found.”
 

The importance of the RIV

The influence of the RIV program extends far beyond the conference itself; there are implications for the field of hospital medicine today and into the future.

“The RIV competition allows the field in hospital medicine to mature and evolve, so we remain cutting edge,” Dr. Mathews said. “That’s the beauty of the innovation field: Research is built off of it.”

Dr. Cumbler said that the growth and evolution of the RIV is reflective of the maturation of hospital medicine as a specialty. “It’s transitioning from a different way to organize patient care to learning more, in a scientific way, about how care can and should be delivered.”

At its heart, the RIV is really about community, he added. “The community of hospitalists is sharing knowledge, graciously and unselfishly, so that we can all improve the quality of care that we’re providing and give patients safer care, a better experience, and improved outcomes.”

Finally, RIV offers a way for hospitalists to be engaged in lifelong learning. “The presenters are teaching from their experience, and the hospitalists who come to the RIV get to leave better clinicians, researchers, and leaders as a result,” Dr. Cumbler said. “These things, to me, are about our evolution as a profession.”

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If prior SHM annual meetings are any guide, a highlight of the upcoming HM18 conference will be the Scientific Abstract and Poster Competition. This event, also known as the Research, Innovations, and Clinical Vignettes (RIV), has become one of the annual meeting’s most popular events. Crowds of attendees cluster around posters to read abstracts summarizing some of the most exciting, cutting-edge research in hospital medicine.

Networking in that crowd is a major factor in the RIV’s popularity, says the HM18 Innovations chair, Benji K. Mathews, MD, FACP, SFHM, CLHM, section head of hospital medicine at Regions Hospital, St. Paul, Minn., which is part of HealthPartners, the largest consumer-governed, non-profit health care organization in the U.S.

Dr. Benji K. Mathews, assistant professor of medicine at the University of Minnesota, Minneapolis
Dr. Benji K. Mathews

“From my standpoint, the power of this Innovations RIV competition is the opportunity to network,” said Dr. Mathews, who is also assistant professor of medicine at the University of Minnesota, Minneapolis. “In addition to primary authors, often these posters have several different people involved, and then there’s the foot traffic: We’re expecting thousands of people to walk through. The hope is to create the opportunity to network, to collaborate intergenerationally and also cross-institutionally.”

The RIV competition features some 1,000 posters this year, Dr. Mathews said. Plenary and oral sessions are chosen from the pool of abstracts prior to the meeting, and their authors are invited to present on-site at HM18.

But in spirit, the RIV is not really a competition, said RIV chair Ethan Cumbler, MD, FACP, FHM, professor of medicine at the University of Colorado.

Dr. Ethan Cumbler, professor of medicine and medical director of the University of Colorado Acute Care Center for the Elderly
Dr. Ethan Cumbler


“It’s really about sharing the latest science and the cases and innovations that are going to change practice tomorrow. The RIV is about sharing with our colleagues and moving the science of hospital medicine forward,” he said.

“Hospitalists can share and discuss their work and exchange ideas in a nonthreatening, collegial manner,” Dr. Mathews added. “In the end, we understand it’s not all about winning. We try to make sure it’s an atmosphere where people can engage and collaborate with each other.”

As far as the competitive element goes, the judges’ decisions are driven by an abstract’s content, organization, and style, Dr. Mathews said. “When we look at abstracts, affecting patient care in the authors’ own hospital is a beautiful thing, but is there a potential in this abstract to reach the masses? Is it able to be implemented beyond their local microcosm to affect people regionally, nationally, internationally? If there’s potential for that, that’s usually a good abstract.”
 

What’s new in 2018

The more than 1,000 posters and oral presentations at HM18 is a new record, and it demonstrates the growth of hospital medicine as a scientific field, Dr. Cumbler said.

“We received a huge number of submissions,” he revealed. “We see that trend rise, year over year, and the quality has been going up as well.”

New this year is a Trainee Award category for resident and student authors. Another difference in 2018: The top 15 advances in Research and Innovations have been given a special track on day 2 of the conference, with oral presentations by the authors sharing their work.

The Vignettes are being featured in a new way as well. “We have so many incredible cases that we’re going to have a clinical vignette luncheon on two different days of the conference,” Dr. Cumbler said. “These are cases that we want to highlight, so that the experience of a hospitalist in one part of the country could help a hospitalist provide the right diagnosis for a patient on the other side of the country. There are lessons to be learned in clinical medicine, and our clinical vignettes is a fantastic way of sharing them.”

In making their selections in the different categories, the judges aimed to highlight some negative studies this year, Dr. Mathews said, which is a slight departure from previous years. “Sometimes you try something and it didn’t work, and it’s important to share that so we don’t just try the same thing over and over.”

This year, Research and Innovations abstracts will be grouped by theme, making it easier for attendees to navigate the posters. “If you’ve got a particular interest in a topic like transitions or communication, you’ll be able to find that portion of the poster session and talk to some of the people who are doing groundbreaking work in that topic,” Dr. Cumbler said. 

He also noted that he expects to see a strong expression of RIV content on social media from HM18, as judges encounter some of the best and most interesting work at RIV. Dr. Mathews is similarly enthusiastic about that amplification of the work.

“I love that the conversation continues into social media platforms such as Twitter,” he said. “People are engaging back and forth, saying, ‘Hey, take a look at this poster.’ Being in a room with countless people interested in research innovations for a field that’s still relatively young – I love that there’s movement toward that.”
 

 

 

Exciting research

By definition, the research on display at the RIV is the best of the best. “It’s difficult to get your work accepted at a national meeting, and it’s a high honor to be selected as a finalist. The poster abstracts or oral presentations that win are always remarkable pieces of work,” Dr. Cumbler said.

Some of this year’s most exciting projects examine prediction models and scoring systems for patients with infections such as sepsis or influenza, he said. “One of the most fascinating abstracts looked at deep learning, or machine learning, to create algorithms to predict sepsis and decompensation in ways that simplistic models might not. Many of our current prediction rules are designed around simple acronyms, because they’re easy to remember: the ABCD score, the CURB-65 score. But if you looked at the source code of the Google search algorithm – not that they’d let you – you’d discover that it doesn’t translate to a simple four-variable prediction model. It’s incredibly complex; it looks at interactions between variables.”

This research attempts to move medical prediction models in that direction, Dr. Cumbler said. “Examining deep learning models, or neural networks, to help clinicians make more accurate predictions and take better care of patients – we are getting a taste of the future of clinical medicine at HM18.”

Several research projects highlighted at RIV this year examine ways to make better use of the data in the electronic health record.

“One of the pieces of research I’m particularly excited to hear more about looks at how the vast data that exists within electronic health records is actually used,” Dr. Cumbler said. “With electronic health records, we have all of the information in a patient’s record at our fingertips, yet this creates incredible new challenges for the hospitalist needing to make decisions in real time, with the limitations of our organic neural networks.” Dr. Cumbler revealed that one of the research teams sharing their work at HM18 explored how hospitalists interact with the volume of information that exists within the health record at the time of admission. “The results are pretty amazing,” he said.

Another project Dr. Cumbler found fascinating examines the impact of delivery of real-time performance data to hospitalists on their phones, and how it affected practice across a number of different performance metrics.

“We will see a project using game theory to teach quality improvement and another sharing important quality improvement work occurring at the intersection of evidence-based medicine and patient experience – like looking at how to keep patients NPO for less unnecessary time,” he said. “It makes perfect sense that we don’t want to keep people hungry in the hospital longer than we need to. It’s really interesting seeing how one team worked to make that happen and what they found.”
 

The importance of the RIV

The influence of the RIV program extends far beyond the conference itself; there are implications for the field of hospital medicine today and into the future.

“The RIV competition allows the field in hospital medicine to mature and evolve, so we remain cutting edge,” Dr. Mathews said. “That’s the beauty of the innovation field: Research is built off of it.”

Dr. Cumbler said that the growth and evolution of the RIV is reflective of the maturation of hospital medicine as a specialty. “It’s transitioning from a different way to organize patient care to learning more, in a scientific way, about how care can and should be delivered.”

At its heart, the RIV is really about community, he added. “The community of hospitalists is sharing knowledge, graciously and unselfishly, so that we can all improve the quality of care that we’re providing and give patients safer care, a better experience, and improved outcomes.”

Finally, RIV offers a way for hospitalists to be engaged in lifelong learning. “The presenters are teaching from their experience, and the hospitalists who come to the RIV get to leave better clinicians, researchers, and leaders as a result,” Dr. Cumbler said. “These things, to me, are about our evolution as a profession.”

 

If prior SHM annual meetings are any guide, a highlight of the upcoming HM18 conference will be the Scientific Abstract and Poster Competition. This event, also known as the Research, Innovations, and Clinical Vignettes (RIV), has become one of the annual meeting’s most popular events. Crowds of attendees cluster around posters to read abstracts summarizing some of the most exciting, cutting-edge research in hospital medicine.

Networking in that crowd is a major factor in the RIV’s popularity, says the HM18 Innovations chair, Benji K. Mathews, MD, FACP, SFHM, CLHM, section head of hospital medicine at Regions Hospital, St. Paul, Minn., which is part of HealthPartners, the largest consumer-governed, non-profit health care organization in the U.S.

Dr. Benji K. Mathews, assistant professor of medicine at the University of Minnesota, Minneapolis
Dr. Benji K. Mathews

“From my standpoint, the power of this Innovations RIV competition is the opportunity to network,” said Dr. Mathews, who is also assistant professor of medicine at the University of Minnesota, Minneapolis. “In addition to primary authors, often these posters have several different people involved, and then there’s the foot traffic: We’re expecting thousands of people to walk through. The hope is to create the opportunity to network, to collaborate intergenerationally and also cross-institutionally.”

The RIV competition features some 1,000 posters this year, Dr. Mathews said. Plenary and oral sessions are chosen from the pool of abstracts prior to the meeting, and their authors are invited to present on-site at HM18.

But in spirit, the RIV is not really a competition, said RIV chair Ethan Cumbler, MD, FACP, FHM, professor of medicine at the University of Colorado.

Dr. Ethan Cumbler, professor of medicine and medical director of the University of Colorado Acute Care Center for the Elderly
Dr. Ethan Cumbler


“It’s really about sharing the latest science and the cases and innovations that are going to change practice tomorrow. The RIV is about sharing with our colleagues and moving the science of hospital medicine forward,” he said.

“Hospitalists can share and discuss their work and exchange ideas in a nonthreatening, collegial manner,” Dr. Mathews added. “In the end, we understand it’s not all about winning. We try to make sure it’s an atmosphere where people can engage and collaborate with each other.”

As far as the competitive element goes, the judges’ decisions are driven by an abstract’s content, organization, and style, Dr. Mathews said. “When we look at abstracts, affecting patient care in the authors’ own hospital is a beautiful thing, but is there a potential in this abstract to reach the masses? Is it able to be implemented beyond their local microcosm to affect people regionally, nationally, internationally? If there’s potential for that, that’s usually a good abstract.”
 

What’s new in 2018

The more than 1,000 posters and oral presentations at HM18 is a new record, and it demonstrates the growth of hospital medicine as a scientific field, Dr. Cumbler said.

“We received a huge number of submissions,” he revealed. “We see that trend rise, year over year, and the quality has been going up as well.”

New this year is a Trainee Award category for resident and student authors. Another difference in 2018: The top 15 advances in Research and Innovations have been given a special track on day 2 of the conference, with oral presentations by the authors sharing their work.

The Vignettes are being featured in a new way as well. “We have so many incredible cases that we’re going to have a clinical vignette luncheon on two different days of the conference,” Dr. Cumbler said. “These are cases that we want to highlight, so that the experience of a hospitalist in one part of the country could help a hospitalist provide the right diagnosis for a patient on the other side of the country. There are lessons to be learned in clinical medicine, and our clinical vignettes is a fantastic way of sharing them.”

In making their selections in the different categories, the judges aimed to highlight some negative studies this year, Dr. Mathews said, which is a slight departure from previous years. “Sometimes you try something and it didn’t work, and it’s important to share that so we don’t just try the same thing over and over.”

This year, Research and Innovations abstracts will be grouped by theme, making it easier for attendees to navigate the posters. “If you’ve got a particular interest in a topic like transitions or communication, you’ll be able to find that portion of the poster session and talk to some of the people who are doing groundbreaking work in that topic,” Dr. Cumbler said. 

He also noted that he expects to see a strong expression of RIV content on social media from HM18, as judges encounter some of the best and most interesting work at RIV. Dr. Mathews is similarly enthusiastic about that amplification of the work.

