When patients are hospitalized more than once in the same month, it may have more to do with their income or education levels than the quality of care they received, a U.S. study suggests.

Perhaps unsurprisingly, patients 85 and older are more likely to return to the hospital within 30 days of being sent home than people a decade or two younger, according to the analysis of data from Medicare, the U.S. health program for the elderly and disabled.

But patients also have higher odds of returning soon after discharge if they lack a high school diploma, have limited income and assets or have health benefits from Medicaid, the U.S. health program for the poor.

The findings suggest that Medicare penalties for what's known as readmissions under the Affordable Care Act may in some instances mete out punishment for outcomes that are beyond doctors' control, said lead study author Dr. Michael Barnett and senior author Dr. Michael McWilliams, colleagues at Harvard Medical School and Brigham and Women's Hospital in Boston.

"Hospitals are being penalized to a large extent based on the patients they serve," the doctors said by email. "Patients admitted to hospitals with higher readmission rates are sicker and more socially disadvantaged in a variety of ways than patients admitted to hospitals with lower readmission rates."

Under the current penalty system, Medicare deducts 3 percent from inpatient payments to hospitals with higher than expected readmission rates, the researchers report in JAMA Internal Medicine. Expected rates are only adjusted for patients' age, sex and recent diagnoses including the one from their hospital stay.

In 2014, the second year of the program, about 2,600 hospitals were fined a combined $428 million for excessive readmissions, the authors report.

To get a better understanding of how individual patient characteristics might influence repeat hospitalizations, the researchers examined several other variables Medicare doesn't consider in determining expected readmission rates - such as education and income levels, marital status, employment, race and ethnicity, smoking status and drinking habits.

They linked records from a nationwide health and retirement survey of Americans over 50 collected between 2000 and 2010 to data from Medicare claims from 2000 to 2012. The combined analysis assessed more than 8,000 hospital admissions.

The researchers sorted hospitals into quintiles based on readmission rates. They found that at least half of the observed difference in the probability of repeat hospitalizations between hospitals with the highest and lowest readmission rates might be accounted for by patient characteristics not currently considered by Medicare.

When researchers only used Medicare's criteria comparing readmission rates, they found the probability of repeat hospitalization was about 15 percent at facilities with the lowest rates and about 19.5 percent at hospitals with the highest rates.

But when they took another look using more criteria on patients' medical, social and economic characteristics, the gap between hospitals with the lowest and the highest readmission rates narrowed to 16 percent and 18.4 percent, respectively, odds of repeat hospitalization.

One limitation of the study, the authors acknowledge, is the data didn't allow them to calculate how considering individual patient characteristics might impact readmission rates at specific hospitals.

Even so, the findings suggest that the current Medicare penalty system for repeat hospitalizations may put facilities serving poor communities at a distinct financial disadvantage, Dr. Carl van Walraven, a senior scientist at the Ottawa Hospital Research Institute in Canada, noted in an accompanying editorial.

"Differences between hospitals in readmissions may be due to who is treated rather than how they're treated," van Walraven said by email.

When patients are hospitalized more than once in the same month, it may have more to do with their income or education levels than the quality of care they received, a U.S. study suggests.

Perhaps unsurprisingly, patients 85 and older are more likely to return to the hospital within 30 days of being sent home than people a decade or two younger, according to the analysis of data from Medicare, the U.S. health program for the elderly and disabled.

But patients also have higher odds of returning soon after discharge if they lack a high school diploma, have limited income and assets or have health benefits from Medicaid, the U.S. health program for the poor.

The findings suggest that Medicare penalties for what's known as readmissions under the Affordable Care Act may in some instances mete out punishment for outcomes that are beyond doctors' control, said lead study author Dr. Michael Barnett and senior author Dr. Michael McWilliams, colleagues at Harvard Medical School and Brigham and Women's Hospital in Boston.

"Hospitals are being penalized to a large extent based on the patients they serve," the doctors said by email. "Patients admitted to hospitals with higher readmission rates are sicker and more socially disadvantaged in a variety of ways than patients admitted to hospitals with lower readmission rates."

Under the current penalty system, Medicare deducts 3 percent from inpatient payments to hospitals with higher than expected readmission rates, the researchers report in JAMA Internal Medicine. Expected rates are only adjusted for patients' age, sex and recent diagnoses including the one from their hospital stay.

