The key word in the title of this Tuesday session at HM12 was "change." In 50 years, healthcare expenditures will consume 50% of the U.S. national GDP. Change in hospital medicine has to happen to accommodate this.

Robert Bessler, a former economics graduate, kept the talk interesting and simple enough even for a non-financial physician like myself. As everyone knows, the cost of health care is rapidly rising and will likely be unsustainable. Bressler described hospital medicine economic management as being made up of "three legs of a stool": These legs are the cost of healthcare, the quality of healthcare, and access to healthcare.

Two important occurrences that complicate quality are the aging baby boomers and the obesity epidemic hitting Americans. Access represents the second leg of the "stool," and it's extremely shaky. The demand for care will eventually exceed the professionals ability to provide it, as more patients become insured and some hospitals go bankrupt (an estimated 15% will do so in the next eight years), said Bressler.

Hospitalists will play a major role in the future in the financial health of medical institutions, the third leg of the stool. Bessler called hospitalists the "pit crew leaders" and our turf encompasses "accountable" acute-care episodes.

Takeaways

• The cost of healthcare is unsustainable.
• Quality will play a key role in decreasing costs.
• Access to healthcare will be constrained.
• Accountable acute-care episodes are on hospitalist "turf."

The key word in the title of this Tuesday session at HM12 was "change." In 50 years, healthcare expenditures will consume 50% of the U.S. national GDP. Change in hospital medicine has to happen to accommodate this.

Robert Bessler, a former economics graduate, kept the talk interesting and simple enough even for a non-financial physician like myself. As everyone knows, the cost of health care is rapidly rising and will likely be unsustainable. Bressler described hospital medicine economic management as being made up of "three legs of a stool": These legs are the cost of healthcare, the quality of healthcare, and access to healthcare.

Two important occurrences that complicate quality are the aging baby boomers and the obesity epidemic hitting Americans. Access represents the second leg of the "stool," and it's extremely shaky. The demand for care will eventually exceed the professionals ability to provide it, as more patients become insured and some hospitals go bankrupt (an estimated 15% will do so in the next eight years), said Bressler.

Hospitalists will play a major role in the future in the financial health of medical institutions, the third leg of the stool. Bessler called hospitalists the "pit crew leaders" and our turf encompasses "accountable" acute-care episodes.

Takeaways

• The cost of healthcare is unsustainable.
• Quality will play a key role in decreasing costs.
• Access to healthcare will be constrained.
• Accountable acute-care episodes are on hospitalist "turf."

The key word in the title of this Tuesday session at HM12 was "change." In 50 years, healthcare expenditures will consume 50% of the U.S. national GDP. Change in hospital medicine has to happen to accommodate this.

Robert Bessler, a former economics graduate, kept the talk interesting and simple enough even for a non-financial physician like myself. As everyone knows, the cost of health care is rapidly rising and will likely be unsustainable. Bressler described hospital medicine economic management as being made up of "three legs of a stool": These legs are the cost of healthcare, the quality of healthcare, and access to healthcare.

Two important occurrences that complicate quality are the aging baby boomers and the obesity epidemic hitting Americans. Access represents the second leg of the "stool," and it's extremely shaky. The demand for care will eventually exceed the professionals ability to provide it, as more patients become insured and some hospitals go bankrupt (an estimated 15% will do so in the next eight years), said Bressler.

Hospitalists will play a major role in the future in the financial health of medical institutions, the third leg of the stool. Bessler called hospitalists the "pit crew leaders" and our turf encompasses "accountable" acute-care episodes.

Takeaways

• The cost of healthcare is unsustainable.
• Quality will play a key role in decreasing costs.
• Access to healthcare will be constrained.
• Accountable acute-care episodes are on hospitalist "turf."

The future of hospital medicine is rooted in the accountability of its practitioners, the new SHM president said Tuesday morning at the Society of Hospital Medicine’s annual meeting.

Shaun Frost, MD, SFHM, FACP, chief medical officer for the Northeast region for Cogent HMG, used his inaugural address at the HM12 award ceremony as a clarion call for HM leaders to view personal and professional accountability as a challenge.

“Delivering genuine results is now what we definitely must do, because the train that is healthcare reform has clearly left the station,” he said. “If we don’t jump aboard this train by delivering tangible and measurable results through true quality performance improvements and honest cost containment, I’m afraid that the consequences could be disastrous for our hospitals, for our communities, for us individually, and for the profession of hospital medicine.”