“I love that the conversation continues into social media platforms such as Twitter,” he said. “People are engaging back and forth, saying, ‘Hey, take a look at this poster.’ Being in a room with countless people interested in research innovations for a field that’s still relatively young – I love that there’s movement toward that.”
 

 

 

Exciting research

By definition, the research on display at the RIV is the best of the best. “It’s difficult to get your work accepted at a national meeting, and it’s a high honor to be selected as a finalist. The poster abstracts or oral presentations that win are always remarkable pieces of work,” Dr. Cumbler said.

Some of this year’s most exciting projects examine prediction models and scoring systems for patients with infections such as sepsis or influenza, he said. “One of the most fascinating abstracts looked at deep learning, or machine learning, to create algorithms to predict sepsis and decompensation in ways that simplistic models might not. Many of our current prediction rules are designed around simple acronyms, because they’re easy to remember: the ABCD score, the CURB-65 score. But if you looked at the source code of the Google search algorithm – not that they’d let you – you’d discover that it doesn’t translate to a simple four-variable prediction model. It’s incredibly complex; it looks at interactions between variables.”

This research attempts to move medical prediction models in that direction, Dr. Cumbler said. “Examining deep learning models, or neural networks, to help clinicians make more accurate predictions and take better care of patients – we are getting a taste of the future of clinical medicine at HM18.”

Several research projects highlighted at RIV this year examine ways to make better use of the data in the electronic health record.

“One of the pieces of research I’m particularly excited to hear more about looks at how the vast data that exists within electronic health records is actually used,” Dr. Cumbler said. “With electronic health records, we have all of the information in a patient’s record at our fingertips, yet this creates incredible new challenges for the hospitalist needing to make decisions in real time, with the limitations of our organic neural networks.” Dr. Cumbler revealed that one of the research teams sharing their work at HM18 explored how hospitalists interact with the volume of information that exists within the health record at the time of admission. “The results are pretty amazing,” he said.

Another project Dr. Cumbler found fascinating examines the impact of delivery of real-time performance data to hospitalists on their phones, and how it affected practice across a number of different performance metrics.

“We will see a project using game theory to teach quality improvement and another sharing important quality improvement work occurring at the intersection of evidence-based medicine and patient experience – like looking at how to keep patients NPO for less unnecessary time,” he said. “It makes perfect sense that we don’t want to keep people hungry in the hospital longer than we need to. It’s really interesting seeing how one team worked to make that happen and what they found.”
 

The importance of the RIV

The influence of the RIV program extends far beyond the conference itself; there are implications for the field of hospital medicine today and into the future.

“The RIV competition allows the field in hospital medicine to mature and evolve, so we remain cutting edge,” Dr. Mathews said. “That’s the beauty of the innovation field: Research is built off of it.”

Dr. Cumbler said that the growth and evolution of the RIV is reflective of the maturation of hospital medicine as a specialty. “It’s transitioning from a different way to organize patient care to learning more, in a scientific way, about how care can and should be delivered.”

At its heart, the RIV is really about community, he added. “The community of hospitalists is sharing knowledge, graciously and unselfishly, so that we can all improve the quality of care that we’re providing and give patients safer care, a better experience, and improved outcomes.”

Finally, RIV offers a way for hospitalists to be engaged in lifelong learning. “The presenters are teaching from their experience, and the hospitalists who come to the RIV get to leave better clinicians, researchers, and leaders as a result,” Dr. Cumbler said. “These things, to me, are about our evolution as a profession.”

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Here are the ‘must-see’ sessions at HM18

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Welcome to Hospital Medicine 2018, the second-happiest place in Orlando – at least for hospitalists who want to be in the know.

The 2018 education program is a ride through the diverse world of hospital medicine, with sessions ranging from clinical updates to cutting-edge techniques, communication tools, building a satisfying career, and finding your way through tangles of red tape and policy.

Two tracks new for 2018 hone in on managing alternative providers and palliative care.

The half-day NP/PA track (beginning April 11 at 7:30 a.m.) recognizes these practitioners for their crucial roles in hospital medicine care delivery. Among the discussions aimed at hospitalists: Best practices in provider utilization and collaboration; supervision vs. collaboration; and challenging situations when working with mid-level providers.

The palliative care track (also a half day, starting April 11 at 10 a.m.) recognizes the crucial role hospitalists play in optimizing end-of-life care. Sessions will help hospitalists understand that role, and guide them in managing pain and other symptoms commonly encountered during this transitional time.

As for the rest of the meeting, picking favorites is as tough as picking between Disney’s Big Thunder Railroad and Splash Mountain, said HM18 course director Dustin Smith, MD, SFHM, of Emory University, Atlanta. “We feel strongly that all offerings at the conference are ‘must-sees,’ and it’s why we offer repeat sessions of what we predict will be the most popular talks overall. Since there are so many good sessions competing for attendees at the same time, we wanted to make sure we offered these repeat sessions of common, high-yield clinical topics.”

The Repeated Sessions track is set for April 10, and runs a full day. The track includes these dynamic sessions:

  • Updates in congestive heart failure: Pablo Quintero, MD; 11-11:40 a.m.
  • He-who-shall-not-be-named: Updates in sepsis and critical care: Patricia Kritek, MD, EdM; 11:50 a.m.-12:30 p.m.
  • Not true love’s kiss? Updates in infectious disease: John Sanders, MD, MPHTM; 2:50-3:30 p.m.
  • Updates in acute coronary syndrome: Jeff Trost, MD; 3:40-4:20 p.m.
  • Waiting in line for ‘It’s a Small World’ and other things we do for no reason: Tony Breu, MD, FHM; 4:30-5:10 p.m.
  • “The Mad Hatter”: Updates in delirium: Ethan Cumbler, MD, FHM; 5:20-6:00 p.m.

In addition to the sepsis update in the Repeated Sessions track, Dr. Smith noted that sepsis will also be the topic of a pre-course offering (April 8, 8:15 a.m.-4:50 p.m.). “The topic of sepsis remains a hot item in hospital medicine,” he said.

“I’d also like to highlight a new pre-course offering this year – ‘Keep your finger on the pulse: Cardiology update for the hospitalist’ (April 8, 8:30 a.m.-4:50 p.m.),” he said. “Many of our pre-course offerings are carry-overs from previous years due to ongoing great success with the individual pre-courses themselves. Although we have had a cardiology pre-course in our lineup of offerings in the past, we chose to offer a freshly redesigned pre-course in cardiology this year to round out the lineup of pre-course offerings and to keep things fresh.”

The “Stump the attentive (not absent-minded) professor” sessions on clinical unknowns in the Diagnostics Reasoning track are also must-sees, Dr. Smith said. So much so, that SHM is offering two of them this year (April 9, 2:00-2:40 p.m.; 3:45-4:25 p.m.).

Dr. Smith’s codirector Kathleen Finn, MD, MPhil, SFHM, also has a few personal favorites on the education program.

“I know the talks in the ‘Seasoning your career track’ will be great,” said Dr. Finn, a hospitalist at Massachusetts General Hospital, Boston. “This new track provides mid-career hospitalists (and new hospitalists) ideas in how to continue to make their career enjoyable and stimulating. It includes talks on how to advance in a leadership position, use emotional intelligence to achieve success, prevent burnout or design your groups schedule so it doesn’t rule your life.”
 

The board weighs in

The 2018 HM18 line-up garnered an enthusiastic thumbs-up from The Hospitalist’s editorial advisory board. We polled these experts for their 2018 “must-see” sessions, and they responded with a selection that spans the meeting’s wide-ranging offerings.



1. Leadership essentials for success in hospital medicine (April 9, 10:35 a.m.-12:05 p.m.)

Amit Vashist, MD, MBA, FHM, system chair, hospitalist division, Mountain State Health Alliance, Virginia/Tennessee, is especially excited about this session, intended to help hospitalists assume leadership roles.

“Given the ever-expanding footprint of hospitalists inside the hospitals and beyond, and the way they are being called upon to be the drivers of an increasingly value-based care, I believe it is imperative for every hospitalist provider – regardless of being in a leadership role or not – to have a fundamental understanding of the leadership nuances pertaining specifically to hospital medicine in order to optimally leverage their skill set to drive transformational changes in the health care arena,” he said. “This primer on leadership essentials should pique the interest of the hospitalists further towards developing a deeper appreciation of some of the leadership dimensions must-haves in the realm of hospital medicine.”

 

 

Dr. Raj Sehgal clinical associate professor of medicine, division of hospital medicine, South Texas Veterans Health Care System and University of Texas Health Sciences Center at San Antonio.
Dr. Raj Sehgal


Raj Sehgal, MD, FHM, clinical associate professor of medicine, University of Texas Health Sciences Center at San Antonio, pegged communication and behavioral medicine as two top picks.

2. Do you have a minute to talk? Peer-to-peer feedback (April 9, 2:50-4:20 p.m.)

“Those of us in academic settings spend a lot of time thinking about giving feedback to – and receiving feedback from – students and residents, but some of the most valuable feedback we can get is from our coworkers,” he said. “Many hospitalist groups are actively working on ways for their providers to learn from each other, such as peer observations, and this session should help in guiding some of those programs.”

3. Through the looking glass: A psychiatrist’s tricks for inpatient acute behavioral emergencies (April 10, 2:50-3:50 p.m.)

“Even for a seasoned hospitalist who never breaks a sweat treating the most acutely medically ill patients, the acutely psychotic (or agitated, or suicidal) patient can provoke significant anxiety,” Dr. Sehgal said. “The opportunity to gain another couple of ‘tools’ to add to our kit for these patients should help alleviate that feeling.”

Dr. Weijen Chang
Dr. Weijen Chang

No need for an academic meeting to be boring, said Weijen Chang, MD, SFHM, chief of pediatric hospital medicine at Baystate Children’s Hospital, Springfield, Mass.

4. Can we just stick to the “Bare Necessities”? – Things we do for no reason (April 9, 10:35-11:35 a.m.)

5. “Mirror, Mirror on the Wall”: Which articles are the fairest of them all? Top pediatric updates (April 10, 5:45-6:45 p.m.)

“I’d say Dr. Lenny Feldman’s [SFHM] ‘Things we do for no reason’ is a must-see. Lenny is a master at simplifying complex issues and communicating them in an easily understood manner, and he’s quite entertaining,” Dr. Chang said. “And of course, another must-see is Top Pediatric Updates. It is entertaining, educational, and we almost got thrown out last year for bringing beer!”

Dr. Sarah Stella, University of Colorado at Denver, Aurora
Dr. Sarah Stella

Sarah Stella, MD, FHM, a hospitalist at Denver Health, had a hard time choosing between the many interesting offerings. “There are quite a few great sessions this year that I’m interested in, but these are my top picks:”

6. Convert your everyday work into scholarship (and get it funded) (April 9, 1:35-2:35 p.m.)

“By virtue of their daily clinical and quality improvement/committee work, many hospitalists are well on their way to generating scholarship and funding, but are unsure how to make this conversion,” she said. “This workshop is a must for academic hospitalists working toward promotion who want a framework and tangible steps on how to get credit for what they are already doing.”

7. “Heigh ho, heigh ho,” it’s off to changing roles mid-career we go (April 11, 8:20-9:00 a.m.)

“Part of what attracts many of us to hospital medicine in the first place is the versatility of what we do and the ability to diversify based on our interests. I think this is a must-see for mid-career hospitalists like myself, or really any hospitalist dreaming of reinventing oneself.”

8. Winning hearts and minds at the bedside: Battling unconscious bias through cultural humility (April 11, 9:10-9:50 a.m.)

“Recognizing and confronting our implicit biases and how they affect patient-physician interactions is hard but incredibly important work,” Dr. Stella said. “I’ll definitely be attending this session by Aziz Ansari, DO, SFHM, to learn how to improve my relationship (and hence outcomes) with my patients.”

Dr. Harry Cho of Mount Sinai, New York City
Dr. Harry Cho

Harry (Hyung) Cho, MD, FHM, assistant professor of medicine and director of quality, safety, and value, division of hospital medicine, Mount Sinai Hospital, New York, had some diverse choices.

9. Being female in hospital medicine: Overcoming individual and institutional barriers in the workplace (April 9, 12:40-2:15 p.m.)

“This is a very timely, very important topic in the news and I think it will draw a lot of people,” he said.

10. Every patient tells a story and the art of diagnosis (April 9, 2:55-3:35 p.m.)

“The presenter is Dr. Lisa Sanders, who writes the ‘Diagnosis’ column for the New York Times and is a Yale University faculty member. She’s a great speaker and, incidentally, was a consultant on the TV show, ‘House, MD.’ ”

Dr. Raman Palabindala, University of Mississippi Medical Center, Jackson
Dr. Raman Palabindala

Raman Palabindala, MD, FHM, a hospitalist at the University of Mississippi Medical Center, Jackson, thinks the most important session at HM18 is the annual update.

