Suzanne Bopp

Nidhi Goel, MD, MHS, is a Med-Peds hospitalist and assistant professor of internal medicine and pediatrics at the University of Maryland, Baltimore. Since August 2017, she has been the president of the Maryland chapter of SHM.

Can you talk about your background and how you became interested in hospital medicine?

I grew up in the Baltimore area, and I went to medical school at the University of Maryland in Baltimore. I trained in internal medicine and pediatrics, also at the University of Maryland. Then I joined the faculty after I finished residency in 2014. I practiced as a hospitalist in internal medicine and pediatrics and was also a teaching hospitalist.

Early in my residency, I worked with teaching hospitalists. I rotated on the hospitalist teams, and I was inspired by their perspective on taking care of patients through a lens of quality and safety. I gained a greater appreciation for the risks associated with taking care of a patient in the hospital setting, and the opportunities to mitigate those risks and provide really high quality patient care. It made me realize that was what I wanted to do – and also to teach residents and students how to do the same.
 

So it was a philosophical attraction to the hospitalist approach?

Yes, and intellectually I’d say that I liked taking care of really complicated, very sick patients. I found that to be interesting – and rewarding when they got better.

Tell us more about what kind of research you do.

I work primarily on projects centered on quality and safety; they involve both adult internal medicine and pediatric patients. Currently on the adult medicine side, we have a project looking at improving outcomes for sepsis in the hospital setting. On the pediatric side, I’ve done a lot of work related to throughput – trying to increase the efficiency of our admissions – and especially our discharge process. Moving patients through the system efficiently has become a significant quality issue, especially during the winter months when our volumes pick up.

How long have you been involved in the Maryland SHM chapter, and what are the rewards of participation?

Early in my residency, I got involved in the chapter because some of the hospitalist faculty I worked with were chapter officers. They believed that the chapter was a good place for residents to be exposed to research and to other hospitalists for networking and camaraderie. So they began inviting us to Maryland chapter meetings, and I found those meetings to be very enlightening – from the practical and research content related to hospital medicine, and to networking with other hospitalists.

I was invited to be part of the Maryland chapter advisory board when I was still a resident, so that I might present trainee perspectives on how the chapter could continue to grow and target some of their activities for the benefit of residents. I stayed involved with the chapter after I finished residency, and when the opportunity presented itself to become an officer, and I decided to take it. I thought serving as a chapter officer would be a really interesting chance to meet more people in the field and to continue to innovate within the chapter setting.
 

Tell us more about the Maryland chapter.

We are a large chapter and we’re very, very active. Around 7 or 8 years ago, the Maryland chapter reached a significant turning point because the officers that were in place at that time had a vision for building the chapter. That was a major inflexion point in how active the chapter became, leading to the kinds of activities that we do now, and the variety of memberships.

One thing that I’m super proud of our chapter for is that we’ve really tried to continue building on the diversity that is represented in our membership. We have members stretching geographically all through the Baltimore and the Washington corridor, as well as out to western Maryland and the Eastern shore. The Maryland chapter has been able to attract members from different organizations throughout the state and from a diversity of practice settings. We have active members who are not just physicians, but also a nurse practitioners, physician assistants, and clinical pharmacists. We have members from throughout the health care delivery process, which really enriches the discussion and the value of the chapter as a whole.
 

What kind of initiatives and programs is the chapter working on?

Every year we have an abstracts competition at our fall meeting. Whoever wins that competition is allowed to present at the national SHM conference, which is a great opportunity. We’re really pushing that competition to make it an even more robust experience.

One thing that we had heard from some of our members, and that we recognized as a need as well, was to make our career guidance a little bit more robust. To that end, we’re creating a separate job fair that is almost like an employment workshop – to help people to buff up their CVs, to talk about interviewing skills, contracts, salary negotiations, as well as exposing job candidates to various hospital groups from throughout the area. That’s something that we’re really excited about. It’s going to take a lot of work, but I think it could be a really high-yield event for our members.

We’re also encouraging our nonphysician members to take more active leadership roles in the chapter; several of our nonphysician members on our chapter advisory board, including pharmacists and physician assistants, and we are trying to make sure that we’re also liaising with some of the professional organizations that represent our nonphysician members. So, for example, the clinical pharmacist who’s on our advisory board also is president of the Maryland chapter of the Society for Hospital Pharmacists. She brings a lot of really great ideas and interesting perspectives, and she’s brought a lot of exposure of our SHM chapter to the clinical pharmacy community as well.
 

What about more long-term goals for your chapter? What’s on the horizon?

We’re targeting early-career hospitalists and helping them to develop their career goals in whatever fashion they see as appropriate.

So, as someone who’s in academics, obviously research and publications are very important for me, but they’re not necessarily as important for other hospitalists. I think our early-career hospitalists are increasingly looking to incorporate things into their practice aside from direct patient care. Our members have interests in various elements of hospital medicine, including patient safety and quality improvement initiatives, clinical informatics, advocacy (especially related to the myriad aspects of health care reform), and strategies surrounding billing and denials. I think having our chapter help our members to realize some of those opportunities and develop their skills in a way that’s personally meaningful to them, as well as good for their marketability as they build their careers, would be a really positive step.

The ultimate goal of the chapter is to service members, so whatever long-term goals we have right now could definitely be fluid as time goes on.
 

What are some concerns of the chapter?

One area of significant discussion among hospitalists in Maryland has been global budgets. Our system of reimbursement is unique in the nation. It’s a system that aims to emphasize high-value care: the idea is to prioritize quality over quantity.

This system requires that hospitals rethink how we provide care in the inpatient setting, and how we create a continuum of care to the post-acute setting. It poses a lot of challenges, but also a lot of opportunities. Hospitalists are positioned perfectly to play a substantial role in implementing solutions.
 

Why might readers want to consider getting involved in their local SHM chapters?

I think it’s really beneficial to have the exposure that being involved with an SHM chapter brings – to people, to perspectives, to knowledge. There’s not really a downside to being involved with a chapter. You can take as little or as much as you want out of it, but I think most of our members find it to be a very enriching experience. Being involved in a chapter means you can have a voice, so that the chapter ends up serving you and your needs as well.

Nidhi Goel, MD, MHS, is a Med-Peds hospitalist and assistant professor of internal medicine and pediatrics at the University of Maryland, Baltimore. Since August 2017, she has been the president of the Maryland chapter of SHM.

Can you talk about your background and how you became interested in hospital medicine?