Dr. Frost said that providing evidence-based improvements will solidify the specialty’s status as a “successful historical improvement to the practice of medicine.” HM leaders who have prided themselves on leading the push for quality have done an admirable job of becoming change agents at their institutions over the past 15 years, said Dr. Frost. And now, he added, the field's reputation is staked to the next wave of reform.

“It’s time for each of us to put our money where our mouths have been,” he said.

Adds outgoing society president Joseph Ming-Wah Li, MD, SFHM: “Expectations are higher than ever for hospital medicine and for SHM … can we meet those expectations? What’s the story that’s going to be told about hospital medicine and SHM five, 10 years from now?”

The future of hospital medicine is rooted in the accountability of its practitioners, the new SHM president said Tuesday morning at the Society of Hospital Medicine’s annual meeting.

Shaun Frost, MD, SFHM, FACP, chief medical officer for the Northeast region for Cogent HMG, used his inaugural address at the HM12 award ceremony as a clarion call for HM leaders to view personal and professional accountability as a challenge.

“Delivering genuine results is now what we definitely must do, because the train that is healthcare reform has clearly left the station,” he said. “If we don’t jump aboard this train by delivering tangible and measurable results through true quality performance improvements and honest cost containment, I’m afraid that the consequences could be disastrous for our hospitals, for our communities, for us individually, and for the profession of hospital medicine.”

Dr. Frost said that providing evidence-based improvements will solidify the specialty’s status as a “successful historical improvement to the practice of medicine.” HM leaders who have prided themselves on leading the push for quality have done an admirable job of becoming change agents at their institutions over the past 15 years, said Dr. Frost. And now, he added, the field's reputation is staked to the next wave of reform.

“It’s time for each of us to put our money where our mouths have been,” he said.

Adds outgoing society president Joseph Ming-Wah Li, MD, SFHM: “Expectations are higher than ever for hospital medicine and for SHM … can we meet those expectations? What’s the story that’s going to be told about hospital medicine and SHM five, 10 years from now?”

The future of hospital medicine is rooted in the accountability of its practitioners, the new SHM president said Tuesday morning at the Society of Hospital Medicine’s annual meeting.

Shaun Frost, MD, SFHM, FACP, chief medical officer for the Northeast region for Cogent HMG, used his inaugural address at the HM12 award ceremony as a clarion call for HM leaders to view personal and professional accountability as a challenge.

“Delivering genuine results is now what we definitely must do, because the train that is healthcare reform has clearly left the station,” he said. “If we don’t jump aboard this train by delivering tangible and measurable results through true quality performance improvements and honest cost containment, I’m afraid that the consequences could be disastrous for our hospitals, for our communities, for us individually, and for the profession of hospital medicine.”

Dr. Frost said that providing evidence-based improvements will solidify the specialty’s status as a “successful historical improvement to the practice of medicine.” HM leaders who have prided themselves on leading the push for quality have done an admirable job of becoming change agents at their institutions over the past 15 years, said Dr. Frost. And now, he added, the field's reputation is staked to the next wave of reform.

“It’s time for each of us to put our money where our mouths have been,” he said.

Adds outgoing society president Joseph Ming-Wah Li, MD, SFHM: “Expectations are higher than ever for hospital medicine and for SHM … can we meet those expectations? What’s the story that’s going to be told about hospital medicine and SHM five, 10 years from now?”

Participants in a Tuesday workshop at HM12 in San Diego learned how using "teach back" as a patient-education strategy can solve some of the barriers to communicating post-discharge information to hospitalized patients.

These barriers include failure to assess a patient's health literacy or to identify the key learner in the patient's family, as well as the sheer volume of important information some patients need, and the lack of time in busy hospital units to convey it all.

The teach-back process involves asking patients to repeat in their own words what the health professional has told them.

"Most people are under the misconception that teaching takes too much time," said Paula Robinson, MSN, RN-BC, manager of patient, family, and consumer education for Lehigh Valley Health System in Allentown, Pa. She advised hospitalists to give patients smaller amounts of information, in three- to five-minute chunks over several days. Further, it may be necessary to prioritize what the patient needs to know, rather than present so much information that the patient won't remember much of it.

Lehigh Valley's commitment to teach back grew out of a QI project mapping patient-flow processes, including care transitions, throughout its health system. It was tested in a pilot unit and included prompts and scripts hardwired into the electronic health record for unit nurses to easily access. Readmission rates at the pilot unit dropped to 14.0% from 28.2% in the year after teach back was implemented; hospital-wide rates shrunk to 21.9% from 25.3%.

Teach back is presented to patients in the spirit of evaluating how effectively the professional has explained the information, and not as a way to test the patient, Robinson said.