11. Update in hospital medicine (April 10, 1:40-2:40 p.m.)“Almost every year, this is the most high energy presentation, and I don’t think I ever missed this session, no matter who is the presenter is,” he said. “As physicians, I think we need this update every year, and this is the best single hour where we can learn a lot as a hospitalist related to hospital medicine. This is the most concentrated extract of the entire meeting. What I learned about the behind scenes efforts up to 50-100 hours of work – why not we take advantage of this session.”

Dr. Lonika Sood, a hospitalist based at Aurora Baycare Medical Center, Green Bay, Wis.
Dr. Lonika Sood

 

Lonika Sood, MD, FHM of the department of hospital medicine, Aurora BayCare Medical Center, Green Bay, Wis., has a passion for both leadership and scholarship, and her choices reflect that interest.

12. How to write a winning abstract (April 11, 7:30-8:30 a.m.)

13. Leadership positions in medical education: How to break into the field (April 11, 11:40 a.m.-12:20 p.m.)

14. Serious illness communication: A skills-based workshop (April 11, 8:00-9:30 a.m.)

“I would recommend all of those, especially for early-career hospitalists. And, having enjoyed and learned a lot from the workshops at HM17, I would highly recommend checking out a few that will help polish your communications – a much-needed skill in hospital medicine,” she said.

Finally, don’t just pick up another embroidered mouse ear hat on your way out. The best HM18 souvenir is taking back the knowledge you gained and – as Dr. Sood said – there’s a session for that.

15. How to bring the things you learn at SHM back to your institution: Advocating for high value care on hospital committees (April 11, 8:00-9:30 a.m.).



For more information on the HM18 education sessions, check the latest version of the conference schedule at http://shmannualconference.org/conference-schedule.


 

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Welcome to Hospital Medicine 2018, the second-happiest place in Orlando – at least for hospitalists who want to be in the know.

The 2018 education program is a ride through the diverse world of hospital medicine, with sessions ranging from clinical updates to cutting-edge techniques, communication tools, building a satisfying career, and finding your way through tangles of red tape and policy.

Two tracks new for 2018 hone in on managing alternative providers and palliative care.

The half-day NP/PA track (beginning April 11 at 7:30 a.m.) recognizes these practitioners for their crucial roles in hospital medicine care delivery. Among the discussions aimed at hospitalists: Best practices in provider utilization and collaboration; supervision vs. collaboration; and challenging situations when working with mid-level providers.

The palliative care track (also a half day, starting April 11 at 10 a.m.) recognizes the crucial role hospitalists play in optimizing end-of-life care. Sessions will help hospitalists understand that role, and guide them in managing pain and other symptoms commonly encountered during this transitional time.

As for the rest of the meeting, picking favorites is as tough as picking between Disney’s Big Thunder Railroad and Splash Mountain, said HM18 course director Dustin Smith, MD, SFHM, of Emory University, Atlanta. “We feel strongly that all offerings at the conference are ‘must-sees,’ and it’s why we offer repeat sessions of what we predict will be the most popular talks overall. Since there are so many good sessions competing for attendees at the same time, we wanted to make sure we offered these repeat sessions of common, high-yield clinical topics.”

The Repeated Sessions track is set for April 10, and runs a full day. The track includes these dynamic sessions:

  • Updates in congestive heart failure: Pablo Quintero, MD; 11-11:40 a.m.
  • He-who-shall-not-be-named: Updates in sepsis and critical care: Patricia Kritek, MD, EdM; 11:50 a.m.-12:30 p.m.
  • Not true love’s kiss? Updates in infectious disease: John Sanders, MD, MPHTM; 2:50-3:30 p.m.
  • Updates in acute coronary syndrome: Jeff Trost, MD; 3:40-4:20 p.m.
  • Waiting in line for ‘It’s a Small World’ and other things we do for no reason: Tony Breu, MD, FHM; 4:30-5:10 p.m.
  • “The Mad Hatter”: Updates in delirium: Ethan Cumbler, MD, FHM; 5:20-6:00 p.m.

In addition to the sepsis update in the Repeated Sessions track, Dr. Smith noted that sepsis will also be the topic of a pre-course offering (April 8, 8:15 a.m.-4:50 p.m.). “The topic of sepsis remains a hot item in hospital medicine,” he said.

“I’d also like to highlight a new pre-course offering this year – ‘Keep your finger on the pulse: Cardiology update for the hospitalist’ (April 8, 8:30 a.m.-4:50 p.m.),” he said. “Many of our pre-course offerings are carry-overs from previous years due to ongoing great success with the individual pre-courses themselves. Although we have had a cardiology pre-course in our lineup of offerings in the past, we chose to offer a freshly redesigned pre-course in cardiology this year to round out the lineup of pre-course offerings and to keep things fresh.”

The “Stump the attentive (not absent-minded) professor” sessions on clinical unknowns in the Diagnostics Reasoning track are also must-sees, Dr. Smith said. So much so, that SHM is offering two of them this year (April 9, 2:00-2:40 p.m.; 3:45-4:25 p.m.).

Dr. Smith’s codirector Kathleen Finn, MD, MPhil, SFHM, also has a few personal favorites on the education program.

“I know the talks in the ‘Seasoning your career track’ will be great,” said Dr. Finn, a hospitalist at Massachusetts General Hospital, Boston. “This new track provides mid-career hospitalists (and new hospitalists) ideas in how to continue to make their career enjoyable and stimulating. It includes talks on how to advance in a leadership position, use emotional intelligence to achieve success, prevent burnout or design your groups schedule so it doesn’t rule your life.”
 

The board weighs in

The 2018 HM18 line-up garnered an enthusiastic thumbs-up from The Hospitalist’s editorial advisory board. We polled these experts for their 2018 “must-see” sessions, and they responded with a selection that spans the meeting’s wide-ranging offerings.



1. Leadership essentials for success in hospital medicine (April 9, 10:35 a.m.-12:05 p.m.)

Amit Vashist, MD, MBA, FHM, system chair, hospitalist division, Mountain State Health Alliance, Virginia/Tennessee, is especially excited about this session, intended to help hospitalists assume leadership roles.

“Given the ever-expanding footprint of hospitalists inside the hospitals and beyond, and the way they are being called upon to be the drivers of an increasingly value-based care, I believe it is imperative for every hospitalist provider – regardless of being in a leadership role or not – to have a fundamental understanding of the leadership nuances pertaining specifically to hospital medicine in order to optimally leverage their skill set to drive transformational changes in the health care arena,” he said. “This primer on leadership essentials should pique the interest of the hospitalists further towards developing a deeper appreciation of some of the leadership dimensions must-haves in the realm of hospital medicine.”

 

 

Dr. Raj Sehgal clinical associate professor of medicine, division of hospital medicine, South Texas Veterans Health Care System and University of Texas Health Sciences Center at San Antonio.
Dr. Raj Sehgal


Raj Sehgal, MD, FHM, clinical associate professor of medicine, University of Texas Health Sciences Center at San Antonio, pegged communication and behavioral medicine as two top picks.

2. Do you have a minute to talk? Peer-to-peer feedback (April 9, 2:50-4:20 p.m.)

“Those of us in academic settings spend a lot of time thinking about giving feedback to – and receiving feedback from – students and residents, but some of the most valuable feedback we can get is from our coworkers,” he said. “Many hospitalist groups are actively working on ways for their providers to learn from each other, such as peer observations, and this session should help in guiding some of those programs.”

3. Through the looking glass: A psychiatrist’s tricks for inpatient acute behavioral emergencies (April 10, 2:50-3:50 p.m.)

“Even for a seasoned hospitalist who never breaks a sweat treating the most acutely medically ill patients, the acutely psychotic (or agitated, or suicidal) patient can provoke significant anxiety,” Dr. Sehgal said. “The opportunity to gain another couple of ‘tools’ to add to our kit for these patients should help alleviate that feeling.”

Dr. Weijen Chang
Dr. Weijen Chang

No need for an academic meeting to be boring, said Weijen Chang, MD, SFHM, chief of pediatric hospital medicine at Baystate Children’s Hospital, Springfield, Mass.

4. Can we just stick to the “Bare Necessities”? – Things we do for no reason (April 9, 10:35-11:35 a.m.)

5. “Mirror, Mirror on the Wall”: Which articles are the fairest of them all? Top pediatric updates (April 10, 5:45-6:45 p.m.)

“I’d say Dr. Lenny Feldman’s [SFHM] ‘Things we do for no reason’ is a must-see. Lenny is a master at simplifying complex issues and communicating them in an easily understood manner, and he’s quite entertaining,” Dr. Chang said. “And of course, another must-see is Top Pediatric Updates. It is entertaining, educational, and we almost got thrown out last year for bringing beer!”

Dr. Sarah Stella, University of Colorado at Denver, Aurora
Dr. Sarah Stella

Sarah Stella, MD, FHM, a hospitalist at Denver Health, had a hard time choosing between the many interesting offerings. “There are quite a few great sessions this year that I’m interested in, but these are my top picks:”

6. Convert your everyday work into scholarship (and get it funded) (April 9, 1:35-2:35 p.m.)

“By virtue of their daily clinical and quality improvement/committee work, many hospitalists are well on their way to generating scholarship and funding, but are unsure how to make this conversion,” she said. “This workshop is a must for academic hospitalists working toward promotion who want a framework and tangible steps on how to get credit for what they are already doing.”

7. “Heigh ho, heigh ho,” it’s off to changing roles mid-career we go (April 11, 8:20-9:00 a.m.)

“Part of what attracts many of us to hospital medicine in the first place is the versatility of what we do and the ability to diversify based on our interests. I think this is a must-see for mid-career hospitalists like myself, or really any hospitalist dreaming of reinventing oneself.”

8. Winning hearts and minds at the bedside: Battling unconscious bias through cultural humility (April 11, 9:10-9:50 a.m.)

“Recognizing and confronting our implicit biases and how they affect patient-physician interactions is hard but incredibly important work,” Dr. Stella said. “I’ll definitely be attending this session by Aziz Ansari, DO, SFHM, to learn how to improve my relationship (and hence outcomes) with my patients.”

Dr. Harry Cho of Mount Sinai, New York City
Dr. Harry Cho

Harry (Hyung) Cho, MD, FHM, assistant professor of medicine and director of quality, safety, and value, division of hospital medicine, Mount Sinai Hospital, New York, had some diverse choices.

9. Being female in hospital medicine: Overcoming individual and institutional barriers in the workplace (April 9, 12:40-2:15 p.m.)

“This is a very timely, very important topic in the news and I think it will draw a lot of people,” he said.

10. Every patient tells a story and the art of diagnosis (April 9, 2:55-3:35 p.m.)

“The presenter is Dr. Lisa Sanders, who writes the ‘Diagnosis’ column for the New York Times and is a Yale University faculty member. She’s a great speaker and, incidentally, was a consultant on the TV show, ‘House, MD.’ ”

Dr. Raman Palabindala, University of Mississippi Medical Center, Jackson
Dr. Raman Palabindala

Raman Palabindala, MD, FHM, a hospitalist at the University of Mississippi Medical Center, Jackson, thinks the most important session at HM18 is the annual update.

11. Update in hospital medicine (April 10, 1:40-2:40 p.m.)“Almost every year, this is the most high energy presentation, and I don’t think I ever missed this session, no matter who is the presenter is,” he said. “As physicians, I think we need this update every year, and this is the best single hour where we can learn a lot as a hospitalist related to hospital medicine. This is the most concentrated extract of the entire meeting. What I learned about the behind scenes efforts up to 50-100 hours of work – why not we take advantage of this session.”

Dr. Lonika Sood, a hospitalist based at Aurora Baycare Medical Center, Green Bay, Wis.
Dr. Lonika Sood

 

Lonika Sood, MD, FHM of the department of hospital medicine, Aurora BayCare Medical Center, Green Bay, Wis., has a passion for both leadership and scholarship, and her choices reflect that interest.

12. How to write a winning abstract (April 11, 7:30-8:30 a.m.)

13. Leadership positions in medical education: How to break into the field (April 11, 11:40 a.m.-12:20 p.m.)

14. Serious illness communication: A skills-based workshop (April 11, 8:00-9:30 a.m.)

“I would recommend all of those, especially for early-career hospitalists. And, having enjoyed and learned a lot from the workshops at HM17, I would highly recommend checking out a few that will help polish your communications – a much-needed skill in hospital medicine,” she said.