I grew up in the Baltimore area, and I went to medical school at the University of Maryland in Baltimore. I trained in internal medicine and pediatrics, also at the University of Maryland. Then I joined the faculty after I finished residency in 2014. I practiced as a hospitalist in internal medicine and pediatrics and was also a teaching hospitalist.

Early in my residency, I worked with teaching hospitalists. I rotated on the hospitalist teams, and I was inspired by their perspective on taking care of patients through a lens of quality and safety. I gained a greater appreciation for the risks associated with taking care of a patient in the hospital setting, and the opportunities to mitigate those risks and provide really high quality patient care. It made me realize that was what I wanted to do – and also to teach residents and students how to do the same.
 

So it was a philosophical attraction to the hospitalist approach?

Yes, and intellectually I’d say that I liked taking care of really complicated, very sick patients. I found that to be interesting – and rewarding when they got better.

Tell us more about what kind of research you do.

I work primarily on projects centered on quality and safety; they involve both adult internal medicine and pediatric patients. Currently on the adult medicine side, we have a project looking at improving outcomes for sepsis in the hospital setting. On the pediatric side, I’ve done a lot of work related to throughput – trying to increase the efficiency of our admissions – and especially our discharge process. Moving patients through the system efficiently has become a significant quality issue, especially during the winter months when our volumes pick up.

How long have you been involved in the Maryland SHM chapter, and what are the rewards of participation?

Early in my residency, I got involved in the chapter because some of the hospitalist faculty I worked with were chapter officers. They believed that the chapter was a good place for residents to be exposed to research and to other hospitalists for networking and camaraderie. So they began inviting us to Maryland chapter meetings, and I found those meetings to be very enlightening – from the practical and research content related to hospital medicine, and to networking with other hospitalists.

I was invited to be part of the Maryland chapter advisory board when I was still a resident, so that I might present trainee perspectives on how the chapter could continue to grow and target some of their activities for the benefit of residents. I stayed involved with the chapter after I finished residency, and when the opportunity presented itself to become an officer, and I decided to take it. I thought serving as a chapter officer would be a really interesting chance to meet more people in the field and to continue to innovate within the chapter setting.
 

Tell us more about the Maryland chapter.

We are a large chapter and we’re very, very active. Around 7 or 8 years ago, the Maryland chapter reached a significant turning point because the officers that were in place at that time had a vision for building the chapter. That was a major inflexion point in how active the chapter became, leading to the kinds of activities that we do now, and the variety of memberships.

One thing that I’m super proud of our chapter for is that we’ve really tried to continue building on the diversity that is represented in our membership. We have members stretching geographically all through the Baltimore and the Washington corridor, as well as out to western Maryland and the Eastern shore. The Maryland chapter has been able to attract members from different organizations throughout the state and from a diversity of practice settings. We have active members who are not just physicians, but also a nurse practitioners, physician assistants, and clinical pharmacists. We have members from throughout the health care delivery process, which really enriches the discussion and the value of the chapter as a whole.
 

What kind of initiatives and programs is the chapter working on?

Every year we have an abstracts competition at our fall meeting. Whoever wins that competition is allowed to present at the national SHM conference, which is a great opportunity. We’re really pushing that competition to make it an even more robust experience.

One thing that we had heard from some of our members, and that we recognized as a need as well, was to make our career guidance a little bit more robust. To that end, we’re creating a separate job fair that is almost like an employment workshop – to help people to buff up their CVs, to talk about interviewing skills, contracts, salary negotiations, as well as exposing job candidates to various hospital groups from throughout the area. That’s something that we’re really excited about. It’s going to take a lot of work, but I think it could be a really high-yield event for our members.

We’re also encouraging our nonphysician members to take more active leadership roles in the chapter; several of our nonphysician members on our chapter advisory board, including pharmacists and physician assistants, and we are trying to make sure that we’re also liaising with some of the professional organizations that represent our nonphysician members. So, for example, the clinical pharmacist who’s on our advisory board also is president of the Maryland chapter of the Society for Hospital Pharmacists. She brings a lot of really great ideas and interesting perspectives, and she’s brought a lot of exposure of our SHM chapter to the clinical pharmacy community as well.
 

What about more long-term goals for your chapter? What’s on the horizon?

We’re targeting early-career hospitalists and helping them to develop their career goals in whatever fashion they see as appropriate.

So, as someone who’s in academics, obviously research and publications are very important for me, but they’re not necessarily as important for other hospitalists. I think our early-career hospitalists are increasingly looking to incorporate things into their practice aside from direct patient care. Our members have interests in various elements of hospital medicine, including patient safety and quality improvement initiatives, clinical informatics, advocacy (especially related to the myriad aspects of health care reform), and strategies surrounding billing and denials. I think having our chapter help our members to realize some of those opportunities and develop their skills in a way that’s personally meaningful to them, as well as good for their marketability as they build their careers, would be a really positive step.

The ultimate goal of the chapter is to service members, so whatever long-term goals we have right now could definitely be fluid as time goes on.
 

What are some concerns of the chapter?

One area of significant discussion among hospitalists in Maryland has been global budgets. Our system of reimbursement is unique in the nation. It’s a system that aims to emphasize high-value care: the idea is to prioritize quality over quantity.

This system requires that hospitals rethink how we provide care in the inpatient setting, and how we create a continuum of care to the post-acute setting. It poses a lot of challenges, but also a lot of opportunities. Hospitalists are positioned perfectly to play a substantial role in implementing solutions.
 

Why might readers want to consider getting involved in their local SHM chapters?

I think it’s really beneficial to have the exposure that being involved with an SHM chapter brings – to people, to perspectives, to knowledge. There’s not really a downside to being involved with a chapter. You can take as little or as much as you want out of it, but I think most of our members find it to be a very enriching experience. Being involved in a chapter means you can have a voice, so that the chapter ends up serving you and your needs as well.

Nidhi Goel, MD, MHS, is a Med-Peds hospitalist and assistant professor of internal medicine and pediatrics at the University of Maryland, Baltimore. Since August 2017, she has been the president of the Maryland chapter of SHM.

Can you talk about your background and how you became interested in hospital medicine?

I grew up in the Baltimore area, and I went to medical school at the University of Maryland in Baltimore. I trained in internal medicine and pediatrics, also at the University of Maryland. Then I joined the faculty after I finished residency in 2014. I practiced as a hospitalist in internal medicine and pediatrics and was also a teaching hospitalist.