Participants in a Tuesday workshop at HM12 in San Diego learned how using "teach back" as a patient-education strategy can solve some of the barriers to communicating post-discharge information to hospitalized patients.

These barriers include failure to assess a patient's health literacy or to identify the key learner in the patient's family, as well as the sheer volume of important information some patients need, and the lack of time in busy hospital units to convey it all.

The teach-back process involves asking patients to repeat in their own words what the health professional has told them.

"Most people are under the misconception that teaching takes too much time," said Paula Robinson, MSN, RN-BC, manager of patient, family, and consumer education for Lehigh Valley Health System in Allentown, Pa. She advised hospitalists to give patients smaller amounts of information, in three- to five-minute chunks over several days. Further, it may be necessary to prioritize what the patient needs to know, rather than present so much information that the patient won't remember much of it.

Lehigh Valley's commitment to teach back grew out of a QI project mapping patient-flow processes, including care transitions, throughout its health system. It was tested in a pilot unit and included prompts and scripts hardwired into the electronic health record for unit nurses to easily access. Readmission rates at the pilot unit dropped to 14.0% from 28.2% in the year after teach back was implemented; hospital-wide rates shrunk to 21.9% from 25.3%.

Teach back is presented to patients in the spirit of evaluating how effectively the professional has explained the information, and not as a way to test the patient, Robinson said.

Participants in a Tuesday workshop at HM12 in San Diego learned how using "teach back" as a patient-education strategy can solve some of the barriers to communicating post-discharge information to hospitalized patients.

These barriers include failure to assess a patient's health literacy or to identify the key learner in the patient's family, as well as the sheer volume of important information some patients need, and the lack of time in busy hospital units to convey it all.

The teach-back process involves asking patients to repeat in their own words what the health professional has told them.

"Most people are under the misconception that teaching takes too much time," said Paula Robinson, MSN, RN-BC, manager of patient, family, and consumer education for Lehigh Valley Health System in Allentown, Pa. She advised hospitalists to give patients smaller amounts of information, in three- to five-minute chunks over several days. Further, it may be necessary to prioritize what the patient needs to know, rather than present so much information that the patient won't remember much of it.

Lehigh Valley's commitment to teach back grew out of a QI project mapping patient-flow processes, including care transitions, throughout its health system. It was tested in a pilot unit and included prompts and scripts hardwired into the electronic health record for unit nurses to easily access. Readmission rates at the pilot unit dropped to 14.0% from 28.2% in the year after teach back was implemented; hospital-wide rates shrunk to 21.9% from 25.3%.

Teach back is presented to patients in the spirit of evaluating how effectively the professional has explained the information, and not as a way to test the patient, Robinson said.

The key word in the title is change. The most frightening number that proves change has to happen is that in 50 years healthcare expenditures will consume 50% of our nation's GDP. No way that can be sustained.

The three legs of the stool to manage HM economics include 1) cost of healthcare, 2) quality of healthcare, and 3) access to healthcare.

Dr. Robert Bessler, a former economics graduate, kept the talk interesting and simple enough even for a non-financial physician like myself. As everyone knows the cost of healthcare is rapidly rising and thus unsustainable, measures to improve quality and improve patient safety form one of the legs of the healthcare economics stool.

Two important occurrences that complicate quality are the aging baby boomers and the obesity epidemic hitting Americans. Access represents the second leg which is extremely shaky. In the near future, demand will exceed the number of professionals to provide care, as more patients become insured. Some hospitals will go bankrupt; estimates are 15% by 2020.

The last leg is cost, an area in which hospitalists will have a major role in the future, as they become more a part of the financial health of medical institutions. Dr. Bessler called hospitalists the "pit crew leaders," and said our turf is the "accountable," acute-care episode.

Key Takeaways:

• Cost of healthcare is unsustainable.
• Quality will provide key role in decreasing costs.
• Access to healthcare will be constrained.
• Accountable acute care episodes is HM's turf.

Dr. Holder is medical director of hospitalist services and chief medical information officer, Decatur Memorial Hospital, Decatur, Ill. He is also chairman of the SHM IT Quality Committee.

The key word in the title is change. The most frightening number that proves change has to happen is that in 50 years healthcare expenditures will consume 50% of our nation's GDP. No way that can be sustained.

The three legs of the stool to manage HM economics include 1) cost of healthcare, 2) quality of healthcare, and 3) access to healthcare.