Finally, don’t just pick up another embroidered mouse ear hat on your way out. The best HM18 souvenir is taking back the knowledge you gained and – as Dr. Sood said – there’s a session for that.

15. How to bring the things you learn at SHM back to your institution: Advocating for high value care on hospital committees (April 11, 8:00-9:30 a.m.).



For more information on the HM18 education sessions, check the latest version of the conference schedule at http://shmannualconference.org/conference-schedule.


 

 

Welcome to Hospital Medicine 2018, the second-happiest place in Orlando – at least for hospitalists who want to be in the know.

The 2018 education program is a ride through the diverse world of hospital medicine, with sessions ranging from clinical updates to cutting-edge techniques, communication tools, building a satisfying career, and finding your way through tangles of red tape and policy.

Two tracks new for 2018 hone in on managing alternative providers and palliative care.

The half-day NP/PA track (beginning April 11 at 7:30 a.m.) recognizes these practitioners for their crucial roles in hospital medicine care delivery. Among the discussions aimed at hospitalists: Best practices in provider utilization and collaboration; supervision vs. collaboration; and challenging situations when working with mid-level providers.

The palliative care track (also a half day, starting April 11 at 10 a.m.) recognizes the crucial role hospitalists play in optimizing end-of-life care. Sessions will help hospitalists understand that role, and guide them in managing pain and other symptoms commonly encountered during this transitional time.

As for the rest of the meeting, picking favorites is as tough as picking between Disney’s Big Thunder Railroad and Splash Mountain, said HM18 course director Dustin Smith, MD, SFHM, of Emory University, Atlanta. “We feel strongly that all offerings at the conference are ‘must-sees,’ and it’s why we offer repeat sessions of what we predict will be the most popular talks overall. Since there are so many good sessions competing for attendees at the same time, we wanted to make sure we offered these repeat sessions of common, high-yield clinical topics.”

The Repeated Sessions track is set for April 10, and runs a full day. The track includes these dynamic sessions:

  • Updates in congestive heart failure: Pablo Quintero, MD; 11-11:40 a.m.
  • He-who-shall-not-be-named: Updates in sepsis and critical care: Patricia Kritek, MD, EdM; 11:50 a.m.-12:30 p.m.
  • Not true love’s kiss? Updates in infectious disease: John Sanders, MD, MPHTM; 2:50-3:30 p.m.
  • Updates in acute coronary syndrome: Jeff Trost, MD; 3:40-4:20 p.m.
  • Waiting in line for ‘It’s a Small World’ and other things we do for no reason: Tony Breu, MD, FHM; 4:30-5:10 p.m.
  • “The Mad Hatter”: Updates in delirium: Ethan Cumbler, MD, FHM; 5:20-6:00 p.m.

In addition to the sepsis update in the Repeated Sessions track, Dr. Smith noted that sepsis will also be the topic of a pre-course offering (April 8, 8:15 a.m.-4:50 p.m.). “The topic of sepsis remains a hot item in hospital medicine,” he said.

“I’d also like to highlight a new pre-course offering this year – ‘Keep your finger on the pulse: Cardiology update for the hospitalist’ (April 8, 8:30 a.m.-4:50 p.m.),” he said. “Many of our pre-course offerings are carry-overs from previous years due to ongoing great success with the individual pre-courses themselves. Although we have had a cardiology pre-course in our lineup of offerings in the past, we chose to offer a freshly redesigned pre-course in cardiology this year to round out the lineup of pre-course offerings and to keep things fresh.”

The “Stump the attentive (not absent-minded) professor” sessions on clinical unknowns in the Diagnostics Reasoning track are also must-sees, Dr. Smith said. So much so, that SHM is offering two of them this year (April 9, 2:00-2:40 p.m.; 3:45-4:25 p.m.).

Dr. Smith’s codirector Kathleen Finn, MD, MPhil, SFHM, also has a few personal favorites on the education program.

“I know the talks in the ‘Seasoning your career track’ will be great,” said Dr. Finn, a hospitalist at Massachusetts General Hospital, Boston. “This new track provides mid-career hospitalists (and new hospitalists) ideas in how to continue to make their career enjoyable and stimulating. It includes talks on how to advance in a leadership position, use emotional intelligence to achieve success, prevent burnout or design your groups schedule so it doesn’t rule your life.”
 

The board weighs in

The 2018 HM18 line-up garnered an enthusiastic thumbs-up from The Hospitalist’s editorial advisory board. We polled these experts for their 2018 “must-see” sessions, and they responded with a selection that spans the meeting’s wide-ranging offerings.



1. Leadership essentials for success in hospital medicine (April 9, 10:35 a.m.-12:05 p.m.)

Amit Vashist, MD, MBA, FHM, system chair, hospitalist division, Mountain State Health Alliance, Virginia/Tennessee, is especially excited about this session, intended to help hospitalists assume leadership roles.

“Given the ever-expanding footprint of hospitalists inside the hospitals and beyond, and the way they are being called upon to be the drivers of an increasingly value-based care, I believe it is imperative for every hospitalist provider – regardless of being in a leadership role or not – to have a fundamental understanding of the leadership nuances pertaining specifically to hospital medicine in order to optimally leverage their skill set to drive transformational changes in the health care arena,” he said. “This primer on leadership essentials should pique the interest of the hospitalists further towards developing a deeper appreciation of some of the leadership dimensions must-haves in the realm of hospital medicine.”

 

 

Dr. Raj Sehgal clinical associate professor of medicine, division of hospital medicine, South Texas Veterans Health Care System and University of Texas Health Sciences Center at San Antonio.
Dr. Raj Sehgal


Raj Sehgal, MD, FHM, clinical associate professor of medicine, University of Texas Health Sciences Center at San Antonio, pegged communication and behavioral medicine as two top picks.

2. Do you have a minute to talk? Peer-to-peer feedback (April 9, 2:50-4:20 p.m.)

“Those of us in academic settings spend a lot of time thinking about giving feedback to – and receiving feedback from – students and residents, but some of the most valuable feedback we can get is from our coworkers,” he said. “Many hospitalist groups are actively working on ways for their providers to learn from each other, such as peer observations, and this session should help in guiding some of those programs.”

3. Through the looking glass: A psychiatrist’s tricks for inpatient acute behavioral emergencies (April 10, 2:50-3:50 p.m.)

“Even for a seasoned hospitalist who never breaks a sweat treating the most acutely medically ill patients, the acutely psychotic (or agitated, or suicidal) patient can provoke significant anxiety,” Dr. Sehgal said. “The opportunity to gain another couple of ‘tools’ to add to our kit for these patients should help alleviate that feeling.”

Dr. Weijen Chang
Dr. Weijen Chang

No need for an academic meeting to be boring, said Weijen Chang, MD, SFHM, chief of pediatric hospital medicine at Baystate Children’s Hospital, Springfield, Mass.

4. Can we just stick to the “Bare Necessities”? – Things we do for no reason (April 9, 10:35-11:35 a.m.)

5. “Mirror, Mirror on the Wall”: Which articles are the fairest of them all? Top pediatric updates (April 10, 5:45-6:45 p.m.)

“I’d say Dr. Lenny Feldman’s [SFHM] ‘Things we do for no reason’ is a must-see. Lenny is a master at simplifying complex issues and communicating them in an easily understood manner, and he’s quite entertaining,” Dr. Chang said. “And of course, another must-see is Top Pediatric Updates. It is entertaining, educational, and we almost got thrown out last year for bringing beer!”

Dr. Sarah Stella, University of Colorado at Denver, Aurora
Dr. Sarah Stella

Sarah Stella, MD, FHM, a hospitalist at Denver Health, had a hard time choosing between the many interesting offerings. “There are quite a few great sessions this year that I’m interested in, but these are my top picks:”

6. Convert your everyday work into scholarship (and get it funded) (April 9, 1:35-2:35 p.m.)

“By virtue of their daily clinical and quality improvement/committee work, many hospitalists are well on their way to generating scholarship and funding, but are unsure how to make this conversion,” she said. “This workshop is a must for academic hospitalists working toward promotion who want a framework and tangible steps on how to get credit for what they are already doing.”

7. “Heigh ho, heigh ho,” it’s off to changing roles mid-career we go (April 11, 8:20-9:00 a.m.)

“Part of what attracts many of us to hospital medicine in the first place is the versatility of what we do and the ability to diversify based on our interests. I think this is a must-see for mid-career hospitalists like myself, or really any hospitalist dreaming of reinventing oneself.”

8. Winning hearts and minds at the bedside: Battling unconscious bias through cultural humility (April 11, 9:10-9:50 a.m.)

“Recognizing and confronting our implicit biases and how they affect patient-physician interactions is hard but incredibly important work,” Dr. Stella said. “I’ll definitely be attending this session by Aziz Ansari, DO, SFHM, to learn how to improve my relationship (and hence outcomes) with my patients.”

Dr. Harry Cho of Mount Sinai, New York City
Dr. Harry Cho

Harry (Hyung) Cho, MD, FHM, assistant professor of medicine and director of quality, safety, and value, division of hospital medicine, Mount Sinai Hospital, New York, had some diverse choices.

9. Being female in hospital medicine: Overcoming individual and institutional barriers in the workplace (April 9, 12:40-2:15 p.m.)

“This is a very timely, very important topic in the news and I think it will draw a lot of people,” he said.

10. Every patient tells a story and the art of diagnosis (April 9, 2:55-3:35 p.m.)

“The presenter is Dr. Lisa Sanders, who writes the ‘Diagnosis’ column for the New York Times and is a Yale University faculty member. She’s a great speaker and, incidentally, was a consultant on the TV show, ‘House, MD.’ ”

Dr. Raman Palabindala, University of Mississippi Medical Center, Jackson
Dr. Raman Palabindala

Raman Palabindala, MD, FHM, a hospitalist at the University of Mississippi Medical Center, Jackson, thinks the most important session at HM18 is the annual update.

11. Update in hospital medicine (April 10, 1:40-2:40 p.m.)“Almost every year, this is the most high energy presentation, and I don’t think I ever missed this session, no matter who is the presenter is,” he said. “As physicians, I think we need this update every year, and this is the best single hour where we can learn a lot as a hospitalist related to hospital medicine. This is the most concentrated extract of the entire meeting. What I learned about the behind scenes efforts up to 50-100 hours of work – why not we take advantage of this session.”

Dr. Lonika Sood, a hospitalist based at Aurora Baycare Medical Center, Green Bay, Wis.
Dr. Lonika Sood

 

Lonika Sood, MD, FHM of the department of hospital medicine, Aurora BayCare Medical Center, Green Bay, Wis., has a passion for both leadership and scholarship, and her choices reflect that interest.

12. How to write a winning abstract (April 11, 7:30-8:30 a.m.)

13. Leadership positions in medical education: How to break into the field (April 11, 11:40 a.m.-12:20 p.m.)

14. Serious illness communication: A skills-based workshop (April 11, 8:00-9:30 a.m.)

“I would recommend all of those, especially for early-career hospitalists. And, having enjoyed and learned a lot from the workshops at HM17, I would highly recommend checking out a few that will help polish your communications – a much-needed skill in hospital medicine,” she said.

Finally, don’t just pick up another embroidered mouse ear hat on your way out. The best HM18 souvenir is taking back the knowledge you gained and – as Dr. Sood said – there’s a session for that.

15. How to bring the things you learn at SHM back to your institution: Advocating for high value care on hospital committees (April 11, 8:00-9:30 a.m.).



For more information on the HM18 education sessions, check the latest version of the conference schedule at http://shmannualconference.org/conference-schedule.


 

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Hospitalists focus on POCUS

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Fri, 09/14/2018 - 11:54

 

Point-of-care ultrasound (POCUS) is proving to be an increasing useful diagnostic tool for clinicians at the bedside, and many hospitalists have expressed interest in learning best practices in the use of the technology.

To that end, the Society of Hospital Medicine (SHM) is offering a half-day POCUS pre-course at Hospital Medicine 2018 this April in Orlando, with the intent of helping hospitalists learn how best to use POCUS in clinical settings.

Dr. Nilam J. Soni of the University of Texas at San Antonio and South Texas Veterans Health Care System
Dr. Nilam J. Soni

“The agenda is really designed to teach people the basics of point-of-care ultrasound,” said Nilam J. Soni, MD, MSc, of the University of Texas at San Antonio and South Texas Veterans Health Care System, also in San Antonio, and a coinstructor of the POCUS pre-course. “It’s designed for the novice learner who has no prior experience in using ultrasound.”