Early in my residency, I worked with teaching hospitalists. I rotated on the hospitalist teams, and I was inspired by their perspective on taking care of patients through a lens of quality and safety. I gained a greater appreciation for the risks associated with taking care of a patient in the hospital setting, and the opportunities to mitigate those risks and provide really high quality patient care. It made me realize that was what I wanted to do – and also to teach residents and students how to do the same.
 

So it was a philosophical attraction to the hospitalist approach?

Yes, and intellectually I’d say that I liked taking care of really complicated, very sick patients. I found that to be interesting – and rewarding when they got better.

Tell us more about what kind of research you do.

I work primarily on projects centered on quality and safety; they involve both adult internal medicine and pediatric patients. Currently on the adult medicine side, we have a project looking at improving outcomes for sepsis in the hospital setting. On the pediatric side, I’ve done a lot of work related to throughput – trying to increase the efficiency of our admissions – and especially our discharge process. Moving patients through the system efficiently has become a significant quality issue, especially during the winter months when our volumes pick up.

How long have you been involved in the Maryland SHM chapter, and what are the rewards of participation?

Early in my residency, I got involved in the chapter because some of the hospitalist faculty I worked with were chapter officers. They believed that the chapter was a good place for residents to be exposed to research and to other hospitalists for networking and camaraderie. So they began inviting us to Maryland chapter meetings, and I found those meetings to be very enlightening – from the practical and research content related to hospital medicine, and to networking with other hospitalists.

I was invited to be part of the Maryland chapter advisory board when I was still a resident, so that I might present trainee perspectives on how the chapter could continue to grow and target some of their activities for the benefit of residents. I stayed involved with the chapter after I finished residency, and when the opportunity presented itself to become an officer, and I decided to take it. I thought serving as a chapter officer would be a really interesting chance to meet more people in the field and to continue to innovate within the chapter setting.
 

Tell us more about the Maryland chapter.

We are a large chapter and we’re very, very active. Around 7 or 8 years ago, the Maryland chapter reached a significant turning point because the officers that were in place at that time had a vision for building the chapter. That was a major inflexion point in how active the chapter became, leading to the kinds of activities that we do now, and the variety of memberships.

One thing that I’m super proud of our chapter for is that we’ve really tried to continue building on the diversity that is represented in our membership. We have members stretching geographically all through the Baltimore and the Washington corridor, as well as out to western Maryland and the Eastern shore. The Maryland chapter has been able to attract members from different organizations throughout the state and from a diversity of practice settings. We have active members who are not just physicians, but also a nurse practitioners, physician assistants, and clinical pharmacists. We have members from throughout the health care delivery process, which really enriches the discussion and the value of the chapter as a whole.
 

What kind of initiatives and programs is the chapter working on?

Every year we have an abstracts competition at our fall meeting. Whoever wins that competition is allowed to present at the national SHM conference, which is a great opportunity. We’re really pushing that competition to make it an even more robust experience.

One thing that we had heard from some of our members, and that we recognized as a need as well, was to make our career guidance a little bit more robust. To that end, we’re creating a separate job fair that is almost like an employment workshop – to help people to buff up their CVs, to talk about interviewing skills, contracts, salary negotiations, as well as exposing job candidates to various hospital groups from throughout the area. That’s something that we’re really excited about. It’s going to take a lot of work, but I think it could be a really high-yield event for our members.

We’re also encouraging our nonphysician members to take more active leadership roles in the chapter; several of our nonphysician members on our chapter advisory board, including pharmacists and physician assistants, and we are trying to make sure that we’re also liaising with some of the professional organizations that represent our nonphysician members. So, for example, the clinical pharmacist who’s on our advisory board also is president of the Maryland chapter of the Society for Hospital Pharmacists. She brings a lot of really great ideas and interesting perspectives, and she’s brought a lot of exposure of our SHM chapter to the clinical pharmacy community as well.
 

What about more long-term goals for your chapter? What’s on the horizon?

We’re targeting early-career hospitalists and helping them to develop their career goals in whatever fashion they see as appropriate.

So, as someone who’s in academics, obviously research and publications are very important for me, but they’re not necessarily as important for other hospitalists. I think our early-career hospitalists are increasingly looking to incorporate things into their practice aside from direct patient care. Our members have interests in various elements of hospital medicine, including patient safety and quality improvement initiatives, clinical informatics, advocacy (especially related to the myriad aspects of health care reform), and strategies surrounding billing and denials. I think having our chapter help our members to realize some of those opportunities and develop their skills in a way that’s personally meaningful to them, as well as good for their marketability as they build their careers, would be a really positive step.

The ultimate goal of the chapter is to service members, so whatever long-term goals we have right now could definitely be fluid as time goes on.
 

What are some concerns of the chapter?

One area of significant discussion among hospitalists in Maryland has been global budgets. Our system of reimbursement is unique in the nation. It’s a system that aims to emphasize high-value care: the idea is to prioritize quality over quantity.

This system requires that hospitals rethink how we provide care in the inpatient setting, and how we create a continuum of care to the post-acute setting. It poses a lot of challenges, but also a lot of opportunities. Hospitalists are positioned perfectly to play a substantial role in implementing solutions.
 

Why might readers want to consider getting involved in their local SHM chapters?

I think it’s really beneficial to have the exposure that being involved with an SHM chapter brings – to people, to perspectives, to knowledge. There’s not really a downside to being involved with a chapter. You can take as little or as much as you want out of it, but I think most of our members find it to be a very enriching experience. Being involved in a chapter means you can have a voice, so that the chapter ends up serving you and your needs as well.

In 2015, 75% of U.S. hospitals with more than 50 beds had palliative care programs – a sharp increase from the 25% that had palliative care in 2000.

“The rapid adoption of this high-value program, which is voluntary and runs counter to the dominant culture in U.S. hospitals, was catalyzed by tens of millions of dollars in philanthropic support for innovation, dissemination, and professionalization in the palliative care field,” according to research published in Health Affairs.
 

Reference

Cassel JB et al. Palliative care leadership centers are key to the diffusion of palliative care innovation. Health Aff. 2018 Feb. doi: 10.1377/hlthaff.2017.1122.

In 2015, 75% of U.S. hospitals with more than 50 beds had palliative care programs – a sharp increase from the 25% that had palliative care in 2000.

“The rapid adoption of this high-value program, which is voluntary and runs counter to the dominant culture in U.S. hospitals, was catalyzed by tens of millions of dollars in philanthropic support for innovation, dissemination, and professionalization in the palliative care field,” according to research published in Health Affairs.
 