In 2014, the second year of the program, about 2,600 hospitals were fined a combined $428 million for excessive readmissions, the authors report.

To get a better understanding of how individual patient characteristics might influence repeat hospitalizations, the researchers examined several other variables Medicare doesn't consider in determining expected readmission rates - such as education and income levels, marital status, employment, race and ethnicity, smoking status and drinking habits.

They linked records from a nationwide health and retirement survey of Americans over 50 collected between 2000 and 2010 to data from Medicare claims from 2000 to 2012. The combined analysis assessed more than 8,000 hospital admissions.

The researchers sorted hospitals into quintiles based on readmission rates. They found that at least half of the observed difference in the probability of repeat hospitalizations between hospitals with the highest and lowest readmission rates might be accounted for by patient characteristics not currently considered by Medicare.

When researchers only used Medicare's criteria comparing readmission rates, they found the probability of repeat hospitalization was about 15 percent at facilities with the lowest rates and about 19.5 percent at hospitals with the highest rates.

But when they took another look using more criteria on patients' medical, social and economic characteristics, the gap between hospitals with the lowest and the highest readmission rates narrowed to 16 percent and 18.4 percent, respectively, odds of repeat hospitalization.

One limitation of the study, the authors acknowledge, is the data didn't allow them to calculate how considering individual patient characteristics might impact readmission rates at specific hospitals.

Even so, the findings suggest that the current Medicare penalty system for repeat hospitalizations may put facilities serving poor communities at a distinct financial disadvantage, Dr. Carl van Walraven, a senior scientist at the Ottawa Hospital Research Institute in Canada, noted in an accompanying editorial.

"Differences between hospitals in readmissions may be due to who is treated rather than how they're treated," van Walraven said by email.

When patients are hospitalized more than once in the same month, it may have more to do with their income or education levels than the quality of care they received, a U.S. study suggests.

Perhaps unsurprisingly, patients 85 and older are more likely to return to the hospital within 30 days of being sent home than people a decade or two younger, according to the analysis of data from Medicare, the U.S. health program for the elderly and disabled.

But patients also have higher odds of returning soon after discharge if they lack a high school diploma, have limited income and assets or have health benefits from Medicaid, the U.S. health program for the poor.

The findings suggest that Medicare penalties for what's known as readmissions under the Affordable Care Act may in some instances mete out punishment for outcomes that are beyond doctors' control, said lead study author Dr. Michael Barnett and senior author Dr. Michael McWilliams, colleagues at Harvard Medical School and Brigham and Women's Hospital in Boston.

"Hospitals are being penalized to a large extent based on the patients they serve," the doctors said by email. "Patients admitted to hospitals with higher readmission rates are sicker and more socially disadvantaged in a variety of ways than patients admitted to hospitals with lower readmission rates."

Under the current penalty system, Medicare deducts 3 percent from inpatient payments to hospitals with higher than expected readmission rates, the researchers report in JAMA Internal Medicine. Expected rates are only adjusted for patients' age, sex and recent diagnoses including the one from their hospital stay.

In 2014, the second year of the program, about 2,600 hospitals were fined a combined $428 million for excessive readmissions, the authors report.

To get a better understanding of how individual patient characteristics might influence repeat hospitalizations, the researchers examined several other variables Medicare doesn't consider in determining expected readmission rates - such as education and income levels, marital status, employment, race and ethnicity, smoking status and drinking habits.

They linked records from a nationwide health and retirement survey of Americans over 50 collected between 2000 and 2010 to data from Medicare claims from 2000 to 2012. The combined analysis assessed more than 8,000 hospital admissions.

The researchers sorted hospitals into quintiles based on readmission rates. They found that at least half of the observed difference in the probability of repeat hospitalizations between hospitals with the highest and lowest readmission rates might be accounted for by patient characteristics not currently considered by Medicare.

When researchers only used Medicare's criteria comparing readmission rates, they found the probability of repeat hospitalization was about 15 percent at facilities with the lowest rates and about 19.5 percent at hospitals with the highest rates.

But when they took another look using more criteria on patients' medical, social and economic characteristics, the gap between hospitals with the lowest and the highest readmission rates narrowed to 16 percent and 18.4 percent, respectively, odds of repeat hospitalization.

One limitation of the study, the authors acknowledge, is the data didn't allow them to calculate how considering individual patient characteristics might impact readmission rates at specific hospitals.