Dr. Robert Bessler, a former economics graduate, kept the talk interesting and simple enough even for a non-financial physician like myself. As everyone knows the cost of healthcare is rapidly rising and thus unsustainable, measures to improve quality and improve patient safety form one of the legs of the healthcare economics stool.

Two important occurrences that complicate quality are the aging baby boomers and the obesity epidemic hitting Americans. Access represents the second leg which is extremely shaky. In the near future, demand will exceed the number of professionals to provide care, as more patients become insured. Some hospitals will go bankrupt; estimates are 15% by 2020.

The last leg is cost, an area in which hospitalists will have a major role in the future, as they become more a part of the financial health of medical institutions. Dr. Bessler called hospitalists the "pit crew leaders," and said our turf is the "accountable," acute-care episode.

Key Takeaways:

• Cost of healthcare is unsustainable.
• Quality will provide key role in decreasing costs.
• Access to healthcare will be constrained.
• Accountable acute care episodes is HM's turf.

Dr. Holder is medical director of hospitalist services and chief medical information officer, Decatur Memorial Hospital, Decatur, Ill. He is also chairman of the SHM IT Quality Committee.

The key word in the title is change. The most frightening number that proves change has to happen is that in 50 years healthcare expenditures will consume 50% of our nation's GDP. No way that can be sustained.

The three legs of the stool to manage HM economics include 1) cost of healthcare, 2) quality of healthcare, and 3) access to healthcare.

Dr. Robert Bessler, a former economics graduate, kept the talk interesting and simple enough even for a non-financial physician like myself. As everyone knows the cost of healthcare is rapidly rising and thus unsustainable, measures to improve quality and improve patient safety form one of the legs of the healthcare economics stool.

Two important occurrences that complicate quality are the aging baby boomers and the obesity epidemic hitting Americans. Access represents the second leg which is extremely shaky. In the near future, demand will exceed the number of professionals to provide care, as more patients become insured. Some hospitals will go bankrupt; estimates are 15% by 2020.

The last leg is cost, an area in which hospitalists will have a major role in the future, as they become more a part of the financial health of medical institutions. Dr. Bessler called hospitalists the "pit crew leaders," and said our turf is the "accountable," acute-care episode.

Key Takeaways:

• Cost of healthcare is unsustainable.
• Quality will provide key role in decreasing costs.
• Access to healthcare will be constrained.
• Accountable acute care episodes is HM's turf.

Dr. Holder is medical director of hospitalist services and chief medical information officer, Decatur Memorial Hospital, Decatur, Ill. He is also chairman of the SHM IT Quality Committee.

Outgoing SHM President Joe Li, MD, SFHM, summarized the Ernest Hemingway history of the “six-word story.” as a metaphor for the future of HM. Hemingway was famous for his short stories; his six-word stories are etched in literary folk lore.

Similarly, the future of hospital medicine will depend on how we are perceived by our six-word stories, Dr. Li said at HM12 in San Diego. Here are a few worrisome outcomes: 

1. “Less continuity, more readmissions, billions lost;” or

2. “Hospitalization, inadequate communications, ready for readmission.”

What we need to work toward are six-word stories that will serve our profession and our patients well, such as “high quality, low cost, high value,” or “hospitalists, high-value, patient-focused care.”

Key Takeaways:

• Our six-word stories are vital to the perception and reality of hospital medicine;
• We are all responsible for the future of the six word stories of hospital medicine.

Dr. Scheurer is physician editor of The Hospitalist.

Outgoing SHM President Joe Li, MD, SFHM, summarized the Ernest Hemingway history of the “six-word story.” as a metaphor for the future of HM. Hemingway was famous for his short stories; his six-word stories are etched in literary folk lore.

Similarly, the future of hospital medicine will depend on how we are perceived by our six-word stories, Dr. Li said at HM12 in San Diego. Here are a few worrisome outcomes: 

1. “Less continuity, more readmissions, billions lost;” or

2. “Hospitalization, inadequate communications, ready for readmission.”

What we need to work toward are six-word stories that will serve our profession and our patients well, such as “high quality, low cost, high value,” or “hospitalists, high-value, patient-focused care.”

Key Takeaways:

• Our six-word stories are vital to the perception and reality of hospital medicine;
• We are all responsible for the future of the six word stories of hospital medicine.

Dr. Scheurer is physician editor of The Hospitalist.

Outgoing SHM President Joe Li, MD, SFHM, summarized the Ernest Hemingway history of the “six-word story.” as a metaphor for the future of HM. Hemingway was famous for his short stories; his six-word stories are etched in literary folk lore.