Reference

Cassel JB et al. Palliative care leadership centers are key to the diffusion of palliative care innovation. Health Aff. 2018 Feb. doi: 10.1377/hlthaff.2017.1122.

In 2015, 75% of U.S. hospitals with more than 50 beds had palliative care programs – a sharp increase from the 25% that had palliative care in 2000.

“The rapid adoption of this high-value program, which is voluntary and runs counter to the dominant culture in U.S. hospitals, was catalyzed by tens of millions of dollars in philanthropic support for innovation, dissemination, and professionalization in the palliative care field,” according to research published in Health Affairs.
 

Reference

Cassel JB et al. Palliative care leadership centers are key to the diffusion of palliative care innovation. Health Aff. 2018 Feb. doi: 10.1377/hlthaff.2017.1122.

Hospitalists have focused much attention on reducing 30-day readmission rates, at a time when 15-20% of health care dollars spent on those readmissions is considered potentially preventable.

But until very recently, no study has explored patient perceptions of the likelihood of readmission during index admission. Now, that’s changed.

Reference

Carter J et al. The association between patient experience factors and likelihood of 30-day readmission: A prospective cohort study. BMJ Qual Saf. 16 Nov 2017. Accessed Feb 2, 2018.

Hospitalists have focused much attention on reducing 30-day readmission rates, at a time when 15-20% of health care dollars spent on those readmissions is considered potentially preventable.

But until very recently, no study has explored patient perceptions of the likelihood of readmission during index admission. Now, that’s changed.

Reference

Carter J et al. The association between patient experience factors and likelihood of 30-day readmission: A prospective cohort study. BMJ Qual Saf. 16 Nov 2017. Accessed Feb 2, 2018.

Hospitalists have focused much attention on reducing 30-day readmission rates, at a time when 15-20% of health care dollars spent on those readmissions is considered potentially preventable.

But until very recently, no study has explored patient perceptions of the likelihood of readmission during index admission. Now, that’s changed.

Reference

Carter J et al. The association between patient experience factors and likelihood of 30-day readmission: A prospective cohort study. BMJ Qual Saf. 16 Nov 2017. Accessed Feb 2, 2018.

When hospital medicine and surgical departments (usually orthopedics or neurosurgery) have joined in comanagement programs, improvements in quality metrics and patient satisfaction have often resulted.

At the Level 1 regional trauma center in which he works, Charles L. Kast, MD, and his colleagues wanted to try a comanagement agreement between hospital medicine and trauma surgery.

“The surgical team identified a need within their own department, which was to improve patient mortality and satisfaction in the inpatient setting,” said Dr. Kast, who is based at North Shore University Hospital, Manhasset, N.Y. “Their leadership sought out our hospital medicine leadership team, who then worked together to synthesize their metrics. We were able to identify other quality indicators, such as readmission rates and hospital-acquired conditions, which we felt could also benefit from our services in order to help them improve.”

Five hospitalists became members of the comanagement team. A single hospitalist rotated for 2 weeks at a time, during which they were relieved of routine hospital medicine rounding responsibilities. The hospitalist attended daily interdisciplinary rounds with the trauma surgery team, during which he/she identified patients that could benefit from hospital medicine comanagement: Patients who were over age 65 years, had multiple chronic medical conditions, or were on high-risk medications were preferentially selected. Approximately 10 patients were seen daily.

The comanagement program was well received by trauma surgeons, who talked about improved patient communication and a fostered sense of collegiality. Preliminary quality and patient satisfaction metrics were also positive.

A top takeaway is that the benefits of surgical comanagement can be demonstrated in “atypical” collaborations, depending on the needs of the department and the hospital’s vision.

“The gains in improved patient quality metrics are only half of the story,” Dr. Kast said. “Collaborating in surgical comanagement improves the satisfaction of the hospitalists and surgeons involved and can lead to future quality improvement projects or original research, both of which we are currently pursuing.”
 

Reference

Kast C et al. The successful development of a hospital medicine-trauma surgery co-management program [abstract]. J Hosp Med. 2017;12(suppl 2). Accessed Feb. 2, 2018.

When hospital medicine and surgical departments (usually orthopedics or neurosurgery) have joined in comanagement programs, improvements in quality metrics and patient satisfaction have often resulted.

At the Level 1 regional trauma center in which he works, Charles L. Kast, MD, and his colleagues wanted to try a comanagement agreement between hospital medicine and trauma surgery.

“The surgical team identified a need within their own department, which was to improve patient mortality and satisfaction in the inpatient setting,” said Dr. Kast, who is based at North Shore University Hospital, Manhasset, N.Y. “Their leadership sought out our hospital medicine leadership team, who then worked together to synthesize their metrics. We were able to identify other quality indicators, such as readmission rates and hospital-acquired conditions, which we felt could also benefit from our services in order to help them improve.”

Five hospitalists became members of the comanagement team. A single hospitalist rotated for 2 weeks at a time, during which they were relieved of routine hospital medicine rounding responsibilities. The hospitalist attended daily interdisciplinary rounds with the trauma surgery team, during which he/she identified patients that could benefit from hospital medicine comanagement: Patients who were over age 65 years, had multiple chronic medical conditions, or were on high-risk medications were preferentially selected. Approximately 10 patients were seen daily.

The comanagement program was well received by trauma surgeons, who talked about improved patient communication and a fostered sense of collegiality. Preliminary quality and patient satisfaction metrics were also positive.

A top takeaway is that the benefits of surgical comanagement can be demonstrated in “atypical” collaborations, depending on the needs of the department and the hospital’s vision.

“The gains in improved patient quality metrics are only half of the story,” Dr. Kast said. “Collaborating in surgical comanagement improves the satisfaction of the hospitalists and surgeons involved and can lead to future quality improvement projects or original research, both of which we are currently pursuing.”
 

Reference

Kast C et al. The successful development of a hospital medicine-trauma surgery co-management program [abstract]. J Hosp Med. 2017;12(suppl 2). Accessed Feb. 2, 2018.

When hospital medicine and surgical departments (usually orthopedics or neurosurgery) have joined in comanagement programs, improvements in quality metrics and patient satisfaction have often resulted.

At the Level 1 regional trauma center in which he works, Charles L. Kast, MD, and his colleagues wanted to try a comanagement agreement between hospital medicine and trauma surgery.