Even so, the findings suggest that the current Medicare penalty system for repeat hospitalizations may put facilities serving poor communities at a distinct financial disadvantage, Dr. Carl van Walraven, a senior scientist at the Ottawa Hospital Research Institute in Canada, noted in an accompanying editorial.

"Differences between hospitals in readmissions may be due to who is treated rather than how they're treated," van Walraven said by email.

At the end of residency, like many of us, I was offered an impressive number of jobs as both a hospitalist and an outpatient internist. I observed my colleagues signing contracts and going through the credentialing process and thought to myself that finding a job that would dictate what hours I worked was the last thing I wanted to do.

So I quit medicine.

I ended up working with a few NGOs (nongovernmental organizations) at the time, becoming the healthcare director of a medium-sized NGO. I learned the enormous amount of red tape that was scattered in that world, and I began missing medicine.

So I unquit medicine.

I decided that the best thing for me was to be my own boss. I didn’t know how to do this. As someone with absolutely no business background, I started reading about different types of work I could do where I was in charge of dictating my hours. Opening up a clinic or starting my own hospitalist group felt like being shackled down in the system again. I talked to my colleagues from residency, and they all seemed underwhelmed with the love of their jobs and overwhelmed by the number of hours that they were working. They still sounded like residents.

After getting a taste of a world outside of medicine, I realized that I had so many hobbies and interests outside of practicing as a hospitalist. I found a love of surfing, I wanted to volunteer and do medical relief work abroad, I wanted to travel the world, and I wanted to study herbal medicine and integrative holistic medicine in great depth—all while being able to keep one foot in the medical system.

That is when I found locum tenens hospitalist-based medicine. Suddenly, I could make my own schedule, decide where and when I would work, and have the flexibility to leave any given hospital if I felt as though I was being pushed into practices that would compromise patient care and safety.

It’s been four years since I began practicing locum tenens hospitalist medicine, and I have never looked back. I have been able to take up surfing more seriously; I’ve traveled around the world and continue to do so—I have been able to travel to Haiti for volunteer work and am traveling to Nepal shortly for medical relief work—and I have been able to dive deeply into integrative holistic medicine. I get to pick and choose how often I work and, most importantly, when I do work, it is an absolute joy. I can happily say I am able to give my patients the care that they deserve without feeling burnt out.

I am a big fan of the way I have decided to practice the art of medicine and can honestly say that I am enjoying my journey.

---

Geeta Arora, MD, board certified in internal medicine and integrative holistic medicine

At the end of residency, like many of us, I was offered an impressive number of jobs as both a hospitalist and an outpatient internist. I observed my colleagues signing contracts and going through the credentialing process and thought to myself that finding a job that would dictate what hours I worked was the last thing I wanted to do.

So I quit medicine.

I ended up working with a few NGOs (nongovernmental organizations) at the time, becoming the healthcare director of a medium-sized NGO. I learned the enormous amount of red tape that was scattered in that world, and I began missing medicine.

So I unquit medicine.

I decided that the best thing for me was to be my own boss. I didn’t know how to do this. As someone with absolutely no business background, I started reading about different types of work I could do where I was in charge of dictating my hours. Opening up a clinic or starting my own hospitalist group felt like being shackled down in the system again. I talked to my colleagues from residency, and they all seemed underwhelmed with the love of their jobs and overwhelmed by the number of hours that they were working. They still sounded like residents.

After getting a taste of a world outside of medicine, I realized that I had so many hobbies and interests outside of practicing as a hospitalist. I found a love of surfing, I wanted to volunteer and do medical relief work abroad, I wanted to travel the world, and I wanted to study herbal medicine and integrative holistic medicine in great depth—all while being able to keep one foot in the medical system.

That is when I found locum tenens hospitalist-based medicine. Suddenly, I could make my own schedule, decide where and when I would work, and have the flexibility to leave any given hospital if I felt as though I was being pushed into practices that would compromise patient care and safety.

It’s been four years since I began practicing locum tenens hospitalist medicine, and I have never looked back. I have been able to take up surfing more seriously; I’ve traveled around the world and continue to do so—I have been able to travel to Haiti for volunteer work and am traveling to Nepal shortly for medical relief work—and I have been able to dive deeply into integrative holistic medicine. I get to pick and choose how often I work and, most importantly, when I do work, it is an absolute joy. I can happily say I am able to give my patients the care that they deserve without feeling burnt out.

