JHM Research Series

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

Do Clinicians Understand Quality Metric Data?

The number and complexity of quality metrics within healthcare continues to expand, many of which are used to compare performance between hospitals, systems, and/or clinicians. To make these comparisons fair, many quality reporting agencies attempt to “risk stratify” these metrics, so as not to penalize those caring for higher complexity patients. Although laudable, these attempts also increase the complexity of the data and may reduce the ability of clinicians to understand and analyze quality performance. A recent article in the Journal of Hospital Medicine explores clinicians’ understanding of quality metrics using central line associated bloodstream infections (CLABSIs) as an example. The investigators used a unique Twitter-based survey to explore clinicians’ interpretation of basic concepts in public-reported CLABSI rates and ratios. I recently caught up with the lead author, Dr. Sushant Govindan, to better understand his team’s research and its implications for quality reporting. Dr. Govindan is a Pulmonary-Critical Care fellow…

The Risk-Outcome-Experience Triad: Mortality Risk and HCAHPS

I had the pleasure of interviewing Mark Cowen, who is in the Department of Medicine and is the Chief of Clinical Decision Services at St. Joseph Mercy Hospital in Ann Arbor, MI. He and his team sought to analyze the relationship between patient’s admission risk of mortality and their ratings of hospitals on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. Their paper was recently published in the Journal of Hospital Medicine. How did you become interested in the relationship between mortality risk and HCAHPS? When our teams were thinking about how to organize our care to maximize our patient outcomes, we realized that the risk of mortality at admit was a high predictor of several poor patient outcomes (such as long length of stay and readmissions). At some point, we also had the notion that these may be the same patients that are providing lower scores…

Perioperative Care: Top of Mind & Topic for #Periop #JHMChat on April 4th

With great successes in hosting our first couple of Twitter chats over the last six months, we’re excited to bring you the third in our quarterly series, #JHMChat, where you ask Journal of Hospital Medicine (JHM) authors about their research and corresponding clinical implications for managing inpatient care. We invite you to join us for the next #JHMChat on Monday, April 4th at 9pm EDT, when we will discuss Dr. Kurt Pfeifer et al.’s article from JHM, “Updates in perioperative medicine”, which you can read here. Perioperative care is a critical skillset for today’s hospitalists. The article authored by Dr. Pfeifer and colleagues highlights key clinical pearls from recent research on best practices in perioperative medicine. As the patient population ages and cases become more medically complex, hospitalists are key providers in ensuring safe, quality care for patients before, during and after surgery. In keeping with our theme of promoting…

Heterogeneity of Interdisciplinary Rounds

I had the pleasure of interviewing Surekha Bhamidipati, a hospitalist in the Department of Medicine at Christiana Care Health System. She and her team sought to analyze the current literature on the structure and outcomes of interdisciplinary rounds among hospitalized medicine patients, to determine the composition and impact of such rounds in her recent Journal of Hospital Medicine (JHM) paper, Structure and Outcomes of Inter-Disciplinary Rounds in Hospitalized Medicine Patients: A Systematic Review and Suggested Taxonomy. What is your background and how did you become interested in evaluating interdisciplinary rounds? I am a Faculty Hospitalist and completed my residency in Internal Medicine. I have been exposed and trained to participate in interdisciplinary rounding since Day#1 of my residency training. After my training, in my first job I also had the experience with very valuable bedside interdisciplinary rounding. Then in my current position, I found that we did interdisciplinary rounding, but…

You Can Learn A Lot From Billing Data.

Because hospitalists lack a specialty code for billing (probably forthcoming), and we do not have formal board certification (I would bet it's in our future), anyone interested in identifying hospitalists beyond their hospital walls has a tough slog.  You can call several thousand hospitals and speak with the appropriate department and question; you can call every internist, pediatrician or family practitioner in the AMA database and ask them, "Are you a hospitalist?"; or you can find an alternate method---because the latter two will keep you busy until the next solar eclipse. Knowing adult inpatient practitioners bill just a small cluster of codes--observation, critical care, or inpatient--having access to a national database with physician billing data (Part B submissions) would provide a route to determine which docs practice in acute care settings.   (more…)