“The surgical team identified a need within their own department, which was to improve patient mortality and satisfaction in the inpatient setting,” said Dr. Kast, who is based at North Shore University Hospital, Manhasset, N.Y. “Their leadership sought out our hospital medicine leadership team, who then worked together to synthesize their metrics. We were able to identify other quality indicators, such as readmission rates and hospital-acquired conditions, which we felt could also benefit from our services in order to help them improve.”

Five hospitalists became members of the comanagement team. A single hospitalist rotated for 2 weeks at a time, during which they were relieved of routine hospital medicine rounding responsibilities. The hospitalist attended daily interdisciplinary rounds with the trauma surgery team, during which he/she identified patients that could benefit from hospital medicine comanagement: Patients who were over age 65 years, had multiple chronic medical conditions, or were on high-risk medications were preferentially selected. Approximately 10 patients were seen daily.

The comanagement program was well received by trauma surgeons, who talked about improved patient communication and a fostered sense of collegiality. Preliminary quality and patient satisfaction metrics were also positive.

A top takeaway is that the benefits of surgical comanagement can be demonstrated in “atypical” collaborations, depending on the needs of the department and the hospital’s vision.

“The gains in improved patient quality metrics are only half of the story,” Dr. Kast said. “Collaborating in surgical comanagement improves the satisfaction of the hospitalists and surgeons involved and can lead to future quality improvement projects or original research, both of which we are currently pursuing.”
 

Reference

Kast C et al. The successful development of a hospital medicine-trauma surgery co-management program [abstract]. J Hosp Med. 2017;12(suppl 2). Accessed Feb. 2, 2018.

For hospitalists, burnout is a widespread and ongoing problem. In 2011, a Mayo Clinic study found that 45% of U.S. physicians had at least one symptom of professional burnout; by 2014, that number had risen to 54%.

shutteratakan/Thinkstock

“Burnout among physicians has been shown to be linked to quality of care, impacting medical errors, mortality ratios in hospitalized patients, and lower patient satisfaction,” said Ingrid T. Katz, MD, MHS, assistant professor of medicine at Harvard Medical School, Boston, and coauthor of a recent column on the subject published in the New England Journal of Medicine.

Widespread burnout is caused by systemic factors, not individual failures. “These systemic factors range from excessive clerical burden to ‘work beyond work,’ where people end up taking work home at night and are often found interfacing with the EHR well after their normal work day,” Dr. Katz said. “Many also express their disdain for the model of practice that no longer values autonomy, which was seen as inherent in the profession prior to the current model of care.”

Moving towards a better framework would require an inherent trust in physicians, limiting unnecessary intrusions into a physician’s practice that do not impact medical care. “It would remove the burden of excessive documentation and allow for physicians to get reinspired by the practice of medicine, an inherently altruistic profession,” Dr. Katz said.

Changes might include eliminating excessive clerical demands and improving EHRs to allow physicians to return to the bedside. Workloads would be geared towards quality in care and not focused on improving the bottom line of a health care system. One health system Dr. Katz wrote about instituted a team-based model; under this system medical assistants gather data and reconcile medications, allowing physicians to focus on performing physical exams and making medical decisions.

“Burnout will diminish when physicians are empowered to be part of the solution and hospital systems make changes that recognize the totality of the challenges that physicians face,” Dr. Katz said, adding that hospitalists are in a unique position to promote such changes on a systemic level. “Leadership needs to be willing to inform and engage their physicians, monitor well-being of physicians as closely as they monitor quality in care, and implement changes when needed.”

Reference

1. Katz IT et al. Beyond Burnout – Redesigning Care to Restore Meaning and Sanity for Physicians. N Engl J Med. 2018 Jan 25. doi: 10.1056/NEJMp1716845.

For hospitalists, burnout is a widespread and ongoing problem. In 2011, a Mayo Clinic study found that 45% of U.S. physicians had at least one symptom of professional burnout; by 2014, that number had risen to 54%.

shutteratakan/Thinkstock

“Burnout among physicians has been shown to be linked to quality of care, impacting medical errors, mortality ratios in hospitalized patients, and lower patient satisfaction,” said Ingrid T. Katz, MD, MHS, assistant professor of medicine at Harvard Medical School, Boston, and coauthor of a recent column on the subject published in the New England Journal of Medicine.

Widespread burnout is caused by systemic factors, not individual failures. “These systemic factors range from excessive clerical burden to ‘work beyond work,’ where people end up taking work home at night and are often found interfacing with the EHR well after their normal work day,” Dr. Katz said. “Many also express their disdain for the model of practice that no longer values autonomy, which was seen as inherent in the profession prior to the current model of care.”

Moving towards a better framework would require an inherent trust in physicians, limiting unnecessary intrusions into a physician’s practice that do not impact medical care. “It would remove the burden of excessive documentation and allow for physicians to get reinspired by the practice of medicine, an inherently altruistic profession,” Dr. Katz said.

Changes might include eliminating excessive clerical demands and improving EHRs to allow physicians to return to the bedside. Workloads would be geared towards quality in care and not focused on improving the bottom line of a health care system. One health system Dr. Katz wrote about instituted a team-based model; under this system medical assistants gather data and reconcile medications, allowing physicians to focus on performing physical exams and making medical decisions.

“Burnout will diminish when physicians are empowered to be part of the solution and hospital systems make changes that recognize the totality of the challenges that physicians face,” Dr. Katz said, adding that hospitalists are in a unique position to promote such changes on a systemic level. “Leadership needs to be willing to inform and engage their physicians, monitor well-being of physicians as closely as they monitor quality in care, and implement changes when needed.”

Reference

1. Katz IT et al. Beyond Burnout – Redesigning Care to Restore Meaning and Sanity for Physicians. N Engl J Med. 2018 Jan 25. doi: 10.1056/NEJMp1716845.

For hospitalists, burnout is a widespread and ongoing problem. In 2011, a Mayo Clinic study found that 45% of U.S. physicians had at least one symptom of professional burnout; by 2014, that number had risen to 54%.

shutteratakan/Thinkstock

“Burnout among physicians has been shown to be linked to quality of care, impacting medical errors, mortality ratios in hospitalized patients, and lower patient satisfaction,” said Ingrid T. Katz, MD, MHS, assistant professor of medicine at Harvard Medical School, Boston, and coauthor of a recent column on the subject published in the New England Journal of Medicine.

Widespread burnout is caused by systemic factors, not individual failures. “These systemic factors range from excessive clerical burden to ‘work beyond work,’ where people end up taking work home at night and are often found interfacing with the EHR well after their normal work day,” Dr. Katz said. “Many also express their disdain for the model of practice that no longer values autonomy, which was seen as inherent in the profession prior to the current model of care.”