Dr. Soni and his coinstructor, Ricardo Antonio Franco-Sadud, MD, of the Medical College of Wisconsin, Milwaukee, will lead attendees through the basics of “Point-of-Care Ultrasound for the Hospitalist” at HM18. Dr. Soni has taught a version of this course for almost a decade and is the assistant director of POCUS training programs with Veterans Affairs’ Simulation Learning Education and Research Network (SimLEARN). The pre-course is a 4.5-hour, multimodal class that involves hands-on training to teach the fundamentals of how to evaluate patients using POCUS.

With this course, Dr. Soni said, SHM is addressing training needs from “above and below.”

“Medical students, residents, fellows – basically doctors in training, whether they are student residents or getting ultrasound instruction in their basic training – when these kids graduate, they are pretty good,” he said. “But what about all the doctors who graduated long ago? They didn’t get any POCUS training. That’s where SHM, CHEST, and some of the other societies come in to play. We can offer these courses for training.”

Ultrasound training and credentialing has become a focus for SHM as interest has grown among clinicians. The Journal of Hospital Medicine recently released a consensus statement, “Credentialing of Hospitalists in Ultrasound-Guided Bedside Procedures,” which offers recommendations for credentialing hospitalists in ultrasound guidance and proposes initial and ongoing pathways to improve how hospitalists perform these procedures. The statement emphasizes how ultrasound guidance is increasingly essential to six bedside procedures that are core competencies of hospitalists: abdominal paracentesis, arterial catheter placement, arthrocentesis, central venous catheter placement, lumbar puncture, and thoracentesis.

According to Brian P. Lucas, MD, of Rush Medical College, Chicago, and lead author of the position statement, SHM’s Education Committee convened a POCUS Task Force to take on the project as American Board of Internal Medicine (ABIM) diplomates are no longer expected as part of their residency training to manually perform certain bedside procedures, with or without ultrasound guidance. SHM’s Board of Directors gave final approval on the statement in September 2017.

“There is much variation in the training and experience of both bedside procedures and point-of-care ultrasound. Many practicing hospitalists, for example, have no experience using ultrasound guidance for central lines,” Dr. Lucas said. “How then should hospitals initially, and then biennially, vet hospitalists’ competence in the performance of ultrasound-guided bedside procedures? This nationwide collaborative of experts, educators and front-line providers puts forth some recommendations to this very thorny problem.”

SHM also offers, in collaboration with the American College of Chest Physicians, a Point-of-Care Ultrasound Certificate of Completion for clinicians. The program is designed primarily to educate hospitalists and other providers caring for acutely ill patients, and requires attendance at a series of training programs within the course of 3 years, at the end of which a clinician must complete a comprehensive skills and knowledge assessment to obtain the certificate.
 

Focus on POCUS

Although medical societies recognize the growing demand, and are offering more ultrasound training, many hospitalists may not be familiar with POCUS specifically and the benefits of utilizing a bedside ultrasound exam, Dr. Soni noted.

“When we talk about point-of-care ultrasound, how is it different from what everyone else thinks about ultrasound? Specifically, it’s a point-of-care bedside exam” Dr. Soni explained. “So, the same provider – whether it’s a physician, nurse practitioner, or PA – who is taking care of a patient, can use ultrasound at the bedside to evaluate specific things in the patient’s body and answer very focused questions.”

The ability to have a hospitalist immediately use an imaging technique at a patient’s bedside can be invaluable, because it allows the clinician to provide a fairly accurate diagnosis in conjunction with patient input. This is much more effective than the traditional process of ultrasound imaging, Dr. Soni said.

“If you go to your primary care doctor [who orders] an ultrasound, you go to the radiology department and the technician captures the images,” he said. “Then the radiologist, who never even sees the patient, reads the ultrasound images with little to no clinical data.” The compartmentalization of the treating clinician, patient, and radiologist leaves the latter without critical information when reading an ultrasound. POCUS can potentially overcome this problematic situation, Dr. Soni suggested.

The HM18 POCUS pre-course has four objectives:

1. Recognize the fundamentals of ultrasound and the basic operation of an ultrasound machine (“knobology”).

2. Differentiate between the different types of ultrasound transducers and determine which is most appropriate for different POCUS applications.

3. Exhibit proper techniques on focused cardiac and lung ultrasound exams and be able to recognize thoracic pathologies from abnormal ultrasound results.

4. Identify and understand normal sonographic appearance of solid abdominal organs and vasculature of the neck and lower extremities and the ability to interpret abnormal ultrasounds to identify pathologies.

While all attendees can expect to learn a new skill that will improve their practice, POCUS training will specifically benefit hospitalists and the institutions in which they work, Dr. Soni said.

“Hospitalists, by nature, work for the hospital. In most cases, hospitalists are subsidized by the hospital. Because of that, the bigger gain from using ultrasound is not in the billing,” he said. “You can bill for focused ultrasound exams of the lungs, heart, abdomen, etc., and you might get a professional fee of $30-$40. But the bigger win in all of this, financially, is giving people more efficient health care. If we can prevent one complication from a bedside procedure or expedite a patient’s care and get them better sooner, we can save the hospital and the system money.”

The SHM is accredited to provide continuing medical education for physicians by the Accreditation Council for Continuing Medical Education. This live activity course will count for a maximum of 4.75 AMA PRA Category 1 Credits.

 

Point-of-Care Ultrasound for the Hospitalist
Sunday, April 8, 7:30 a.m.–12:15 p.m.

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Point-of-care ultrasound (POCUS) is proving to be an increasing useful diagnostic tool for clinicians at the bedside, and many hospitalists have expressed interest in learning best practices in the use of the technology.

To that end, the Society of Hospital Medicine (SHM) is offering a half-day POCUS pre-course at Hospital Medicine 2018 this April in Orlando, with the intent of helping hospitalists learn how best to use POCUS in clinical settings.

Dr. Nilam J. Soni of the University of Texas at San Antonio and South Texas Veterans Health Care System
Dr. Nilam J. Soni

“The agenda is really designed to teach people the basics of point-of-care ultrasound,” said Nilam J. Soni, MD, MSc, of the University of Texas at San Antonio and South Texas Veterans Health Care System, also in San Antonio, and a coinstructor of the POCUS pre-course. “It’s designed for the novice learner who has no prior experience in using ultrasound.”

Dr. Soni and his coinstructor, Ricardo Antonio Franco-Sadud, MD, of the Medical College of Wisconsin, Milwaukee, will lead attendees through the basics of “Point-of-Care Ultrasound for the Hospitalist” at HM18. Dr. Soni has taught a version of this course for almost a decade and is the assistant director of POCUS training programs with Veterans Affairs’ Simulation Learning Education and Research Network (SimLEARN). The pre-course is a 4.5-hour, multimodal class that involves hands-on training to teach the fundamentals of how to evaluate patients using POCUS.

With this course, Dr. Soni said, SHM is addressing training needs from “above and below.”

“Medical students, residents, fellows – basically doctors in training, whether they are student residents or getting ultrasound instruction in their basic training – when these kids graduate, they are pretty good,” he said. “But what about all the doctors who graduated long ago? They didn’t get any POCUS training. That’s where SHM, CHEST, and some of the other societies come in to play. We can offer these courses for training.”

Ultrasound training and credentialing has become a focus for SHM as interest has grown among clinicians. The Journal of Hospital Medicine recently released a consensus statement, “Credentialing of Hospitalists in Ultrasound-Guided Bedside Procedures,” which offers recommendations for credentialing hospitalists in ultrasound guidance and proposes initial and ongoing pathways to improve how hospitalists perform these procedures. The statement emphasizes how ultrasound guidance is increasingly essential to six bedside procedures that are core competencies of hospitalists: abdominal paracentesis, arterial catheter placement, arthrocentesis, central venous catheter placement, lumbar puncture, and thoracentesis.

According to Brian P. Lucas, MD, of Rush Medical College, Chicago, and lead author of the position statement, SHM’s Education Committee convened a POCUS Task Force to take on the project as American Board of Internal Medicine (ABIM) diplomates are no longer expected as part of their residency training to manually perform certain bedside procedures, with or without ultrasound guidance. SHM’s Board of Directors gave final approval on the statement in September 2017.

“There is much variation in the training and experience of both bedside procedures and point-of-care ultrasound. Many practicing hospitalists, for example, have no experience using ultrasound guidance for central lines,” Dr. Lucas said. “How then should hospitals initially, and then biennially, vet hospitalists’ competence in the performance of ultrasound-guided bedside procedures? This nationwide collaborative of experts, educators and front-line providers puts forth some recommendations to this very thorny problem.”

SHM also offers, in collaboration with the American College of Chest Physicians, a Point-of-Care Ultrasound Certificate of Completion for clinicians. The program is designed primarily to educate hospitalists and other providers caring for acutely ill patients, and requires attendance at a series of training programs within the course of 3 years, at the end of which a clinician must complete a comprehensive skills and knowledge assessment to obtain the certificate.
 

Focus on POCUS

Although medical societies recognize the growing demand, and are offering more ultrasound training, many hospitalists may not be familiar with POCUS specifically and the benefits of utilizing a bedside ultrasound exam, Dr. Soni noted.

“When we talk about point-of-care ultrasound, how is it different from what everyone else thinks about ultrasound? Specifically, it’s a point-of-care bedside exam” Dr. Soni explained. “So, the same provider – whether it’s a physician, nurse practitioner, or PA – who is taking care of a patient, can use ultrasound at the bedside to evaluate specific things in the patient’s body and answer very focused questions.”

The ability to have a hospitalist immediately use an imaging technique at a patient’s bedside can be invaluable, because it allows the clinician to provide a fairly accurate diagnosis in conjunction with patient input. This is much more effective than the traditional process of ultrasound imaging, Dr. Soni said.

“If you go to your primary care doctor [who orders] an ultrasound, you go to the radiology department and the technician captures the images,” he said. “Then the radiologist, who never even sees the patient, reads the ultrasound images with little to no clinical data.” The compartmentalization of the treating clinician, patient, and radiologist leaves the latter without critical information when reading an ultrasound. POCUS can potentially overcome this problematic situation, Dr. Soni suggested.

The HM18 POCUS pre-course has four objectives:

1. Recognize the fundamentals of ultrasound and the basic operation of an ultrasound machine (“knobology”).

2. Differentiate between the different types of ultrasound transducers and determine which is most appropriate for different POCUS applications.

3. Exhibit proper techniques on focused cardiac and lung ultrasound exams and be able to recognize thoracic pathologies from abnormal ultrasound results.

4. Identify and understand normal sonographic appearance of solid abdominal organs and vasculature of the neck and lower extremities and the ability to interpret abnormal ultrasounds to identify pathologies.

While all attendees can expect to learn a new skill that will improve their practice, POCUS training will specifically benefit hospitalists and the institutions in which they work, Dr. Soni said.

“Hospitalists, by nature, work for the hospital. In most cases, hospitalists are subsidized by the hospital. Because of that, the bigger gain from using ultrasound is not in the billing,” he said. “You can bill for focused ultrasound exams of the lungs, heart, abdomen, etc., and you might get a professional fee of $30-$40. But the bigger win in all of this, financially, is giving people more efficient health care. If we can prevent one complication from a bedside procedure or expedite a patient’s care and get them better sooner, we can save the hospital and the system money.”

The SHM is accredited to provide continuing medical education for physicians by the Accreditation Council for Continuing Medical Education. This live activity course will count for a maximum of 4.75 AMA PRA Category 1 Credits.

 

Point-of-Care Ultrasound for the Hospitalist
Sunday, April 8, 7:30 a.m.–12:15 p.m.

 

Point-of-care ultrasound (POCUS) is proving to be an increasing useful diagnostic tool for clinicians at the bedside, and many hospitalists have expressed interest in learning best practices in the use of the technology.

To that end, the Society of Hospital Medicine (SHM) is offering a half-day POCUS pre-course at Hospital Medicine 2018 this April in Orlando, with the intent of helping hospitalists learn how best to use POCUS in clinical settings.

Dr. Nilam J. Soni of the University of Texas at San Antonio and South Texas Veterans Health Care System
Dr. Nilam J. Soni

“The agenda is really designed to teach people the basics of point-of-care ultrasound,” said Nilam J. Soni, MD, MSc, of the University of Texas at San Antonio and South Texas Veterans Health Care System, also in San Antonio, and a coinstructor of the POCUS pre-course. “It’s designed for the novice learner who has no prior experience in using ultrasound.”

