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It’s That Time again…

It’s That Time again…

Aug 27, 2015 | No Comments

It’s that time of year again, when hospitals around the country are being notified of their 30-day readmission penalties from CMS. Now in the fourth year of the program, many hospitals have come to dread the announcement of how much they are being penalized each year.1 This year the readmission reduction program will decrease Medicare payments within a total of...

  • Conflict: Ten Rounds in the Ring with Our Inpatient Data
    Aug 26, 2015 | No Comments

    by Frank Zadravecz, MPH Fortunately, my research world isn’t rife with inter-colleague conflict. Data, on the other hand continues to pick fights. As researchers, we have banded together to make sense of the patient measurements, physiologic alarms, and adverse outcomes we see in our hospital. Often where we are led by the data is perplexing. Pieces that we assume would...

  • Welcome to Uncomfort Inn. You Can Check out Anytime You’d Like
    Welcome to Uncomfort Inn. You Can Check out Anytime You’d Like
    Aug 25, 2015 | 2 Comments

    “A good laugh and a long sleep are the best cures in the doctor’s book.” -Irish proverb “You can check out anytime you’d like, but you can never leave.” -Hotel California, the Eagles Welcome to the hotel that functions like a hospital. 1700 CHECK IN Hello, sir, thanks for checking in today to “UnComfort Inn”. It looks like this is...

  • Catch Me If You Can. With My Dirty Hands That Is.
    Catch Me If You Can. With My Dirty Hands That Is.
    Aug 24, 2015 | 4 Comments

      Economists describe preferences in two ways: revealed and stated.  Say, for example, I asked you to implement a penalty program for your team with the goal of decreasing the number of occasions members did not clean their hands after a patient encounter.  Because you know bad hands equal bad outcomes, you’re apt to offer up a more than token sanction....

  • On Research and the Circus
    Aug 20, 2015 | No Comments

    by Mimi Zander The other week I had the pleasure of attending a cat circus. It was a stage show of 10-15 cats (plus a chicken, a groundhog, and 2 curious rats) walking on tight ropes, completing dangerous jumps, and a cat band complete with drums, guitar, and cow bell. In the beginning of the show the cat herder, Samatha...

  • Making Hospital Medicine a Sustainable Specialty
    Aug 19, 2015 | 2 Comments

    by Leslie Flores, MHA, SFHM Despite hospital medicine’s meteoric rise as the fastest-growing specialty in history and the fact that there are almost 50,000 hospitalists in the U.S. today, I’m a little worried about the future of the specialty. There are two conflicting messages I’m hearing increasingly in the work we do with hospitalist practices around the country. Hospital executives are...

  • SHM Media Highlights: July 30 – August 13
    Aug 18, 2015 | No Comments

    SUMMARY The hospital medicine movement was part of national media coverage about end-of life-care, business news and antibiotic use in the last two weeks. SHM’s Senior Physician Advisor Dr. Eric Howell was quoted in a piece on “superbugs” in HealthDay that was syndicated to multiple national news outlets, including CBS News. Meanwhile, business and healthcare press covered the acquisition of...

  • Misjudge the Outlier Patient at Your Peril
    Misjudge the Outlier Patient at Your Peril
    Aug 17, 2015 | No Comments

      A few weeks ago, I wrote about small numbers of patients consuming large and disproportionate shares of health care goods.  The thinking being, if we focus efforts on outliers, hospitals will save money and FTEs by economizing in the right places.  Why waste resources on interventions applied to fifty percent of the hospital population when only ten or twenty...

  • House Elves of Hospital Medicine
    House Elves of Hospital Medicine
    Aug 13, 2015 | Comments Off on House Elves of Hospital Medicine

    I read a fascinating article from ProPublica about an NP, Heather Alfonso, who pleaded guilty in June to accepting $83,000 in payments from a drug company in exchange for prescribing a high priced drug used to treat cancer pain. However disturbing this is, notably in the data released by the federal government on payments by drug and device companies to...

  • The Strange Case of Dr. Jekyll and Mr. Hyde
    Aug 11, 2015 | Comments Off on The Strange Case of Dr. Jekyll and Mr. Hyde

    by Frank Zadravecz, MPH This story intrigues me, not so much its time-tested message on good versus evil, rather strangely its reflections on scientific inquiry. Robert Louis Stevenson paints the character Dr. Hastie Lanyon as a man committed to deductive reasoning and logic, conveniently the antithesis of Dr. Jekyll. After Lanyon witnesses Jekyll’s transformation from the grotesque Mr. Hyde, he...

  • Hospital readmissions and length of stay
    Aug 10, 2015 | Comments Off on Hospital readmissions and length of stay

      I am pleased to cross-post a terrific piece from The Incidental Economist on the sometimes rival effects of LOS shortening and readmissions.  (I can’t recommend TIE enough by the way–and do not let the title fool you, it is a health care site). We feel the yin and yang tensions daily on this subject: discharge promptly (“sicker and quicker”) but...

  • Introducing SHM Media Highlights
    Aug 6, 2015 | Comments Off on Introducing SHM Media Highlights

    Welcome to “SHM Media Highlights,” a new series of blog posts on The Hospital Leader that highlights news articles about the hospital medicine movement and SHM. We’re posting these highlights to The Hospital Leader to give hospitalists and others in healthcare an idea about how news about hospital medicine is spreading. SHM monitors the media on a daily basis, and we will post...

  • Wake Up! How Hospital Noise Is Preventing Sleep & Recovery
    Aug 5, 2015 | Comments Off on Wake Up! How Hospital Noise Is Preventing Sleep & Recovery

    by Monica Shah When I first stepped onto patient floors, I noticed the amount of commotion, from alarms beeping to staff conversations to loud knocks on patient doors. I couldn’t help but think, I wish I had some ear plugs! That was when it hit me that if I was feeling jolted just by visiting patient floors, what were patients...

  • Meet The Villain of Hospital Costs: The Chargemaster
    Jul 30, 2015 | 5 Comments

    by Christopher Moriates, MD Author of Understanding Value-Based Healthcare* The hospital chargemaster has become nearly a household term, following its turn as the villain in highly publicized features in Time magazine, The New York Times, and the The Daily Show. Nobody seems to like the chargemaster. But what exactly is it and how does it relate to hospital costs? The...

  • Reimagining the Sounds of the Hospital: Theory to Practice
    Reimagining the Sounds of the Hospital: Theory to Practice
    Jul 29, 2015 | Comments Off on Reimagining the Sounds of the Hospital: Theory to Practice

    By Mimi Zander During my undergraduate studies at Rutgers University, I studied English, women’s and gender studies, and literary theory. As part of The Institute for Women’s Leadership Scholars Program, during class discussions, we would circle back to the idea of bridging theory and practice. The first step is identifying the problem. The next step is to discuss, research, and...

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