Moving towards a better framework would require an inherent trust in physicians, limiting unnecessary intrusions into a physician’s practice that do not impact medical care. “It would remove the burden of excessive documentation and allow for physicians to get reinspired by the practice of medicine, an inherently altruistic profession,” Dr. Katz said.

Changes might include eliminating excessive clerical demands and improving EHRs to allow physicians to return to the bedside. Workloads would be geared towards quality in care and not focused on improving the bottom line of a health care system. One health system Dr. Katz wrote about instituted a team-based model; under this system medical assistants gather data and reconcile medications, allowing physicians to focus on performing physical exams and making medical decisions.

“Burnout will diminish when physicians are empowered to be part of the solution and hospital systems make changes that recognize the totality of the challenges that physicians face,” Dr. Katz said, adding that hospitalists are in a unique position to promote such changes on a systemic level. “Leadership needs to be willing to inform and engage their physicians, monitor well-being of physicians as closely as they monitor quality in care, and implement changes when needed.”

Reference

1. Katz IT et al. Beyond Burnout – Redesigning Care to Restore Meaning and Sanity for Physicians. N Engl J Med. 2018 Jan 25. doi: 10.1056/NEJMp1716845.

Hospitalists hearing the constant noise from cardiac telemetry monitoring systems can experience alarm fatigue – a nationwide phenomenon that can lead to an increase in patient deaths.

©Petr Vaclavek/Fotolia.com

The American Heart Association reports that fewer than one in four adults survived an in-hospital cardiac arrest in 2013; other studies showed that up to 44% of inpatient cardiac arrests were not detected appropriately, according to the Cleveland Clinic.

Clinicians at the Cleveland Clinic have tried centralized monitoring to address the problem. They’ve established a “mission control” center, where off-site personnel monitor sensors and high-definition cameras and vital signs such as blood pressure, heart rate, and respiration. On-site action is requested when appropriate; unimportant alarms are dismissed.

In August 2016, results from the first 13 months of the Cleveland Clinic program were published in JAMA. They revealed that the monitoring system could help reduce rates of unimportant alarms with no increase in cardiopulmonary arrest events. The centralized unit monitored 99,048 patient orders, and ultimately detected serious problems and accurately notified on-site staff for 79% of 3,243 events, which included a rhythm and/or rate change within 1 hour or less of the event. Accurate notification to on-site hospital staff was more than 84%.

Since then, improvements to the system have continued, according to Cleveland Clinic, and include doubling the number of monitored patients per technician and improved clinical outcomes.


 

Reference

Cleveland Clinic: Consult QD – An update on the centralized cardiac telemetry monitoring unit

Hospitalists hearing the constant noise from cardiac telemetry monitoring systems can experience alarm fatigue – a nationwide phenomenon that can lead to an increase in patient deaths.

©Petr Vaclavek/Fotolia.com

The American Heart Association reports that fewer than one in four adults survived an in-hospital cardiac arrest in 2013; other studies showed that up to 44% of inpatient cardiac arrests were not detected appropriately, according to the Cleveland Clinic.

Clinicians at the Cleveland Clinic have tried centralized monitoring to address the problem. They’ve established a “mission control” center, where off-site personnel monitor sensors and high-definition cameras and vital signs such as blood pressure, heart rate, and respiration. On-site action is requested when appropriate; unimportant alarms are dismissed.

In August 2016, results from the first 13 months of the Cleveland Clinic program were published in JAMA. They revealed that the monitoring system could help reduce rates of unimportant alarms with no increase in cardiopulmonary arrest events. The centralized unit monitored 99,048 patient orders, and ultimately detected serious problems and accurately notified on-site staff for 79% of 3,243 events, which included a rhythm and/or rate change within 1 hour or less of the event. Accurate notification to on-site hospital staff was more than 84%.

Since then, improvements to the system have continued, according to Cleveland Clinic, and include doubling the number of monitored patients per technician and improved clinical outcomes.


 

Reference

Cleveland Clinic: Consult QD – An update on the centralized cardiac telemetry monitoring unit

Hospitalists hearing the constant noise from cardiac telemetry monitoring systems can experience alarm fatigue – a nationwide phenomenon that can lead to an increase in patient deaths.

©Petr Vaclavek/Fotolia.com

The American Heart Association reports that fewer than one in four adults survived an in-hospital cardiac arrest in 2013; other studies showed that up to 44% of inpatient cardiac arrests were not detected appropriately, according to the Cleveland Clinic.

Clinicians at the Cleveland Clinic have tried centralized monitoring to address the problem. They’ve established a “mission control” center, where off-site personnel monitor sensors and high-definition cameras and vital signs such as blood pressure, heart rate, and respiration. On-site action is requested when appropriate; unimportant alarms are dismissed.

In August 2016, results from the first 13 months of the Cleveland Clinic program were published in JAMA. They revealed that the monitoring system could help reduce rates of unimportant alarms with no increase in cardiopulmonary arrest events. The centralized unit monitored 99,048 patient orders, and ultimately detected serious problems and accurately notified on-site staff for 79% of 3,243 events, which included a rhythm and/or rate change within 1 hour or less of the event. Accurate notification to on-site hospital staff was more than 84%.

Since then, improvements to the system have continued, according to Cleveland Clinic, and include doubling the number of monitored patients per technician and improved clinical outcomes.


 

Reference

Cleveland Clinic: Consult QD – An update on the centralized cardiac telemetry monitoring unit

Hospitalists are key players in improving hospital performance, but they may be overlooking a leading cause of morbidity and mortality, especially among older adults.

Research suggests that at the time of hospital admission, some 20%-50% of all patients are at risk for malnutrition or are malnourished, but only 7% of those patients are diagnosed during their stay, according to research cited in an abstract presented at HM17.¹

“Because individuals who are malnourished lack sufficient nutrients to promote healing and rehabilitation, and are at increased risk of medical complications, it can have a serious impact on patient safety indicators, such as rates of pressure ulcers, wound healing, and risk of falls,” said lead author Eleanor Fitall of Avalere Health. “Early identification and subsequent treatment of these patients is the best way to prevent this risk.”

To address the issue, Avalere Health and the Academy of Nutrition and Dietetics established the Malnutrition Quality Improvement Initiative (MQii), a multi-stakeholder effort to identify tools to support hospital-based care teams in improving malnutrition care quality. They developed a malnutrition Toolkit, which was piloted in 2016 and was shown to effectively improve malnutrition care.