Similarly, the future of hospital medicine will depend on how we are perceived by our six-word stories, Dr. Li said at HM12 in San Diego. Here are a few worrisome outcomes: 

1. “Less continuity, more readmissions, billions lost;” or

2. “Hospitalization, inadequate communications, ready for readmission.”

What we need to work toward are six-word stories that will serve our profession and our patients well, such as “high quality, low cost, high value,” or “hospitalists, high-value, patient-focused care.”

Key Takeaways:

• Our six-word stories are vital to the perception and reality of hospital medicine;
• We are all responsible for the future of the six word stories of hospital medicine.

Dr. Scheurer is physician editor of The Hospitalist.

We have staked our reputation on our ability to improve healthcare quality, and we need to deliver, according to incoming SHM President Shaun Frost, MD, SFHM, who addressed hospitalists this morning at HM12 in San Diego. Such care delivery will require personal accountability to embrace the work necessary to realize the potential of HM.

As Lou Holtz, the former Notre Dame head football coach, once said, “when all is said and done, a lot more is said than done.” Although always couched within a system, many current limitations with quality improvement and patient safety are rooted at the level of individual accountability. Dr. Frost pointed to hand hygiene and sign-out performance as tangible examples.

Key Takeaways:

• We are at a point in our profession where we need to define and enforce individual accountability for processes considered vital to good patient care.
• We need to all hold ourselves accountability for our ability to deliver genuine results.

Dr. Scheurer is physician editor of The Hospitalist

We have staked our reputation on our ability to improve healthcare quality, and we need to deliver, according to incoming SHM President Shaun Frost, MD, SFHM, who addressed hospitalists this morning at HM12 in San Diego. Such care delivery will require personal accountability to embrace the work necessary to realize the potential of HM.

As Lou Holtz, the former Notre Dame head football coach, once said, “when all is said and done, a lot more is said than done.” Although always couched within a system, many current limitations with quality improvement and patient safety are rooted at the level of individual accountability. Dr. Frost pointed to hand hygiene and sign-out performance as tangible examples.

Key Takeaways:

• We are at a point in our profession where we need to define and enforce individual accountability for processes considered vital to good patient care.
• We need to all hold ourselves accountability for our ability to deliver genuine results.

Dr. Scheurer is physician editor of The Hospitalist

We have staked our reputation on our ability to improve healthcare quality, and we need to deliver, according to incoming SHM President Shaun Frost, MD, SFHM, who addressed hospitalists this morning at HM12 in San Diego. Such care delivery will require personal accountability to embrace the work necessary to realize the potential of HM.

As Lou Holtz, the former Notre Dame head football coach, once said, “when all is said and done, a lot more is said than done.” Although always couched within a system, many current limitations with quality improvement and patient safety are rooted at the level of individual accountability. Dr. Frost pointed to hand hygiene and sign-out performance as tangible examples.

Key Takeaways:

• We are at a point in our profession where we need to define and enforce individual accountability for processes considered vital to good patient care.
• We need to all hold ourselves accountability for our ability to deliver genuine results.

Dr. Scheurer is physician editor of The Hospitalist

"Palliative care is not about death and dying or just pain management," said Sarah Friebert, MD, at a morning breakout session on Tuesday at HM12. Rather, she said, palliative care is a method of holistic care delivery for individuals with chronic, complex, and/or life-threatening conditions.

"There is a role for [palliative] subspecialty care" beyond just "good care," said Dr. Friebert. It is a model of shared management with other caregivers that is similar to other models of chronic disease. Additionally, palliative care has evolved to embrace an integrated model, such that palliation is longitudinally woven together with care for curing, dying, and bereavement.

Families continue to have many unmet needs, and hospitalists should provide them with clear and honest communication. Involving the palliative care team early on in the course of the illness is important to facilitate effective care.

Takeaways

• Palliative care is not code for "hospice."
• Other care (providers and treatment) does not need to be given up.
• Early integration of the palliative care team is essential.
• Consider using triggers to prompt referral to palliative care.

Dr. Shen is medical director of hospital medicine and assistant professor of pediatrics at UTMB Austin Pediatrics and Dell Children's Medical Center of Central Texas.

"Palliative care is not about death and dying or just pain management," said Sarah Friebert, MD, at a morning breakout session on Tuesday at HM12. Rather, she said, palliative care is a method of holistic care delivery for individuals with chronic, complex, and/or life-threatening conditions.

"There is a role for [palliative] subspecialty care" beyond just "good care," said Dr. Friebert. It is a model of shared management with other caregivers that is similar to other models of chronic disease. Additionally, palliative care has evolved to embrace an integrated model, such that palliation is longitudinally woven together with care for curing, dying, and bereavement.