I am a big fan of the way I have decided to practice the art of medicine and can honestly say that I am enjoying my journey.

---

Geeta Arora, MD, board certified in internal medicine and integrative holistic medicine

At the end of residency, like many of us, I was offered an impressive number of jobs as both a hospitalist and an outpatient internist. I observed my colleagues signing contracts and going through the credentialing process and thought to myself that finding a job that would dictate what hours I worked was the last thing I wanted to do.

So I quit medicine.

I ended up working with a few NGOs (nongovernmental organizations) at the time, becoming the healthcare director of a medium-sized NGO. I learned the enormous amount of red tape that was scattered in that world, and I began missing medicine.

So I unquit medicine.

I decided that the best thing for me was to be my own boss. I didn’t know how to do this. As someone with absolutely no business background, I started reading about different types of work I could do where I was in charge of dictating my hours. Opening up a clinic or starting my own hospitalist group felt like being shackled down in the system again. I talked to my colleagues from residency, and they all seemed underwhelmed with the love of their jobs and overwhelmed by the number of hours that they were working. They still sounded like residents.

After getting a taste of a world outside of medicine, I realized that I had so many hobbies and interests outside of practicing as a hospitalist. I found a love of surfing, I wanted to volunteer and do medical relief work abroad, I wanted to travel the world, and I wanted to study herbal medicine and integrative holistic medicine in great depth—all while being able to keep one foot in the medical system.

That is when I found locum tenens hospitalist-based medicine. Suddenly, I could make my own schedule, decide where and when I would work, and have the flexibility to leave any given hospital if I felt as though I was being pushed into practices that would compromise patient care and safety.

It’s been four years since I began practicing locum tenens hospitalist medicine, and I have never looked back. I have been able to take up surfing more seriously; I’ve traveled around the world and continue to do so—I have been able to travel to Haiti for volunteer work and am traveling to Nepal shortly for medical relief work—and I have been able to dive deeply into integrative holistic medicine. I get to pick and choose how often I work and, most importantly, when I do work, it is an absolute joy. I can happily say I am able to give my patients the care that they deserve without feeling burnt out.

I am a big fan of the way I have decided to practice the art of medicine and can honestly say that I am enjoying my journey.

---

Geeta Arora, MD, board certified in internal medicine and integrative holistic medicine

SHM’s website offers a wealth of downloadable guides and toolkits, authored by the national experts on topics like:

• End-of-life care;
• Opioid monitoring;
• Antibiotic resistance;
• Post-acute care;
• VTE;
• Pain management; and
• Coronary heart disease (CHD).

SHM’s website offers a wealth of downloadable guides and toolkits, authored by the national experts on topics like:

• End-of-life care;
• Opioid monitoring;
• Antibiotic resistance;
• Post-acute care;
• VTE;
• Pain management; and
• Coronary heart disease (CHD).

SHM’s website offers a wealth of downloadable guides and toolkits, authored by the national experts on topics like:

• End-of-life care;
• Opioid monitoring;
• Antibiotic resistance;
• Post-acute care;
• VTE;
• Pain management; and
• Coronary heart disease (CHD).

Starting QI programs in your hospital doesn’t just make the hospital better; it strengthens the health of your communities and advances the professional development of all of the hospitalists around you.

And it’s now easier than ever to get started, right from your computer.

Online Webinars

Coaching a Quality Improvement Team: Basics for Being Sure Any QI team and Project Are on the Right Track

Presenter: Jordan Messler, MD, SFHM

Date: October 28, 2015

Time: 1:00 p.m. EDT

---

Elevating Provider Experience to Improve Patient Experience

Presenter: Mark Rudolph, MD

Date: November 11, 2015

Time: 2:00 p.m. EDT

Starting QI programs in your hospital doesn’t just make the hospital better; it strengthens the health of your communities and advances the professional development of all of the hospitalists around you.

And it’s now easier than ever to get started, right from your computer.

Online Webinars

Coaching a Quality Improvement Team: Basics for Being Sure Any QI team and Project Are on the Right Track

Presenter: Jordan Messler, MD, SFHM

Date: October 28, 2015

Time: 1:00 p.m. EDT

---

Elevating Provider Experience to Improve Patient Experience

Presenter: Mark Rudolph, MD

Date: November 11, 2015

Time: 2:00 p.m. EDT

Starting QI programs in your hospital doesn’t just make the hospital better; it strengthens the health of your communities and advances the professional development of all of the hospitalists around you.

