Hospital Physicians' Stethoscopes: Bacterial Contamination After a Simple Cleaning Protocol.

Background: Stethoscope surfaces become contaminated with bacteria due to inconsistent cleaning practices,​ as​​ ​​​​cleaning frequency and practical clean​s​ing approaches are not well-established.

Methods: We investigated bacterial contamination of stethoscopes at baseline, after simple cleaning, and after examining one patient. We surveyed 30 hospital providers on stethoscope cleaning practices and then measured bacterial contamination of stethoscope diaphragm surfaces before cleaning, after cleaning with alcohol-based hand sanitizer, and after use in examining one patient.

Here's the rub: A case of constrictive pericarditis in an adult with cystic fibrosis.

We present a rare coexistence of constrictive pericarditis in a patient with cystic fibrosis. Careful attention to cardiac friction rub auscultated on initial examination prompted echocardiography revealing constrictive pericarditis further confirmed by cardiac magnetic resonance imaging that allowed for dedicated treatment in addition to management of his concurrent respiratory infection.

Efficiently finding and using evidence to guide clinical practice and improve care.

Using evidence to guide patient care improves patient outcomes. However, the volume of clinical and scientific literature and demands on provider time make staying current challenging. Primary literature searching or using public search engines to answer clinical questions often results in low-quality or incorrect answers, potentially yielding suboptimal clinical care.

Reorganizing a hospital ward as an accountable care unit.

Traditional hospital wards are not specifically designed as effective clinical microsystems. The feasibility and sustainability of doing so are unclear, as are the possible outcomes. To reorganize a traditional hospital ward with the traits of an effective clinical microsystem, we designed it to have 4 specific features: (1) unit-based teams, (2) structured interdisciplinary bedside rounds, (3) unit-level performance reporting, and (4) unit-level nurse and physician coleadership.

Evaluating Simulation-Based ACLS Education on Patient Outcomes: A Randomized, Controlled Pilot Study.

Background: Simulation training is widely accepted as an effective teaching tool, especially for dealing with high-risk situations.

Objective: We assessed whether standardized, simulation-based advanced cardiac life support (ACLS) training improved performance in managing simulated and actual cardiac arrests.

Methods: A total of 103 second- and third-year internal medicine residents were randomized to 2 groups.

Avoiding handover fumbles: a controlled trial of a structured handover tool versus traditional handover methods.

Background: Handover of patient information represents a critical time period during a patient's hospitalisation. While recent guidelines promote standardised communication during these patient care transitions, significant variability in structure and practice persists among hospitals and providers.

Methods: The authors surveyed internal medicine residents regarding handover practices before and after introduction of a structured, web-based handover application.

Hospitalists and intensivists in the medical ICU: a prospective observational study comparing mortality and length of stay between two staffing models.

Background: A shortage of critical care specialists or intensivists, coupled with expanding United States critical care needs, mandates identification of alternate qualified physicians for intensive care unit (ICU) staffing.

Objective: To compare mortality and length of stay (LOS) of medical ICU patients cared for by a hospitalist or an intensivist-led team.

Design: Prospective observational study.

Hospitalist handoffs: a systematic review and task force recommendations.

Background: Handoffs are ubiquitous to Hospital Medicine and are considered a vulnerable time for patient safety.

Purpose: To develop recommendations for hospitalist handoffs during shift change and service change.

Data Sources: PubMed (through January 2007), Agency for Healthcare Research and Quality (AHRQ) Patient Safety Network, white papers, and hand search of article bibliographies.

Spreading the word, not the infection: reaching hospitalists about the prevention of antimicrobial resistance.

Background: To reach and engage hospitalists in the prevention of antimicrobial resistance, the Society of Hospital Medicine and the Centers for Disease Control and Prevention developed and conducted a quality improvement workshop based on the Centers for Disease Control and Prevention's Campaign to Prevent Antimicrobial Resistance in Healthcare Settings.

Methods: We aimed to examine motivating factors, perceived barriers, and cues to action for hospitalists to learn about and engage in the prevention of antimicrobial resistance and to determine whether a workshop can facilitate the implementation of a quality improvement project. Using the Health Belief Model as a theoretical framework, we interviewed hospitalists who attended (attendees) and did not attend (nonattendees) the workshop.

Impact of Society of Hospital Medicine workshops on hospitalists' knowledge and perceptions of health care-associated infections and antimicrobial resistance.

Background: Health care-associated infections and antimicrobial resistance threaten the safety of hospitalized patients. New prevention strategies are necessary to address these problems. In response, the Society of Hospital Medicine (SHM) in collaboration with the Centers for Disease Control and Prevention developed and conducted workshops to educate hospitalists about conducting quality improvement programs to address antimicrobial resistance and health care-associated infections in hospitalized patients.

How to use the core competencies in hospital medicine: a framework for curriculum development.

Background: The seminal article that coined the term hospitalist, published in 1996, attributed the role of the hospitalist to enhancing throughput and cost reduction, primarily through reduction in length of stay, accomplished by having a dedicated clinician on site in the hospital. Since that time the role of the hospitalist has evolved, and hospitalists are being called upon to demonstrate that they actually improve quality of care and the education of the next generation of physicians. A companion article in this issue describes in detail the rationale for the development of the Core Competencies document and the methods by which it was created.

Core competencies in hospital medicine: development and methodology.

Background: The hospitalist model of inpatient care has been rapidly expanding over the last decade, with significant growth related to the quality and efficiency of care provision. This growth and development have stimulated a need to better define and characterize the field of hospital medicine. Training and developing curricula specific to hospital medicine are the next step in the evolution of the field.

How to use The Core Competencies in Hospital Medicine: a framework for curriculum development.

Background: The seminal article that coined the term hospitalist, published in 1996, attributed the role of the hospitalist to enhancing throughput and cost reduction, primarily through reduction in length of stay, accomplished by having a dedicated clinician on site in the hospital. Since that time the role of the hospitalist has evolved, and hospitalists are being called upon to demonstrate that they actually improve quality of care and the education of the next generation of physicians. A companion article in this issue describes in detail the rationale for the development of the Core Competencies document and the methods by which it was created.

Core competencies in hospital medicine: development and methodology.

Background: The hospitalist model of inpatient care has been rapidly expanding over the last decade, with significant growth related to the quality and efficiency of care provision. This growth and development have stimulated a need to better define and characterize the field of hospital medicine. Training and developing curricula specific to hospital medicine are the next step in the evolution of the field.