Families continue to have many unmet needs, and hospitalists should provide them with clear and honest communication. Involving the palliative care team early on in the course of the illness is important to facilitate effective care.

Takeaways

• Palliative care is not code for "hospice."
• Other care (providers and treatment) does not need to be given up.
• Early integration of the palliative care team is essential.
• Consider using triggers to prompt referral to palliative care.

Dr. Shen is medical director of hospital medicine and assistant professor of pediatrics at UTMB Austin Pediatrics and Dell Children's Medical Center of Central Texas.

"Palliative care is not about death and dying or just pain management," said Sarah Friebert, MD, at a morning breakout session on Tuesday at HM12. Rather, she said, palliative care is a method of holistic care delivery for individuals with chronic, complex, and/or life-threatening conditions.

"There is a role for [palliative] subspecialty care" beyond just "good care," said Dr. Friebert. It is a model of shared management with other caregivers that is similar to other models of chronic disease. Additionally, palliative care has evolved to embrace an integrated model, such that palliation is longitudinally woven together with care for curing, dying, and bereavement.

Families continue to have many unmet needs, and hospitalists should provide them with clear and honest communication. Involving the palliative care team early on in the course of the illness is important to facilitate effective care.

Takeaways

• Palliative care is not code for "hospice."
• Other care (providers and treatment) does not need to be given up.
• Early integration of the palliative care team is essential.
• Consider using triggers to prompt referral to palliative care.

Dr. Shen is medical director of hospital medicine and assistant professor of pediatrics at UTMB Austin Pediatrics and Dell Children's Medical Center of Central Texas.

Shalini Chandra, MD, MS, Gregory Harlan, MD, FAAP, MPH, Brian Donovan, MD, MMM, FACP, SFHM, and Judy Shumway, DO, MPH, led a standing-room only morning breakout session on Monday at HM12 that focused on the challenges and opportunities of scheduling and rounding.

Dr. Harlan, a hospitalist at IPC, introduced the topic of innovative scheduling by placing the issue in a framework easily understood by hospitalists: quality improvement. He advocated identifying the salient problems faced by each individual group and then applying changes that make sense to each facility and group.

Dr. Chandra, a hospitalist at Johns Hopkins Bayview Medical Center, further elaborated on this by explaining how the PDSA (plan, do, study, act) approach can be used to initiate and assess the changes implemented in scheduling. Metrics such as hospitalist morale, patient satisfaction, length of stay, and time of discharge, can be used to assess the effect of each scheduling change.

Dr. Donovan, medical director of IPC, described a “zone” approach to scheduling. This rounding scheme assigns a hospitalist to a geographic unit, allowing for greater accessibility and higher efficiency. Closer relationships with multidisciplinary personnel can be achieved with this model.

Takeaways

• Test your scheduling changes with PDSA methods of quality improvement.
• Multidisciplinary rounds are critical to success.
• "Zone" rounding allows the development of physician leaders in each zone, and enable more efficiency.
• Engaging stakeholders in the success of physician scheduling is critical; this may enable more support and resources for these changes from administration.

Dr. Chang is a pediatric hospitalist with the University of San Diego Medical Center and  Rady Children's Hospital, San Diego.

Shalini Chandra, MD, MS, Gregory Harlan, MD, FAAP, MPH, Brian Donovan, MD, MMM, FACP, SFHM, and Judy Shumway, DO, MPH, led a standing-room only morning breakout session on Monday at HM12 that focused on the challenges and opportunities of scheduling and rounding.

Dr. Harlan, a hospitalist at IPC, introduced the topic of innovative scheduling by placing the issue in a framework easily understood by hospitalists: quality improvement. He advocated identifying the salient problems faced by each individual group and then applying changes that make sense to each facility and group.

Dr. Chandra, a hospitalist at Johns Hopkins Bayview Medical Center, further elaborated on this by explaining how the PDSA (plan, do, study, act) approach can be used to initiate and assess the changes implemented in scheduling. Metrics such as hospitalist morale, patient satisfaction, length of stay, and time of discharge, can be used to assess the effect of each scheduling change.

Dr. Donovan, medical director of IPC, described a “zone” approach to scheduling. This rounding scheme assigns a hospitalist to a geographic unit, allowing for greater accessibility and higher efficiency. Closer relationships with multidisciplinary personnel can be achieved with this model.