Dr. Soni and his coinstructor, Ricardo Antonio Franco-Sadud, MD, of the Medical College of Wisconsin, Milwaukee, will lead attendees through the basics of “Point-of-Care Ultrasound for the Hospitalist” at HM18. Dr. Soni has taught a version of this course for almost a decade and is the assistant director of POCUS training programs with Veterans Affairs’ Simulation Learning Education and Research Network (SimLEARN). The pre-course is a 4.5-hour, multimodal class that involves hands-on training to teach the fundamentals of how to evaluate patients using POCUS.

With this course, Dr. Soni said, SHM is addressing training needs from “above and below.”

“Medical students, residents, fellows – basically doctors in training, whether they are student residents or getting ultrasound instruction in their basic training – when these kids graduate, they are pretty good,” he said. “But what about all the doctors who graduated long ago? They didn’t get any POCUS training. That’s where SHM, CHEST, and some of the other societies come in to play. We can offer these courses for training.”

Ultrasound training and credentialing has become a focus for SHM as interest has grown among clinicians. The Journal of Hospital Medicine recently released a consensus statement, “Credentialing of Hospitalists in Ultrasound-Guided Bedside Procedures,” which offers recommendations for credentialing hospitalists in ultrasound guidance and proposes initial and ongoing pathways to improve how hospitalists perform these procedures. The statement emphasizes how ultrasound guidance is increasingly essential to six bedside procedures that are core competencies of hospitalists: abdominal paracentesis, arterial catheter placement, arthrocentesis, central venous catheter placement, lumbar puncture, and thoracentesis.

According to Brian P. Lucas, MD, of Rush Medical College, Chicago, and lead author of the position statement, SHM’s Education Committee convened a POCUS Task Force to take on the project as American Board of Internal Medicine (ABIM) diplomates are no longer expected as part of their residency training to manually perform certain bedside procedures, with or without ultrasound guidance. SHM’s Board of Directors gave final approval on the statement in September 2017.

“There is much variation in the training and experience of both bedside procedures and point-of-care ultrasound. Many practicing hospitalists, for example, have no experience using ultrasound guidance for central lines,” Dr. Lucas said. “How then should hospitals initially, and then biennially, vet hospitalists’ competence in the performance of ultrasound-guided bedside procedures? This nationwide collaborative of experts, educators and front-line providers puts forth some recommendations to this very thorny problem.”

SHM also offers, in collaboration with the American College of Chest Physicians, a Point-of-Care Ultrasound Certificate of Completion for clinicians. The program is designed primarily to educate hospitalists and other providers caring for acutely ill patients, and requires attendance at a series of training programs within the course of 3 years, at the end of which a clinician must complete a comprehensive skills and knowledge assessment to obtain the certificate.
 

Focus on POCUS

Although medical societies recognize the growing demand, and are offering more ultrasound training, many hospitalists may not be familiar with POCUS specifically and the benefits of utilizing a bedside ultrasound exam, Dr. Soni noted.

“When we talk about point-of-care ultrasound, how is it different from what everyone else thinks about ultrasound? Specifically, it’s a point-of-care bedside exam” Dr. Soni explained. “So, the same provider – whether it’s a physician, nurse practitioner, or PA – who is taking care of a patient, can use ultrasound at the bedside to evaluate specific things in the patient’s body and answer very focused questions.”

The ability to have a hospitalist immediately use an imaging technique at a patient’s bedside can be invaluable, because it allows the clinician to provide a fairly accurate diagnosis in conjunction with patient input. This is much more effective than the traditional process of ultrasound imaging, Dr. Soni said.

“If you go to your primary care doctor [who orders] an ultrasound, you go to the radiology department and the technician captures the images,” he said. “Then the radiologist, who never even sees the patient, reads the ultrasound images with little to no clinical data.” The compartmentalization of the treating clinician, patient, and radiologist leaves the latter without critical information when reading an ultrasound. POCUS can potentially overcome this problematic situation, Dr. Soni suggested.

The HM18 POCUS pre-course has four objectives:

1. Recognize the fundamentals of ultrasound and the basic operation of an ultrasound machine (“knobology”).

2. Differentiate between the different types of ultrasound transducers and determine which is most appropriate for different POCUS applications.

3. Exhibit proper techniques on focused cardiac and lung ultrasound exams and be able to recognize thoracic pathologies from abnormal ultrasound results.

4. Identify and understand normal sonographic appearance of solid abdominal organs and vasculature of the neck and lower extremities and the ability to interpret abnormal ultrasounds to identify pathologies.

While all attendees can expect to learn a new skill that will improve their practice, POCUS training will specifically benefit hospitalists and the institutions in which they work, Dr. Soni said.

“Hospitalists, by nature, work for the hospital. In most cases, hospitalists are subsidized by the hospital. Because of that, the bigger gain from using ultrasound is not in the billing,” he said. “You can bill for focused ultrasound exams of the lungs, heart, abdomen, etc., and you might get a professional fee of $30-$40. But the bigger win in all of this, financially, is giving people more efficient health care. If we can prevent one complication from a bedside procedure or expedite a patient’s care and get them better sooner, we can save the hospital and the system money.”

The SHM is accredited to provide continuing medical education for physicians by the Accreditation Council for Continuing Medical Education. This live activity course will count for a maximum of 4.75 AMA PRA Category 1 Credits.

 

Point-of-Care Ultrasound for the Hospitalist
Sunday, April 8, 7:30 a.m.–12:15 p.m.

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New tracks bring focus to HM18 program

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Fri, 09/14/2018 - 11:54

 

At the 2018 annual meeting of the Society of Hospital Medicine – running from April 8 to 11 in Orlando – the theme could well be “in with the new, and in with the new.”

Planners for Hospital Medicine 2018 (HM18) have managed to pack the conference with five new tracks: Great Debate, Nurse Practitioner/Physician’s Assistant (NP/PA), Palliative Care, Seasoning Your Career, and a new Career Development workshop track. And they did this while eliminating only one track that was on the schedule last year – technology – and without adding any extra days to the meeting.

Dr. Kathleen Finn, Massachusetts General Hospital, Boston
Dr. Kathleen Finn
The trick was including more half-day tracks. With more tracks in smaller time chunks, the schedule provides more flexibility, and attendees have more choices to find what they’re looking for, said Kathleen Finn, MD, FHM, an assistant professor of medicine at Harvard Medical School, Boston, and the HM18 course director.

“We decided, since there were a bunch of themes that we really wanted to cover, we would do half-day tracks. The shorter tracks are also a way to gauge interest in a topic without making a big commitment to it,” Dr. Finn said. “The grouping of topics in smaller tracks in the Day-at-a-Glance helps people easily see a collection of lectures or a theme they might want to attend.”

While choosing themes for the meeting, the planners were trying to stay true to their own theme: timeliness.

“There’s pressure to make it a very relevant meeting,” Dr. Finn said. “We really want to have our finger on the pulse of what practicing hospitalists need and want to know and what is important to them. All the members of the committee feel very invested in figuring out: What is timely? What do we want to talk about right now? What are the active discussions and issues going on in health care that affect us in our practice?”

Assistant course director Dustin Smith, MD, FHM, an associate professor of medicine at Emory University, Atlanta, said much of the information for this year’s meeting came from the 2017 annual meeting, including attendance at sessions, speaker reviews, and session ratings.

“It’s building on momentum from the previous meeting,” he said. “Sometimes we choose things to offer that we know are going to go well, and sometimes we choose things that we hope go well, and all of a sudden we see [that they] go very, very well.” For instance, he said, the topic of sepsis was so popular last year that it has its own precourse this year.

The data on which the HM18 program is built doesn’t stop there. The 23 members of the planning committee – chosen strategically to represent a wide geographic range and array of practice types – all bring their own thoughts and experiences, as well as input from colleagues at their own centers. Then there are the submissions for workshop topics: Any SHM member can submit an idea, and – while just a few are chosen – those ideas help organizers see patterns of interest that can affect the planning of the rest of the sessions.

Here are more details on the new tracks:
 

Great debate

The annual meeting has traditionally had a “Great Debate” on perioperative medicine, but the format – with carefully chosen speakers who are dynamic and entertaining – will be used to cover pulmonary medicine and infectious diseases this year as well.

“It’s a hugely successful talk,” Dr. Finn said. “We can tell by our numbers that lots of people go, and it’s always funny, and it’s a very clever way of discussing the latest literature – by having two very dynamic speakers present a case and then debate the two options of the case and then use the literature to support the answer,” she said.

The hope is that the format will be more than just entertaining but will be an effective teaching tool, too.

“We think the high level of engagement and format of the talk leads to better overall education for those who attend,” Dr. Smith said.
 

NP/PA

This track includes topics chosen by the committee for advanced practice professionals.

“There are many hospitalist programs that include NP/PAs – this is what came through in all the feedback – and everybody is struggling with how do you best incorporate NPs and PAs into the group practice and have everybody work at the top of their license and work well together,” Dr. Finn said.

“The idea, too, is to be very inclusive of all providers and offering a track that focuses on NP/PAs but also includes physicians, physician leaders, and physician administrators,” Dr. Smith said. “It’s not designed for one type of practicing professional; it should be a good educational track for all.”
 

 

 

Palliative care

This was a topic that had been sprinkled throughout programs in previous years, but Dr. Finn and Dr. Smith said it was considered too important not to have its own track this year.

“I think hospitalists are often the doctors caring for patients at the end of their lives since many Americans die in the hospital,” Dr. Finn said. “So as a result, this is a skill set that as hospitalists we need to be very good at.”
 

Seasoning your career

This is a track geared toward one of this year’s themes: With “hospital medicine” now a concept that’s more than two decades old, how do hospitalists keep up the momentum in their careers, how do they take stock, how do they make the important decisions they face as they move ahead in their jobs?

“Hospital medicine is now over 20 years old – many hospitalists are now mid-career,” Dr. Finn said. “We picked an entire track on ‘seasoning your career’ to offer people ideas and skills to reflect on and rethink their career. Do you want to expand what you’re doing? Do you want to change it? How do you make this a lifelong career?”
 

Career development

There have always been workshops with a ‘career development’ focus, but this year six of them were chosen to be placed under the heading of an official “career development” workshop track.

“When you review the Day-at-a-Glance schedule, it really demarcates it,” Dr. Smith said. “This really helps attendees be able to quickly look through and find where they want to be for their next session.”

“Are there other skills you want to take on for the second half of your career?” Dr. Finn said. “Do you want to take on leadership? Do you want to learn how to better give your peers feedback? Do you want to promote women in your group? Do you want to prevent burnout or use emotional intelligence to improve your career? We cohorted these topics together.”



Aside from the new tracks, the course directors also drew attention to other new elements of the HM18 program.

For instance there are new topics in the Rapid Fire sessions. In the “Managing the patient on your service: Appendicitis, Bowel and biliary obstruction” session, a general surgeon will talk about how to manage these surgical issues when the patient is on a medical service. In “Interventional radiology: What every hospitalist needs to know,” an interventional radiologist will discuss when hospitalists may want to call in an interventional radiologist or refer to a hospital that has an interventional radiologist. And “Vulnerable populations and hospitalists” will continue with the theme of social determinants of health that was highlighted at last year’s meeting by keynote speaker Karen DeSalvo, MD, the national coordinator for health information technology.

Dr. Smith said that the program committee directors work with the Rapid Fire presenters so that the three or four questions discussed in the sessions are what attendees will want to learn most.

“We take an additional step: Once we recruit the speaker and have identified the topic, we have members of our committee work with the speakers,” he said.

“We don’t want them to come and give us an esoteric talk in an area that interests them. We want them to answer the clinical questions that hospitalists have,” Dr. Finn added.

Dr. Finn and Dr. Smith also highlighted sessions with a twist. For example, “Stupefy: EKGs for fun” is a session about EKGs that encourages hospitalists to “just go have fun reading them,” Dr. Finn said, while “Voldemort is on the plane: Airplane emergencies,” is scheduled for the final day of the conference, just before everyone flies back home.

As for catchy Disney-influenced titles, such as “The Mad Hatter: Updates in delirium” and “Waiting in line for ‘It’s a Small World’ and other things we do for no reason,” part of the credit can go to Dr. Finn’s niece. She said she “hired” her to come up with a list of Disney, Pixar, and Harry Potter movies and catchphrases. Then the committee worked them into the session titles.

Dr. Smith joked that part of his role was to veto some titles that were “a bit too cringe-worthy.”

“The theme of Orlando is making people happy,” Dr. Finn said. “One of the goals – the hopes – for me for at this meeting is that people bring their inner child and get curious again and explore new ideas and new topics and new career possibilities.”