“Since the poster presentation in May, we have successfully implemented the Toolkit at 50 hospitals via a multi-hospital Learning Collaborative,” Ms. Fitall said. They are now recruiting hospitals and health systems to participate in an expanded Learning Collaborative. Interested sites should contact the MQii team at [email protected].

“By supporting efforts to improve malnutrition care in the inpatient setting, hospitalists can help reduce the incidence of these problems as well as decrease rates of readmissions and reduce patient lengths of stay,” Ms. Fitall said. “Hospitalists are critical to addressing malnutrition care gaps in the hospital. Dietitians that have undertaken malnutrition quality improvement projects using the MQii Toolkit have found that they are most successful when hospitalists are actively engaged in the team, particularly when looking to improve the rate of malnutrition diagnosis. Hospitalists are ideally positioned to champion these efforts.”

Support for MQii was provided by Abbott, she said.
 

Reference

1. Fitall E, Bruno M, Jones K, Lynch J, Silver H, Godamunne K, Valladares A, Mitchell K. Malnutrition Care: “Low Hanging Fruit” for Hospitalist Clinical Performance Improvement [abstract]. J Hosp Med. 2017;12(suppl 2).

Hospitalists are key players in improving hospital performance, but they may be overlooking a leading cause of morbidity and mortality, especially among older adults.

Research suggests that at the time of hospital admission, some 20%-50% of all patients are at risk for malnutrition or are malnourished, but only 7% of those patients are diagnosed during their stay, according to research cited in an abstract presented at HM17.¹

“Because individuals who are malnourished lack sufficient nutrients to promote healing and rehabilitation, and are at increased risk of medical complications, it can have a serious impact on patient safety indicators, such as rates of pressure ulcers, wound healing, and risk of falls,” said lead author Eleanor Fitall of Avalere Health. “Early identification and subsequent treatment of these patients is the best way to prevent this risk.”

To address the issue, Avalere Health and the Academy of Nutrition and Dietetics established the Malnutrition Quality Improvement Initiative (MQii), a multi-stakeholder effort to identify tools to support hospital-based care teams in improving malnutrition care quality. They developed a malnutrition Toolkit, which was piloted in 2016 and was shown to effectively improve malnutrition care.

“Since the poster presentation in May, we have successfully implemented the Toolkit at 50 hospitals via a multi-hospital Learning Collaborative,” Ms. Fitall said. They are now recruiting hospitals and health systems to participate in an expanded Learning Collaborative. Interested sites should contact the MQii team at [email protected].

“By supporting efforts to improve malnutrition care in the inpatient setting, hospitalists can help reduce the incidence of these problems as well as decrease rates of readmissions and reduce patient lengths of stay,” Ms. Fitall said. “Hospitalists are critical to addressing malnutrition care gaps in the hospital. Dietitians that have undertaken malnutrition quality improvement projects using the MQii Toolkit have found that they are most successful when hospitalists are actively engaged in the team, particularly when looking to improve the rate of malnutrition diagnosis. Hospitalists are ideally positioned to champion these efforts.”

Support for MQii was provided by Abbott, she said.
 

Reference

1. Fitall E, Bruno M, Jones K, Lynch J, Silver H, Godamunne K, Valladares A, Mitchell K. Malnutrition Care: “Low Hanging Fruit” for Hospitalist Clinical Performance Improvement [abstract]. J Hosp Med. 2017;12(suppl 2).

Hospitalists are key players in improving hospital performance, but they may be overlooking a leading cause of morbidity and mortality, especially among older adults.

Research suggests that at the time of hospital admission, some 20%-50% of all patients are at risk for malnutrition or are malnourished, but only 7% of those patients are diagnosed during their stay, according to research cited in an abstract presented at HM17.¹

“Because individuals who are malnourished lack sufficient nutrients to promote healing and rehabilitation, and are at increased risk of medical complications, it can have a serious impact on patient safety indicators, such as rates of pressure ulcers, wound healing, and risk of falls,” said lead author Eleanor Fitall of Avalere Health. “Early identification and subsequent treatment of these patients is the best way to prevent this risk.”

To address the issue, Avalere Health and the Academy of Nutrition and Dietetics established the Malnutrition Quality Improvement Initiative (MQii), a multi-stakeholder effort to identify tools to support hospital-based care teams in improving malnutrition care quality. They developed a malnutrition Toolkit, which was piloted in 2016 and was shown to effectively improve malnutrition care.

“Since the poster presentation in May, we have successfully implemented the Toolkit at 50 hospitals via a multi-hospital Learning Collaborative,” Ms. Fitall said. They are now recruiting hospitals and health systems to participate in an expanded Learning Collaborative. Interested sites should contact the MQii team at [email protected].

“By supporting efforts to improve malnutrition care in the inpatient setting, hospitalists can help reduce the incidence of these problems as well as decrease rates of readmissions and reduce patient lengths of stay,” Ms. Fitall said. “Hospitalists are critical to addressing malnutrition care gaps in the hospital. Dietitians that have undertaken malnutrition quality improvement projects using the MQii Toolkit have found that they are most successful when hospitalists are actively engaged in the team, particularly when looking to improve the rate of malnutrition diagnosis. Hospitalists are ideally positioned to champion these efforts.”

Support for MQii was provided by Abbott, she said.
 

Reference

1. Fitall E, Bruno M, Jones K, Lynch J, Silver H, Godamunne K, Valladares A, Mitchell K. Malnutrition Care: “Low Hanging Fruit” for Hospitalist Clinical Performance Improvement [abstract]. J Hosp Med. 2017;12(suppl 2).

There are recent advances in preexposure prophylaxis, or PrEP, as a promising prevention option for HIV, according to a recent study.¹

grandeduc/Thinkstock

Reference

1. Desai M, Field N, Grant R, McCormack S. “Recent advances in pre-exposure prophylaxis for HIV.” BMJ. 2017;359:j5011.

There are recent advances in preexposure prophylaxis, or PrEP, as a promising prevention option for HIV, according to a recent study.¹

grandeduc/Thinkstock

Reference

1. Desai M, Field N, Grant R, McCormack S. “Recent advances in pre-exposure prophylaxis for HIV.” BMJ. 2017;359:j5011.

There are recent advances in preexposure prophylaxis, or PrEP, as a promising prevention option for HIV, according to a recent study.¹

grandeduc/Thinkstock

Reference

1. Desai M, Field N, Grant R, McCormack S. “Recent advances in pre-exposure prophylaxis for HIV.” BMJ. 2017;359:j5011.

Hospitalists and other physicians have long struggled with medication noncompliance, which can lead to sicker patients and higher rates of readmittance, and costs some $100-$289 billion a year.