Takeaways

• Test your scheduling changes with PDSA methods of quality improvement.
• Multidisciplinary rounds are critical to success.
• "Zone" rounding allows the development of physician leaders in each zone, and enable more efficiency.
• Engaging stakeholders in the success of physician scheduling is critical; this may enable more support and resources for these changes from administration.

Dr. Chang is a pediatric hospitalist with the University of San Diego Medical Center and  Rady Children's Hospital, San Diego.

Shalini Chandra, MD, MS, Gregory Harlan, MD, FAAP, MPH, Brian Donovan, MD, MMM, FACP, SFHM, and Judy Shumway, DO, MPH, led a standing-room only morning breakout session on Monday at HM12 that focused on the challenges and opportunities of scheduling and rounding.

Dr. Harlan, a hospitalist at IPC, introduced the topic of innovative scheduling by placing the issue in a framework easily understood by hospitalists: quality improvement. He advocated identifying the salient problems faced by each individual group and then applying changes that make sense to each facility and group.

Dr. Chandra, a hospitalist at Johns Hopkins Bayview Medical Center, further elaborated on this by explaining how the PDSA (plan, do, study, act) approach can be used to initiate and assess the changes implemented in scheduling. Metrics such as hospitalist morale, patient satisfaction, length of stay, and time of discharge, can be used to assess the effect of each scheduling change.

Dr. Donovan, medical director of IPC, described a “zone” approach to scheduling. This rounding scheme assigns a hospitalist to a geographic unit, allowing for greater accessibility and higher efficiency. Closer relationships with multidisciplinary personnel can be achieved with this model.

Takeaways

• Test your scheduling changes with PDSA methods of quality improvement.
• Multidisciplinary rounds are critical to success.
• "Zone" rounding allows the development of physician leaders in each zone, and enable more efficiency.
• Engaging stakeholders in the success of physician scheduling is critical; this may enable more support and resources for these changes from administration.

Dr. Chang is a pediatric hospitalist with the University of San Diego Medical Center and  Rady Children's Hospital, San Diego.

Three longtime hospitalists were announced today as new members of the Society of Hospital Medicine's 2012-13 Board of Directors.

Jeff Glasheen, MD, SFHM, Nasim Afsar, MD, SFHM, and Brian Harte, MD, SFHM, are newly elected members of the board. Each will serve a three-year term. Dr. Glasheen is director of the hospitalist service at the University of Colorado Denver, and former physician editor of The Hospitalist. Dr. Afsar is director of quality for HM and neurosurgery at Ronald Reagan UCLA Medical Center in Los Angeles. Dr. Harte is chief operating officer of Hillcrest Hospital in Ohio and chairman of hospital medicine at The Cleveland Clinic.

The board voted Eric Howell, MD, SFHM, as president-elect. Burke T. Kealey, MD, SFHM, is board treasurer and Erin Stucky Fisher, MD, MHM, is board secretary.

The other board members are: Shaun Frost, MD, SFHM, president; Joseph M. Li, MD, SFHM, past president; Lakshmi Halasyamani, MD, SFHM; Robert Harrington Jr., MD, SFHM; Janet Nagamine, MD, SFHM; and Eric M. Siegal, MD, SFHM.

Three longtime hospitalists were announced today as new members of the Society of Hospital Medicine's 2012-13 Board of Directors.

Jeff Glasheen, MD, SFHM, Nasim Afsar, MD, SFHM, and Brian Harte, MD, SFHM, are newly elected members of the board. Each will serve a three-year term. Dr. Glasheen is director of the hospitalist service at the University of Colorado Denver, and former physician editor of The Hospitalist. Dr. Afsar is director of quality for HM and neurosurgery at Ronald Reagan UCLA Medical Center in Los Angeles. Dr. Harte is chief operating officer of Hillcrest Hospital in Ohio and chairman of hospital medicine at The Cleveland Clinic.

The board voted Eric Howell, MD, SFHM, as president-elect. Burke T. Kealey, MD, SFHM, is board treasurer and Erin Stucky Fisher, MD, MHM, is board secretary.

The other board members are: Shaun Frost, MD, SFHM, president; Joseph M. Li, MD, SFHM, past president; Lakshmi Halasyamani, MD, SFHM; Robert Harrington Jr., MD, SFHM; Janet Nagamine, MD, SFHM; and Eric M. Siegal, MD, SFHM.

Three longtime hospitalists were announced today as new members of the Society of Hospital Medicine's 2012-13 Board of Directors.