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At the 2018 annual meeting of the Society of Hospital Medicine – running from April 8 to 11 in Orlando – the theme could well be “in with the new, and in with the new.”

Planners for Hospital Medicine 2018 (HM18) have managed to pack the conference with five new tracks: Great Debate, Nurse Practitioner/Physician’s Assistant (NP/PA), Palliative Care, Seasoning Your Career, and a new Career Development workshop track. And they did this while eliminating only one track that was on the schedule last year – technology – and without adding any extra days to the meeting.

Dr. Kathleen Finn, Massachusetts General Hospital, Boston
Dr. Kathleen Finn
The trick was including more half-day tracks. With more tracks in smaller time chunks, the schedule provides more flexibility, and attendees have more choices to find what they’re looking for, said Kathleen Finn, MD, FHM, an assistant professor of medicine at Harvard Medical School, Boston, and the HM18 course director.

“We decided, since there were a bunch of themes that we really wanted to cover, we would do half-day tracks. The shorter tracks are also a way to gauge interest in a topic without making a big commitment to it,” Dr. Finn said. “The grouping of topics in smaller tracks in the Day-at-a-Glance helps people easily see a collection of lectures or a theme they might want to attend.”

While choosing themes for the meeting, the planners were trying to stay true to their own theme: timeliness.

“There’s pressure to make it a very relevant meeting,” Dr. Finn said. “We really want to have our finger on the pulse of what practicing hospitalists need and want to know and what is important to them. All the members of the committee feel very invested in figuring out: What is timely? What do we want to talk about right now? What are the active discussions and issues going on in health care that affect us in our practice?”

Assistant course director Dustin Smith, MD, FHM, an associate professor of medicine at Emory University, Atlanta, said much of the information for this year’s meeting came from the 2017 annual meeting, including attendance at sessions, speaker reviews, and session ratings.

“It’s building on momentum from the previous meeting,” he said. “Sometimes we choose things to offer that we know are going to go well, and sometimes we choose things that we hope go well, and all of a sudden we see [that they] go very, very well.” For instance, he said, the topic of sepsis was so popular last year that it has its own precourse this year.

The data on which the HM18 program is built doesn’t stop there. The 23 members of the planning committee – chosen strategically to represent a wide geographic range and array of practice types – all bring their own thoughts and experiences, as well as input from colleagues at their own centers. Then there are the submissions for workshop topics: Any SHM member can submit an idea, and – while just a few are chosen – those ideas help organizers see patterns of interest that can affect the planning of the rest of the sessions.

Here are more details on the new tracks:
 

Great debate

The annual meeting has traditionally had a “Great Debate” on perioperative medicine, but the format – with carefully chosen speakers who are dynamic and entertaining – will be used to cover pulmonary medicine and infectious diseases this year as well.

“It’s a hugely successful talk,” Dr. Finn said. “We can tell by our numbers that lots of people go, and it’s always funny, and it’s a very clever way of discussing the latest literature – by having two very dynamic speakers present a case and then debate the two options of the case and then use the literature to support the answer,” she said.

The hope is that the format will be more than just entertaining but will be an effective teaching tool, too.

“We think the high level of engagement and format of the talk leads to better overall education for those who attend,” Dr. Smith said.
 

NP/PA

This track includes topics chosen by the committee for advanced practice professionals.

“There are many hospitalist programs that include NP/PAs – this is what came through in all the feedback – and everybody is struggling with how do you best incorporate NPs and PAs into the group practice and have everybody work at the top of their license and work well together,” Dr. Finn said.

“The idea, too, is to be very inclusive of all providers and offering a track that focuses on NP/PAs but also includes physicians, physician leaders, and physician administrators,” Dr. Smith said. “It’s not designed for one type of practicing professional; it should be a good educational track for all.”
 

 

 

Palliative care

This was a topic that had been sprinkled throughout programs in previous years, but Dr. Finn and Dr. Smith said it was considered too important not to have its own track this year.

“I think hospitalists are often the doctors caring for patients at the end of their lives since many Americans die in the hospital,” Dr. Finn said. “So as a result, this is a skill set that as hospitalists we need to be very good at.”
 

Seasoning your career

This is a track geared toward one of this year’s themes: With “hospital medicine” now a concept that’s more than two decades old, how do hospitalists keep up the momentum in their careers, how do they take stock, how do they make the important decisions they face as they move ahead in their jobs?

“Hospital medicine is now over 20 years old – many hospitalists are now mid-career,” Dr. Finn said. “We picked an entire track on ‘seasoning your career’ to offer people ideas and skills to reflect on and rethink their career. Do you want to expand what you’re doing? Do you want to change it? How do you make this a lifelong career?”
 

Career development

There have always been workshops with a ‘career development’ focus, but this year six of them were chosen to be placed under the heading of an official “career development” workshop track.

“When you review the Day-at-a-Glance schedule, it really demarcates it,” Dr. Smith said. “This really helps attendees be able to quickly look through and find where they want to be for their next session.”

“Are there other skills you want to take on for the second half of your career?” Dr. Finn said. “Do you want to take on leadership? Do you want to learn how to better give your peers feedback? Do you want to promote women in your group? Do you want to prevent burnout or use emotional intelligence to improve your career? We cohorted these topics together.”



Aside from the new tracks, the course directors also drew attention to other new elements of the HM18 program.

For instance there are new topics in the Rapid Fire sessions. In the “Managing the patient on your service: Appendicitis, Bowel and biliary obstruction” session, a general surgeon will talk about how to manage these surgical issues when the patient is on a medical service. In “Interventional radiology: What every hospitalist needs to know,” an interventional radiologist will discuss when hospitalists may want to call in an interventional radiologist or refer to a hospital that has an interventional radiologist. And “Vulnerable populations and hospitalists” will continue with the theme of social determinants of health that was highlighted at last year’s meeting by keynote speaker Karen DeSalvo, MD, the national coordinator for health information technology.

Dr. Smith said that the program committee directors work with the Rapid Fire presenters so that the three or four questions discussed in the sessions are what attendees will want to learn most.

“We take an additional step: Once we recruit the speaker and have identified the topic, we have members of our committee work with the speakers,” he said.

“We don’t want them to come and give us an esoteric talk in an area that interests them. We want them to answer the clinical questions that hospitalists have,” Dr. Finn added.

Dr. Finn and Dr. Smith also highlighted sessions with a twist. For example, “Stupefy: EKGs for fun” is a session about EKGs that encourages hospitalists to “just go have fun reading them,” Dr. Finn said, while “Voldemort is on the plane: Airplane emergencies,” is scheduled for the final day of the conference, just before everyone flies back home.

As for catchy Disney-influenced titles, such as “The Mad Hatter: Updates in delirium” and “Waiting in line for ‘It’s a Small World’ and other things we do for no reason,” part of the credit can go to Dr. Finn’s niece. She said she “hired” her to come up with a list of Disney, Pixar, and Harry Potter movies and catchphrases. Then the committee worked them into the session titles.

Dr. Smith joked that part of his role was to veto some titles that were “a bit too cringe-worthy.”

“The theme of Orlando is making people happy,” Dr. Finn said. “One of the goals – the hopes – for me for at this meeting is that people bring their inner child and get curious again and explore new ideas and new topics and new career possibilities.”

 

At the 2018 annual meeting of the Society of Hospital Medicine – running from April 8 to 11 in Orlando – the theme could well be “in with the new, and in with the new.”

Planners for Hospital Medicine 2018 (HM18) have managed to pack the conference with five new tracks: Great Debate, Nurse Practitioner/Physician’s Assistant (NP/PA), Palliative Care, Seasoning Your Career, and a new Career Development workshop track. And they did this while eliminating only one track that was on the schedule last year – technology – and without adding any extra days to the meeting.

Dr. Kathleen Finn, Massachusetts General Hospital, Boston
Dr. Kathleen Finn
The trick was including more half-day tracks. With more tracks in smaller time chunks, the schedule provides more flexibility, and attendees have more choices to find what they’re looking for, said Kathleen Finn, MD, FHM, an assistant professor of medicine at Harvard Medical School, Boston, and the HM18 course director.

“We decided, since there were a bunch of themes that we really wanted to cover, we would do half-day tracks. The shorter tracks are also a way to gauge interest in a topic without making a big commitment to it,” Dr. Finn said. “The grouping of topics in smaller tracks in the Day-at-a-Glance helps people easily see a collection of lectures or a theme they might want to attend.”

While choosing themes for the meeting, the planners were trying to stay true to their own theme: timeliness.

“There’s pressure to make it a very relevant meeting,” Dr. Finn said. “We really want to have our finger on the pulse of what practicing hospitalists need and want to know and what is important to them. All the members of the committee feel very invested in figuring out: What is timely? What do we want to talk about right now? What are the active discussions and issues going on in health care that affect us in our practice?”

Assistant course director Dustin Smith, MD, FHM, an associate professor of medicine at Emory University, Atlanta, said much of the information for this year’s meeting came from the 2017 annual meeting, including attendance at sessions, speaker reviews, and session ratings.

“It’s building on momentum from the previous meeting,” he said. “Sometimes we choose things to offer that we know are going to go well, and sometimes we choose things that we hope go well, and all of a sudden we see [that they] go very, very well.” For instance, he said, the topic of sepsis was so popular last year that it has its own precourse this year.

The data on which the HM18 program is built doesn’t stop there. The 23 members of the planning committee – chosen strategically to represent a wide geographic range and array of practice types – all bring their own thoughts and experiences, as well as input from colleagues at their own centers. Then there are the submissions for workshop topics: Any SHM member can submit an idea, and – while just a few are chosen – those ideas help organizers see patterns of interest that can affect the planning of the rest of the sessions.

Here are more details on the new tracks:
 

Great debate

The annual meeting has traditionally had a “Great Debate” on perioperative medicine, but the format – with carefully chosen speakers who are dynamic and entertaining – will be used to cover pulmonary medicine and infectious diseases this year as well.

“It’s a hugely successful talk,” Dr. Finn said. “We can tell by our numbers that lots of people go, and it’s always funny, and it’s a very clever way of discussing the latest literature – by having two very dynamic speakers present a case and then debate the two options of the case and then use the literature to support the answer,” she said.

The hope is that the format will be more than just entertaining but will be an effective teaching tool, too.

“We think the high level of engagement and format of the talk leads to better overall education for those who attend,” Dr. Smith said.
 

NP/PA

This track includes topics chosen by the committee for advanced practice professionals.

“There are many hospitalist programs that include NP/PAs – this is what came through in all the feedback – and everybody is struggling with how do you best incorporate NPs and PAs into the group practice and have everybody work at the top of their license and work well together,” Dr. Finn said.

“The idea, too, is to be very inclusive of all providers and offering a track that focuses on NP/PAs but also includes physicians, physician leaders, and physician administrators,” Dr. Smith said. “It’s not designed for one type of practicing professional; it should be a good educational track for all.”
 

 

 

Palliative care

This was a topic that had been sprinkled throughout programs in previous years, but Dr. Finn and Dr. Smith said it was considered too important not to have its own track this year.

“I think hospitalists are often the doctors caring for patients at the end of their lives since many Americans die in the hospital,” Dr. Finn said. “So as a result, this is a skill set that as hospitalists we need to be very good at.”
 

Seasoning your career

This is a track geared toward one of this year’s themes: With “hospital medicine” now a concept that’s more than two decades old, how do hospitalists keep up the momentum in their careers, how do they take stock, how do they make the important decisions they face as they move ahead in their jobs?

“Hospital medicine is now over 20 years old – many hospitalists are now mid-career,” Dr. Finn said. “We picked an entire track on ‘seasoning your career’ to offer people ideas and skills to reflect on and rethink their career. Do you want to expand what you’re doing? Do you want to change it? How do you make this a lifelong career?”
 

Career development

There have always been workshops with a ‘career development’ focus, but this year six of them were chosen to be placed under the heading of an official “career development” workshop track.

“When you review the Day-at-a-Glance schedule, it really demarcates it,” Dr. Smith said. “This really helps attendees be able to quickly look through and find where they want to be for their next session.”

“Are there other skills you want to take on for the second half of your career?” Dr. Finn said. “Do you want to take on leadership? Do you want to learn how to better give your peers feedback? Do you want to promote women in your group? Do you want to prevent burnout or use emotional intelligence to improve your career? We cohorted these topics together.”



Aside from the new tracks, the course directors also drew attention to other new elements of the HM18 program.