And it’s now easier than ever to get started, right from your computer.

Online Webinars

Coaching a Quality Improvement Team: Basics for Being Sure Any QI team and Project Are on the Right Track

Presenter: Jordan Messler, MD, SFHM

Date: October 28, 2015

Time: 1:00 p.m. EDT

---

Elevating Provider Experience to Improve Patient Experience

Presenter: Mark Rudolph, MD

Date: November 11, 2015

Time: 2:00 p.m. EDT

Plan your schedule today to attend HM16 in San Diego, March 6-9, 2016.

Hospital Medicine 2016 has been updated to meet the educational needs of hospitalists of all stripes, with new sessions and pre-courses, as well as entirely new tracks on the most cutting-edge topics in the movement.

New tracks planned: post-acute care, health IT for hospitalists, co-management/peri-operative medicine.

Recurring tracks: rapid fire, clinical, young hospitalists, practice management, academic/research, quality, pediatric, potpourri, the doctor-patient relationship.

For an updated list of pre-courses and other sessions, visit Hospital Medicine 2016. Register by Jan. 11, 2016, to save $50.

Plan your schedule today to attend HM16 in San Diego, March 6-9, 2016.

Hospital Medicine 2016 has been updated to meet the educational needs of hospitalists of all stripes, with new sessions and pre-courses, as well as entirely new tracks on the most cutting-edge topics in the movement.

New tracks planned: post-acute care, health IT for hospitalists, co-management/peri-operative medicine.

Recurring tracks: rapid fire, clinical, young hospitalists, practice management, academic/research, quality, pediatric, potpourri, the doctor-patient relationship.

For an updated list of pre-courses and other sessions, visit Hospital Medicine 2016. Register by Jan. 11, 2016, to save $50.

Plan your schedule today to attend HM16 in San Diego, March 6-9, 2016.

Hospital Medicine 2016 has been updated to meet the educational needs of hospitalists of all stripes, with new sessions and pre-courses, as well as entirely new tracks on the most cutting-edge topics in the movement.

New tracks planned: post-acute care, health IT for hospitalists, co-management/peri-operative medicine.

Recurring tracks: rapid fire, clinical, young hospitalists, practice management, academic/research, quality, pediatric, potpourri, the doctor-patient relationship.

For an updated list of pre-courses and other sessions, visit Hospital Medicine 2016. Register by Jan. 11, 2016, to save $50.

You are one of the best representatives of the hospital medicine movement. You can share your enthusiasm for the specialty and for improving the care of hospitalized patients by telling others about SHM.

And, as an added bonus, you can earn credit toward SHM membership dues.

Through the end of the year, all active SHM members can earn 2016-2017 dues credits and special recognition for recruiting new physician, physician assistant, nurse practitioner, pharmacist, or affiliate members.

Active members will be eligible for:

• A $35 credit toward 2016-2017 dues when recruiting one new member;
• A $50 credit toward 2016-2017 dues when recruiting 2-4 new members;
• A $75 credit toward 2016-2017 dues when recruiting 5-9 new members; or
• A $125 credit toward 2016-2017 dues when recruiting 10+ new members.

For every member recruited, individuals will receive one entry into a grand prize drawing to receive complimentary registration to HM16 in San Diego.

Click here for more details.

You are one of the best representatives of the hospital medicine movement. You can share your enthusiasm for the specialty and for improving the care of hospitalized patients by telling others about SHM.

And, as an added bonus, you can earn credit toward SHM membership dues.

Through the end of the year, all active SHM members can earn 2016-2017 dues credits and special recognition for recruiting new physician, physician assistant, nurse practitioner, pharmacist, or affiliate members.

Active members will be eligible for:

• A $35 credit toward 2016-2017 dues when recruiting one new member;
• A $50 credit toward 2016-2017 dues when recruiting 2-4 new members;
• A $75 credit toward 2016-2017 dues when recruiting 5-9 new members; or
• A $125 credit toward 2016-2017 dues when recruiting 10+ new members.

For every member recruited, individuals will receive one entry into a grand prize drawing to receive complimentary registration to HM16 in San Diego.

Click here for more details.