There is a growing field of digital devices being developed to address this problem. The Food and Drug Administration has just approved the newest one: a medication with a sensor embedded that can tell doctors if, and when, patients take their medicine, according to an article in the New York Times.¹ It’s expected to become available in 2018.

Reference

1. Belluck P. “First Digital Pill Approved to Worries About Biomedical ‘Big Brother.’ ” New York Times. Nov 13, 2017.

Hospitalists and other physicians have long struggled with medication noncompliance, which can lead to sicker patients and higher rates of readmittance, and costs some $100-$289 billion a year.

There is a growing field of digital devices being developed to address this problem. The Food and Drug Administration has just approved the newest one: a medication with a sensor embedded that can tell doctors if, and when, patients take their medicine, according to an article in the New York Times.¹ It’s expected to become available in 2018.

Reference

1. Belluck P. “First Digital Pill Approved to Worries About Biomedical ‘Big Brother.’ ” New York Times. Nov 13, 2017.

Hospitalists and other physicians have long struggled with medication noncompliance, which can lead to sicker patients and higher rates of readmittance, and costs some $100-$289 billion a year.

There is a growing field of digital devices being developed to address this problem. The Food and Drug Administration has just approved the newest one: a medication with a sensor embedded that can tell doctors if, and when, patients take their medicine, according to an article in the New York Times.¹ It’s expected to become available in 2018.

Reference

1. Belluck P. “First Digital Pill Approved to Worries About Biomedical ‘Big Brother.’ ” New York Times. Nov 13, 2017.

Hospitalists regularly treat patients with limited health literacy, and in many cases, the hospitalist may not even be aware of it. “Patients are unlikely to know or, more importantly, disclose their limited health literacy status,” according to a recent study.¹ But hospitalists certainly see its effects: Limited health literacy often results in poor outcomes and high rates of readmittance.

“We know patients with limited health literacy are common and that they have poor health outcomes,” said study coauthor Robert Leverence, MD. “We also know there are ways to mitigate those outcomes. For that reason, we believe screening is important. In our study, we showed such routine screening is feasible in a large teaching hospital.”

The study describes the implementation of a hospital-wide routine health literacy assessment at an academic medical center initiated by nurses and applied to all adult inpatients. “We incorporated the health literacy screen and care plan into our electronic health record,” the authors wrote. “When a patient screens positive for limited health literacy, two automated responses are triggered: a one-time alert on chart entry for all users ... and a nursing care plan containing relevant educational recommendations.”

“To me it is a cringe-worthy event to give a 10-page AVS to a patient who can’t read,” Dr. Leverence added. “Health literacy screening allows us to tailor the discharge process to meet the needs of the individual patient. Once these patients are identified, then appropriate efforts can be efficiently deployed.”

Those efforts might include, at discharge, offering easy-to-read materials and teach-back, and having a caregiver in the room and a pharmacist performing bedside medication education.
 

Reference

1. Warring C, Pinkney J, Delvo-Favre E, et al. “Implementation of a Routine Health Literacy Assessment at an Academic Medical Center.” J Healthc Qual. doi: 10.1097/JHQ.0000000000000116

Hospitalists regularly treat patients with limited health literacy, and in many cases, the hospitalist may not even be aware of it. “Patients are unlikely to know or, more importantly, disclose their limited health literacy status,” according to a recent study.¹ But hospitalists certainly see its effects: Limited health literacy often results in poor outcomes and high rates of readmittance.

“We know patients with limited health literacy are common and that they have poor health outcomes,” said study coauthor Robert Leverence, MD. “We also know there are ways to mitigate those outcomes. For that reason, we believe screening is important. In our study, we showed such routine screening is feasible in a large teaching hospital.”

The study describes the implementation of a hospital-wide routine health literacy assessment at an academic medical center initiated by nurses and applied to all adult inpatients. “We incorporated the health literacy screen and care plan into our electronic health record,” the authors wrote. “When a patient screens positive for limited health literacy, two automated responses are triggered: a one-time alert on chart entry for all users ... and a nursing care plan containing relevant educational recommendations.”

“To me it is a cringe-worthy event to give a 10-page AVS to a patient who can’t read,” Dr. Leverence added. “Health literacy screening allows us to tailor the discharge process to meet the needs of the individual patient. Once these patients are identified, then appropriate efforts can be efficiently deployed.”

Those efforts might include, at discharge, offering easy-to-read materials and teach-back, and having a caregiver in the room and a pharmacist performing bedside medication education.
 

Reference

1. Warring C, Pinkney J, Delvo-Favre E, et al. “Implementation of a Routine Health Literacy Assessment at an Academic Medical Center.” J Healthc Qual. doi: 10.1097/JHQ.0000000000000116

Hospitalists regularly treat patients with limited health literacy, and in many cases, the hospitalist may not even be aware of it. “Patients are unlikely to know or, more importantly, disclose their limited health literacy status,” according to a recent study.¹ But hospitalists certainly see its effects: Limited health literacy often results in poor outcomes and high rates of readmittance.

“We know patients with limited health literacy are common and that they have poor health outcomes,” said study coauthor Robert Leverence, MD. “We also know there are ways to mitigate those outcomes. For that reason, we believe screening is important. In our study, we showed such routine screening is feasible in a large teaching hospital.”

The study describes the implementation of a hospital-wide routine health literacy assessment at an academic medical center initiated by nurses and applied to all adult inpatients. “We incorporated the health literacy screen and care plan into our electronic health record,” the authors wrote. “When a patient screens positive for limited health literacy, two automated responses are triggered: a one-time alert on chart entry for all users ... and a nursing care plan containing relevant educational recommendations.”

“To me it is a cringe-worthy event to give a 10-page AVS to a patient who can’t read,” Dr. Leverence added. “Health literacy screening allows us to tailor the discharge process to meet the needs of the individual patient. Once these patients are identified, then appropriate efforts can be efficiently deployed.”

Those efforts might include, at discharge, offering easy-to-read materials and teach-back, and having a caregiver in the room and a pharmacist performing bedside medication education.
 

Reference

1. Warring C, Pinkney J, Delvo-Favre E, et al. “Implementation of a Routine Health Literacy Assessment at an Academic Medical Center.” J Healthc Qual. doi: 10.1097/JHQ.0000000000000116