Jeff Glasheen, MD, SFHM, Nasim Afsar, MD, SFHM, and Brian Harte, MD, SFHM, are newly elected members of the board. Each will serve a three-year term. Dr. Glasheen is director of the hospitalist service at the University of Colorado Denver, and former physician editor of The Hospitalist. Dr. Afsar is director of quality for HM and neurosurgery at Ronald Reagan UCLA Medical Center in Los Angeles. Dr. Harte is chief operating officer of Hillcrest Hospital in Ohio and chairman of hospital medicine at The Cleveland Clinic.

The board voted Eric Howell, MD, SFHM, as president-elect. Burke T. Kealey, MD, SFHM, is board treasurer and Erin Stucky Fisher, MD, MHM, is board secretary.

The other board members are: Shaun Frost, MD, SFHM, president; Joseph M. Li, MD, SFHM, past president; Lakshmi Halasyamani, MD, SFHM; Robert Harrington Jr., MD, SFHM; Janet Nagamine, MD, SFHM; and Eric M. Siegal, MD, SFHM.

The topic was of strong interest, as demonstrated by the standing-room-only group of hospitalists attending Monday afternoon's presentation at HM12 in San Diego on the brand new antithrombic therapy from ACCP. I doubt giving away a new IPAD 3 would have brought a bigger audience. However, no one left disappointed, leaving with valuable new information which could be used at the bedside.

The excellent, evidence-based rapid fire presentation by Catherine Curley took us as a tour guide through key aspects of the new guidelines. The methodology improvements were extremely important. She used the more-controversial topics as examples: treatment of submassive PE, use of catheter directed thrombolysis in patients with acute DVT, and the recommended VTE prophylaxis. She even threw in some anatomy lessons for us clinicians.

Key Takeaways:

1. Major innovations in the methodology in the AT9. Focus on the absolute effects allow the provider to weight the benefit and risk of therapy easily, rigorous conflict of interests review of the editors, re-analysis of many older studies, and simplified recommendations with emphasis on summary of finding tables as opposed to texts
.
2. A strong focus on patient-centered outcomes. This is the first major guideline I have seen that recommends specifically focusing on the patients preferences.

Dr. Holder is medical director of hospitalist services and chief medical information officer at Decatur (Ill.) Memorial Hospital.

The topic was of strong interest, as demonstrated by the standing-room-only group of hospitalists attending Monday afternoon's presentation at HM12 in San Diego on the brand new antithrombic therapy from ACCP. I doubt giving away a new IPAD 3 would have brought a bigger audience. However, no one left disappointed, leaving with valuable new information which could be used at the bedside.

The excellent, evidence-based rapid fire presentation by Catherine Curley took us as a tour guide through key aspects of the new guidelines. The methodology improvements were extremely important. She used the more-controversial topics as examples: treatment of submassive PE, use of catheter directed thrombolysis in patients with acute DVT, and the recommended VTE prophylaxis. She even threw in some anatomy lessons for us clinicians.

Key Takeaways:

1. Major innovations in the methodology in the AT9. Focus on the absolute effects allow the provider to weight the benefit and risk of therapy easily, rigorous conflict of interests review of the editors, re-analysis of many older studies, and simplified recommendations with emphasis on summary of finding tables as opposed to texts
.
2. A strong focus on patient-centered outcomes. This is the first major guideline I have seen that recommends specifically focusing on the patients preferences.

Dr. Holder is medical director of hospitalist services and chief medical information officer at Decatur (Ill.) Memorial Hospital.

The topic was of strong interest, as demonstrated by the standing-room-only group of hospitalists attending Monday afternoon's presentation at HM12 in San Diego on the brand new antithrombic therapy from ACCP. I doubt giving away a new IPAD 3 would have brought a bigger audience. However, no one left disappointed, leaving with valuable new information which could be used at the bedside.

The excellent, evidence-based rapid fire presentation by Catherine Curley took us as a tour guide through key aspects of the new guidelines. The methodology improvements were extremely important. She used the more-controversial topics as examples: treatment of submassive PE, use of catheter directed thrombolysis in patients with acute DVT, and the recommended VTE prophylaxis. She even threw in some anatomy lessons for us clinicians.

Key Takeaways:

1. Major innovations in the methodology in the AT9. Focus on the absolute effects allow the provider to weight the benefit and risk of therapy easily, rigorous conflict of interests review of the editors, re-analysis of many older studies, and simplified recommendations with emphasis on summary of finding tables as opposed to texts
.
2. A strong focus on patient-centered outcomes. This is the first major guideline I have seen that recommends specifically focusing on the patients preferences.

Dr. Holder is medical director of hospitalist services and chief medical information officer at Decatur (Ill.) Memorial Hospital.