For instance there are new topics in the Rapid Fire sessions. In the “Managing the patient on your service: Appendicitis, Bowel and biliary obstruction” session, a general surgeon will talk about how to manage these surgical issues when the patient is on a medical service. In “Interventional radiology: What every hospitalist needs to know,” an interventional radiologist will discuss when hospitalists may want to call in an interventional radiologist or refer to a hospital that has an interventional radiologist. And “Vulnerable populations and hospitalists” will continue with the theme of social determinants of health that was highlighted at last year’s meeting by keynote speaker Karen DeSalvo, MD, the national coordinator for health information technology.

Dr. Smith said that the program committee directors work with the Rapid Fire presenters so that the three or four questions discussed in the sessions are what attendees will want to learn most.

“We take an additional step: Once we recruit the speaker and have identified the topic, we have members of our committee work with the speakers,” he said.

“We don’t want them to come and give us an esoteric talk in an area that interests them. We want them to answer the clinical questions that hospitalists have,” Dr. Finn added.

Dr. Finn and Dr. Smith also highlighted sessions with a twist. For example, “Stupefy: EKGs for fun” is a session about EKGs that encourages hospitalists to “just go have fun reading them,” Dr. Finn said, while “Voldemort is on the plane: Airplane emergencies,” is scheduled for the final day of the conference, just before everyone flies back home.

As for catchy Disney-influenced titles, such as “The Mad Hatter: Updates in delirium” and “Waiting in line for ‘It’s a Small World’ and other things we do for no reason,” part of the credit can go to Dr. Finn’s niece. She said she “hired” her to come up with a list of Disney, Pixar, and Harry Potter movies and catchphrases. Then the committee worked them into the session titles.

Dr. Smith joked that part of his role was to veto some titles that were “a bit too cringe-worthy.”

“The theme of Orlando is making people happy,” Dr. Finn said. “One of the goals – the hopes – for me for at this meeting is that people bring their inner child and get curious again and explore new ideas and new topics and new career possibilities.”

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‘Update in Hospital Medicine’ to highlight practice pearls

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High-impact studies for clinicians in all settings

 



Barbara Slawski, MD, MS, SFHM, and Cynthia Cooper, MD, hadn’t met in person until early 2018. But that doesn’t mean they haven’t spent a lot of time together.

Once a month, usually on a Friday afternoon, the two hospitalists checked in with one another through relaxed, wide-ranging phone calls. Together they have combed the medical literature and conferred over the past year, making long lists of candidate studies for the “top 20” journal articles of 2018 for practicing hospitalists.

The two physicians are preparing for the “Update in Hospital Medicine” session they will comoderate at HM18 – historically one of the most popular at SHM annual meetings – where the research findings of these “Top 20” articles are summarized for conference attendees. Their hope, they said, is to present research that each attendee can bring home to improve patient outcomes on a daily basis, while making for a smoother and more efficient practice of hospital medicine.

Dr. Barbara Slawski, chief of the section of perioperative medicine at the Medical College of Wisconsin in Milwaukee
Dr. Barbara Slawski
Dr. Slawski, chief of the section of perioperative medicine at the Medical College of Wisconsin in Milwaukee, said the presentations will not simply summarize study results, but also will help attendees focus on the key findings – the clinical pearls – that represent real opportunities to update practice.

Through a process each physician describes as collegial, Dr. Slawski and Dr. Cooper have winnowed their lists and are nearly ready to make their final calls. Since hospital medicine crosses so many disciplines, each physician said, in separate interviews, that doing justice to the literature has been time-consuming and intellectually challenging – but worthwhile.

Dr. Cooper, a hospitalist at Massachusetts General Hospital, Boston, said that although she and Dr. Slawski practice in geographically diverse areas, their practice settings – academic medical centers – have many similarities. She said that as she reviewed the medical literature over the past year, she gave considerable thought to the particular challenges and demands of hospitalists who practice in community hospitals and rural settings, where the level of support and access to subspecialty consults might be very different from the academic milieu where both she and Dr. Slawski practice.
 

Dr. Cynthia Cooper

“We hope that our unique approaches lend more breadth to the session,” said Dr. Slawski. “We want to make sure we have a good representation of SHM’s constituency, and that we present high-impact studies.”

In addition to her work at Mass General, Dr. Cooper also holds an appointment at Harvard Medical School. She said that the challenge over the past year has been to find the studies that are not focused just on primary care, but that really touch on the unique practice demands and skill set of physicians who practice hospital-based medicine.

Dr. Slawski said that cardiology is one of the areas that’s had relevant, practice-changing findings this past year: She expects to put at least one practice-changing cardiology article on the “Top 20” list. “How do we address patients with suspected acute coronary syndromes? Well, we have some new direction this year,” she said.

To hit the mark of articles that are relevant for all, Dr. Cooper said she wants to make sure to include a focus on research that touches on the practicalities of hospital-based practice – possible topics include prediction scores, hepatic encephalopathy, and the management of sepsis.

Dr. Slawski said that in addition to relevance, she and Dr. Cooper looked for methodological rigor in the studies they’ll be presenting; they agreed that having an adequate sample size for statistical power was a must.

The two presenters said they’re working hard to put together a session that’s as enjoyable as it is relevant. “I hope we’ll be able to inject some humor into the presentation, too,” Dr. Cooper said. Dr. Slawski agreed, noting that the bar has been set high at SHM. “It feels like a community,” she said. “There are always great speakers with a sense of humor.”

Dr. Slawski stressed that even though they’ll have their list ready to go for HM18, they will still be scouring journals until the week of the meeting so they can update their presentation with any late-breaking news of significance.

Neither Dr. Slawski nor Dr. Cooper reported any relevant conflicts of interest.

 

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Barbara Slawski, MD, MS, SFHM, and Cynthia Cooper, MD, hadn’t met in person until early 2018. But that doesn’t mean they haven’t spent a lot of time together.

Once a month, usually on a Friday afternoon, the two hospitalists checked in with one another through relaxed, wide-ranging phone calls. Together they have combed the medical literature and conferred over the past year, making long lists of candidate studies for the “top 20” journal articles of 2018 for practicing hospitalists.

The two physicians are preparing for the “Update in Hospital Medicine” session they will comoderate at HM18 – historically one of the most popular at SHM annual meetings – where the research findings of these “Top 20” articles are summarized for conference attendees. Their hope, they said, is to present research that each attendee can bring home to improve patient outcomes on a daily basis, while making for a smoother and more efficient practice of hospital medicine.

Dr. Barbara Slawski, chief of the section of perioperative medicine at the Medical College of Wisconsin in Milwaukee
Dr. Barbara Slawski
Dr. Slawski, chief of the section of perioperative medicine at the Medical College of Wisconsin in Milwaukee, said the presentations will not simply summarize study results, but also will help attendees focus on the key findings – the clinical pearls – that represent real opportunities to update practice.

Through a process each physician describes as collegial, Dr. Slawski and Dr. Cooper have winnowed their lists and are nearly ready to make their final calls. Since hospital medicine crosses so many disciplines, each physician said, in separate interviews, that doing justice to the literature has been time-consuming and intellectually challenging – but worthwhile.

Dr. Cooper, a hospitalist at Massachusetts General Hospital, Boston, said that although she and Dr. Slawski practice in geographically diverse areas, their practice settings – academic medical centers – have many similarities. She said that as she reviewed the medical literature over the past year, she gave considerable thought to the particular challenges and demands of hospitalists who practice in community hospitals and rural settings, where the level of support and access to subspecialty consults might be very different from the academic milieu where both she and Dr. Slawski practice.
 

Dr. Cynthia Cooper

“We hope that our unique approaches lend more breadth to the session,” said Dr. Slawski. “We want to make sure we have a good representation of SHM’s constituency, and that we present high-impact studies.”

In addition to her work at Mass General, Dr. Cooper also holds an appointment at Harvard Medical School. She said that the challenge over the past year has been to find the studies that are not focused just on primary care, but that really touch on the unique practice demands and skill set of physicians who practice hospital-based medicine.

Dr. Slawski said that cardiology is one of the areas that’s had relevant, practice-changing findings this past year: She expects to put at least one practice-changing cardiology article on the “Top 20” list. “How do we address patients with suspected acute coronary syndromes? Well, we have some new direction this year,” she said.

To hit the mark of articles that are relevant for all, Dr. Cooper said she wants to make sure to include a focus on research that touches on the practicalities of hospital-based practice – possible topics include prediction scores, hepatic encephalopathy, and the management of sepsis.

Dr. Slawski said that in addition to relevance, she and Dr. Cooper looked for methodological rigor in the studies they’ll be presenting; they agreed that having an adequate sample size for statistical power was a must.

The two presenters said they’re working hard to put together a session that’s as enjoyable as it is relevant. “I hope we’ll be able to inject some humor into the presentation, too,” Dr. Cooper said. Dr. Slawski agreed, noting that the bar has been set high at SHM. “It feels like a community,” she said. “There are always great speakers with a sense of humor.”

Dr. Slawski stressed that even though they’ll have their list ready to go for HM18, they will still be scouring journals until the week of the meeting so they can update their presentation with any late-breaking news of significance.

Neither Dr. Slawski nor Dr. Cooper reported any relevant conflicts of interest.

 

 



Barbara Slawski, MD, MS, SFHM, and Cynthia Cooper, MD, hadn’t met in person until early 2018. But that doesn’t mean they haven’t spent a lot of time together.

Once a month, usually on a Friday afternoon, the two hospitalists checked in with one another through relaxed, wide-ranging phone calls. Together they have combed the medical literature and conferred over the past year, making long lists of candidate studies for the “top 20” journal articles of 2018 for practicing hospitalists.

The two physicians are preparing for the “Update in Hospital Medicine” session they will comoderate at HM18 – historically one of the most popular at SHM annual meetings – where the research findings of these “Top 20” articles are summarized for conference attendees. Their hope, they said, is to present research that each attendee can bring home to improve patient outcomes on a daily basis, while making for a smoother and more efficient practice of hospital medicine.

Dr. Barbara Slawski, chief of the section of perioperative medicine at the Medical College of Wisconsin in Milwaukee
Dr. Barbara Slawski
Dr. Slawski, chief of the section of perioperative medicine at the Medical College of Wisconsin in Milwaukee, said the presentations will not simply summarize study results, but also will help attendees focus on the key findings – the clinical pearls – that represent real opportunities to update practice.

Through a process each physician describes as collegial, Dr. Slawski and Dr. Cooper have winnowed their lists and are nearly ready to make their final calls. Since hospital medicine crosses so many disciplines, each physician said, in separate interviews, that doing justice to the literature has been time-consuming and intellectually challenging – but worthwhile.

Dr. Cooper, a hospitalist at Massachusetts General Hospital, Boston, said that although she and Dr. Slawski practice in geographically diverse areas, their practice settings – academic medical centers – have many similarities. She said that as she reviewed the medical literature over the past year, she gave considerable thought to the particular challenges and demands of hospitalists who practice in community hospitals and rural settings, where the level of support and access to subspecialty consults might be very different from the academic milieu where both she and Dr. Slawski practice.
 

Dr. Cynthia Cooper

“We hope that our unique approaches lend more breadth to the session,” said Dr. Slawski. “We want to make sure we have a good representation of SHM’s constituency, and that we present high-impact studies.”

In addition to her work at Mass General, Dr. Cooper also holds an appointment at Harvard Medical School. She said that the challenge over the past year has been to find the studies that are not focused just on primary care, but that really touch on the unique practice demands and skill set of physicians who practice hospital-based medicine.

Dr. Slawski said that cardiology is one of the areas that’s had relevant, practice-changing findings this past year: She expects to put at least one practice-changing cardiology article on the “Top 20” list. “How do we address patients with suspected acute coronary syndromes? Well, we have some new direction this year,” she said.

To hit the mark of articles that are relevant for all, Dr. Cooper said she wants to make sure to include a focus on research that touches on the practicalities of hospital-based practice – possible topics include prediction scores, hepatic encephalopathy, and the management of sepsis.

Dr. Slawski said that in addition to relevance, she and Dr. Cooper looked for methodological rigor in the studies they’ll be presenting; they agreed that having an adequate sample size for statistical power was a must.

The two presenters said they’re working hard to put together a session that’s as enjoyable as it is relevant. “I hope we’ll be able to inject some humor into the presentation, too,” Dr. Cooper said. Dr. Slawski agreed, noting that the bar has been set high at SHM. “It feels like a community,” she said. “There are always great speakers with a sense of humor.”

Dr. Slawski stressed that even though they’ll have their list ready to go for HM18, they will still be scouring journals until the week of the meeting so they can update their presentation with any late-breaking news of significance.

Neither Dr. Slawski nor Dr. Cooper reported any relevant conflicts of interest.

 

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