You are one of the best representatives of the hospital medicine movement. You can share your enthusiasm for the specialty and for improving the care of hospitalized patients by telling others about SHM.

And, as an added bonus, you can earn credit toward SHM membership dues.

Through the end of the year, all active SHM members can earn 2016-2017 dues credits and special recognition for recruiting new physician, physician assistant, nurse practitioner, pharmacist, or affiliate members.

Active members will be eligible for:

• A $35 credit toward 2016-2017 dues when recruiting one new member;
• A $50 credit toward 2016-2017 dues when recruiting 2-4 new members;
• A $75 credit toward 2016-2017 dues when recruiting 5-9 new members; or
• A $125 credit toward 2016-2017 dues when recruiting 10+ new members.

For every member recruited, individuals will receive one entry into a grand prize drawing to receive complimentary registration to HM16 in San Diego.

Click here for more details.

Are you ready to shape the future of the hospital medicine movement? Now is the time to step up by nominating yourself or someone else for SHM’s many leadership and recognition opportunities. But act quickly. The deadline for many of them is October 16. You can help lead the movement and earn recognition through:

• Nominating yourself or a colleague for one of SHM’s Awards of Excellence, which will be presented at HM16 in San Diego;
• Joining a committee that matches your professional interests or personal passions;
• Applying for SHM’s board of directors; or
• Nominating a colleague for the Master in Hospital Medicine designation, SHM’s most prestigious honor.

For more information, click on the “membership” section of the SHM website.

Are you ready to shape the future of the hospital medicine movement? Now is the time to step up by nominating yourself or someone else for SHM’s many leadership and recognition opportunities. But act quickly. The deadline for many of them is October 16. You can help lead the movement and earn recognition through:

• Nominating yourself or a colleague for one of SHM’s Awards of Excellence, which will be presented at HM16 in San Diego;
• Joining a committee that matches your professional interests or personal passions;
• Applying for SHM’s board of directors; or
• Nominating a colleague for the Master in Hospital Medicine designation, SHM’s most prestigious honor.

For more information, click on the “membership” section of the SHM website.

Are you ready to shape the future of the hospital medicine movement? Now is the time to step up by nominating yourself or someone else for SHM’s many leadership and recognition opportunities. But act quickly. The deadline for many of them is October 16. You can help lead the movement and earn recognition through:

• Nominating yourself or a colleague for one of SHM’s Awards of Excellence, which will be presented at HM16 in San Diego;
• Joining a committee that matches your professional interests or personal passions;
• Applying for SHM’s board of directors; or
• Nominating a colleague for the Master in Hospital Medicine designation, SHM’s most prestigious honor.

For more information, click on the “membership” section of the SHM website.

Studying for the Focused Practice in Hospital Medicine Maintenance of Certification Exam? SHM’s new online test prep tool is now available!

SPARK is the only test prep resource designed specifically for hospitalists and the American Board of Internal Medicine Focused Practice in Hospital Medicine MOC exam. Unlike other test prep tools, this focuses on topics unique to the everyday practice of hospital medicine, including:

• Palliative care, medical ethics, and decision-making;
• Peri-operative care and consultative co-management; and
• Quality, safety, and clinical reasoning.

SPARK gives hospitalists the peace of mind that comes with knowing they are ready for the MOC exam; it features 175 vignette-style, single best answer, multiple-choice questions, complete with answers, discussion, reasoning, references, and quizzing capabilities. This new resource provides targeted study areas to supplement other educational material.

Studying for the Focused Practice in Hospital Medicine Maintenance of Certification Exam? SHM’s new online test prep tool is now available!

SPARK is the only test prep resource designed specifically for hospitalists and the American Board of Internal Medicine Focused Practice in Hospital Medicine MOC exam. Unlike other test prep tools, this focuses on topics unique to the everyday practice of hospital medicine, including:

• Palliative care, medical ethics, and decision-making;
• Peri-operative care and consultative co-management; and
• Quality, safety, and clinical reasoning.

SPARK gives hospitalists the peace of mind that comes with knowing they are ready for the MOC exam; it features 175 vignette-style, single best answer, multiple-choice questions, complete with answers, discussion, reasoning, references, and quizzing capabilities. This new resource provides targeted study areas to supplement other educational material.

Studying for the Focused Practice in Hospital Medicine Maintenance of Certification Exam? SHM’s new online test prep tool is now available!

