Hospitalists’ perceptions of their residency training needs: results of a national survey

Plauth, William H.; Pantilat, Steven Z.; Wachter, Robert M.; Fenton, Cynthia

doi:10.1016/s0002-9343(01)00837-3

Cited by 84 publications

(75 citation statements)

References 15 publications

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“…26 In one survey, hospitalists reported that although palliative care was very important to their practice, they had not received enough training in palliative care knowledge and skills. 27 …”

Section: Fear Of Taking Away Hopementioning

confidence: 99%

Discussing resuscitation preferences with patients: Challenges and rewards

Chittenden

Clark

Pantilat

2006

Journal of Hospital Medicine

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This paper was submitted on behalf of the Palliative Care Task Force.Discussing preferences regarding resuscitation is a challenging and important task for any physician. Understanding patients' wishes at the end of life allows physicians to provide the type of care patients want, to avoid unwanted interventions, and to promote patient autonomy and dignity. Hospitalists face an even greater challenge because they are often meeting a patient for the first time in a crisis situation. Despite the frequency with which clinicians have these conversations, they typically fall short when discussing code status with patients. In this evidencebased review, we discuss physician barriers to conducting effective discussions, offer a variety of approaches to enhancing these conversations, and review important communication techniques.

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Section: Fear Of Taking Away Hopementioning

confidence: 99%

Discussing resuscitation preferences with patients: Challenges and rewards

Chittenden

Clark

Pantilat

2006

Journal of Hospital Medicine

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“…These areas are generally underemphasized in resident training but considered important, particularly for those considering a career in hospitalist medicine. 17,18 Hospitalist clinician educators have been instrumental in helping our residents fulfill the latest Accreditation Council for Graduate Medical Education requirements, particularly those that focus on "system-based learning." 19 Under the guidance of HCEs, our residents have become involved in a number of multidisciplinary committees focused on specific inpatient issues.…”

Section: Resource Utilization: Patient Outcomes Including Length Of Smentioning

confidence: 99%

The positive impact of initiation of hospitalist clinician educators

et al. 2004

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OBJECTIVE:Although hospitalists have been shown to improve both financial and educational outcomes, their ability to manage dual roles as clinicians and educators has been infrequently demonstrated, particularly in the community setting where large numbers of residents train. We evaluated the impact of hospitalists on financial and educational outcomes at a midsized community teaching hospital 1 year after implementation. DESIGN:Two hospitalist clinician educators ( HCEs) were hired to provide inpatient medical care while participating in resident education. Length of stay and cost per case data were calculated for all patients admitted to the hospitalist service during their first year and compared with patients admitted to private physicians. The hospitalists' top 11 discharge diagnoses were individually assessed. For the same time period, categorical medicine residents ( N = 36) were given an anonymous written survey to assess the HCEs' impact on resident education and service. RESULTS:Resource consumption: length of stay was reduced by 20.8% and total cost per case was reduced by 18.4% comparing the HCEs with community-based physicians. Reductions in both length of stay and cost per case were noted for 8 of the 11 most common discharge diagnoses. Resident survey: over 75% of residents responded, with all noting improvement in the quality of attending rounds, bedside teaching, and the overall inpatient experience. Residents' roles as teachers and team leaders were largely unchanged. A driving force behind the expansion of the hospitalist movement is the potential to deliver high-quality medical care while decreasing inpatient costs and improving efficiency. Several institutions have demonstrated that both length of stay (LOS) and cost per case (C/C) have been reduced through the use of hospitalists. CONCLUSION:1-6 On average, hospitalists have been reported to reduce LOS by 16.6% and C/C by 13.4%. 1 Such decreases have been shown in both academic 2,3 and community-based institutions. [4][5][6] Though economic forces ultimately drive the utilization of hospitalists, other outcomes, such as the benefit of hospitalists on the medical education of internal medicine residents and medical students, have been explored to a limited extent. 7 In one large university medical center, residents expressed satisfaction with the teaching provided by hospitalists and reported that it was equivalent and often superior to that of traditional ward attendings. 2 In fact, these residents requested that hospitalists be a part of all of their future inpatient ward rotations. Another university medical center found that the presence of hospitalists improved the quality of attending rounds, increased the emphasis on resident education during inpatient rotations, and enhanced residents' overall learning experience. 8Despite the fact that hospitalists often serve in dual roles as clinicians and educators, there are few data on their ability to effectively manage these roles simultaneously. For academic community-based teaching hospital...

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“…Hospitalists who manage neurologic, neurosurgical, trauma, and psychiatric patients report being undertrained for such conditions. 31,32 Hospital medicine groups need to ensure training needs are met and supported. Given the successes of comanagement and the increasing complexity of surgical patients, 33 this practice will likely expand to a greater variety of nonmedical patients.…”

Section: Surgical Comanagementmentioning

confidence: 99%

“…Development of admission criteria that include specific diagnoses which match hospitalists' scope of practice is also important (Table 1). 32 The protocol-based and diagnosis-specific nature of SSU may enhance quality of care through standardization. Future research may delineate the utility of SSU.…”

Section: Short Stay Unitsmentioning

confidence: 99%

Evolving practice of hospital medicine and its impact on hospital throughput and efficiencies

Chadaga

Maher

Maller³

et al. 2012

Journal of Hospital Medicine

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Hospitalists are uniquely positioned to implement strategies to improve patient flow and efficiency. Hospital leaders have stated they expect hospitalists to comanage surgical patients, participate in observation units, and screen medical admissions, in addition to providing inpatient care for medical patients. We review how the hospitalists' role in acute inpatient care, surgical comanagement, short stay units, chest pain units, and active bed management has improved throughput and patient flow. Journal of Hospital Medicine 2012. © 2012 Society of Hospital Medicine

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Hospitalists’ perceptions of their residency training needs: results of a national survey

Cited by 84 publications

References 15 publications

Discussing resuscitation preferences with patients: Challenges and rewards

Discussing resuscitation preferences with patients: Challenges and rewards

The positive impact of initiation of hospitalist clinician educators

Evolving practice of hospital medicine and its impact on hospital throughput and efficiencies

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