SPARK is the only test prep resource designed specifically for hospitalists and the American Board of Internal Medicine Focused Practice in Hospital Medicine MOC exam. Unlike other test prep tools, this focuses on topics unique to the everyday practice of hospital medicine, including:

• Palliative care, medical ethics, and decision-making;
• Peri-operative care and consultative co-management; and
• Quality, safety, and clinical reasoning.

SPARK gives hospitalists the peace of mind that comes with knowing they are ready for the MOC exam; it features 175 vignette-style, single best answer, multiple-choice questions, complete with answers, discussion, reasoning, references, and quizzing capabilities. This new resource provides targeted study areas to supplement other educational material.

Get started today on your application for SHM’s other designations, Fellow in Hospital Medicine (FHM) and Senior Fellow in Hospital Medicine (SFHM). Don’t wait until the last minute; the application can take some time to assemble.

Click here to apply.

Get started today on your application for SHM’s other designations, Fellow in Hospital Medicine (FHM) and Senior Fellow in Hospital Medicine (SFHM). Don’t wait until the last minute; the application can take some time to assemble.

Click here to apply.

Get started today on your application for SHM’s other designations, Fellow in Hospital Medicine (FHM) and Senior Fellow in Hospital Medicine (SFHM). Don’t wait until the last minute; the application can take some time to assemble.

Click here to apply.

Approximately 1.7 million patients are hospitalized for acute coronary syndrome (ACS), and 600,000 die of an acute myocardial infarction. Although ACS is a major cause of morbidity and mortality, a broad range of clinical strategies can affect outcomes if implemented effectively. In addition, quality improvement (QI) strategies implemented around ACS can improve performance on quality measures.

The ACS PI-CME is a self-directed, web-based activity designed to help you evaluate your practice. Participation is free. Upon completion of the activity, participants will receive 20 CME credits.

The educational interventions will be pragmatic and address the challenges faced by clinicians responsible for managing patient care. They include:

• Etiology and diagnosis of ACS: educating the team on the pathophysiology of atherosclerotic plaque;
• Inpatient treatment of ACS; and
• Transitions of care for ACS patients.

Act today, because spaces are limited for this program. For more information, visit the QI section of SHM’s website.

---

Brendon Shank is SHM’s associate vice president of communications.ences (CHS) 13-105 10833 Le Conte Ave., Los Angeles, Calif.

Approximately 1.7 million patients are hospitalized for acute coronary syndrome (ACS), and 600,000 die of an acute myocardial infarction. Although ACS is a major cause of morbidity and mortality, a broad range of clinical strategies can affect outcomes if implemented effectively. In addition, quality improvement (QI) strategies implemented around ACS can improve performance on quality measures.

The ACS PI-CME is a self-directed, web-based activity designed to help you evaluate your practice. Participation is free. Upon completion of the activity, participants will receive 20 CME credits.

The educational interventions will be pragmatic and address the challenges faced by clinicians responsible for managing patient care. They include:

• Etiology and diagnosis of ACS: educating the team on the pathophysiology of atherosclerotic plaque;
• Inpatient treatment of ACS; and
• Transitions of care for ACS patients.

Act today, because spaces are limited for this program. For more information, visit the QI section of SHM’s website.

---

Brendon Shank is SHM’s associate vice president of communications.ences (CHS) 13-105 10833 Le Conte Ave., Los Angeles, Calif.

Approximately 1.7 million patients are hospitalized for acute coronary syndrome (ACS), and 600,000 die of an acute myocardial infarction. Although ACS is a major cause of morbidity and mortality, a broad range of clinical strategies can affect outcomes if implemented effectively. In addition, quality improvement (QI) strategies implemented around ACS can improve performance on quality measures.

The ACS PI-CME is a self-directed, web-based activity designed to help you evaluate your practice. Participation is free. Upon completion of the activity, participants will receive 20 CME credits.

The educational interventions will be pragmatic and address the challenges faced by clinicians responsible for managing patient care. They include:

• Etiology and diagnosis of ACS: educating the team on the pathophysiology of atherosclerotic plaque;
• Inpatient treatment of ACS; and
• Transitions of care for ACS patients.

Act today, because spaces are limited for this program. For more information, visit the QI section of SHM’s website.

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Brendon Shank is SHM’s associate vice president of communications.ences (CHS) 13-105 10833 Le Conte Ave., Los Angeles, Calif.