scholarly journals Hospitalists as Triagists: Description of the Triagist Role across Academic Medical Centers

2019 ◽  
pp. 87-90
Author(s):  
Sadie Trammel Velasquez ◽  
Emily S Wang ◽  
Andrew A White ◽  
Jagriti Chadha ◽  
Michael Mader ◽  
...  
Keyword(s):  
Electronic Communication ◽  
Academic Medical Centers ◽  
Inpatient Service ◽  
Advanced Practice ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Medical Centers ◽  
Academic Medical ◽  
Communication Practices ◽  
Similarities And Differences

From the hospitalist perspective, triaging involves the evaluation of a patient for potential admission to an inpatient service. Although traditionally done by residents, many academic hospitalist groups have assumed the responsibility for triaging. We conducted a cross-sectional survey of 235 adult hospitalists at 10 academic medical centers (AMCs) to describe the similarities and differences in the triagist role and assess the activities and skills associated with the role. Eight AMCs have a defined triagist role; at the others, hospitalists supervise residents/advanced practice providers. The triagist role is generally filled by a faculty physician and shared by all hospitalists. We found significant variability in verbal communication practices (P = .02) and electronic communication practices (P < .0001) between the triagist and the current provider (eg, emergency department, clinic provider), and in the percentage of patients evaluated in person (P < .0001). Communication skills, personal efficiency, and systems knowledge are dominant themes of attributes of an effective triagist.

scholarly journals Pattern of Frequent But Nontargeted Pharmacologic Thromboprophylaxis for Hospitalized Patients With Cancer at Academic Medical Centers: A Prospective, Cross-Sectional, Multicenter Study

2014 ◽  
Vol 32 (17) ◽  
pp. 1792-1796 ◽  
Author(s):  
Jeffrey I. Zwicker ◽  
Adam Rojan ◽  
Federico Campigotto ◽  
Nadia Rehman ◽  
Renee Funches ◽  
...  
Keyword(s):  
High Risk ◽  
Scoring System ◽  
Hospitalized Patients ◽  
Academic Medical Centers ◽  
Cross Sectional ◽  
Patients With Cancer ◽  
Medical Centers ◽  
Academic Medical ◽  
Pharmacologic Thromboprophylaxis ◽  
To Receive

Purpose Hospitalized patients with cancer are considered to be at high risk for venous thromboembolism (VTE). Despite strong recommendations in numerous clinical practice guidelines, retrospective studies have shown that pharmacologic thromboprophylaxis is underutilized in hospitalized patients with cancer. Patients and Methods We conducted a prospective, cross-sectional study of hospitalized patients with cancer at five academic hospitals to determine prescription rates of thromboprophylaxis and factors influencing its use during hospitalization. Results A total of 775 patients with cancer were enrolled across five academic medical centers. Two hundred forty-seven patients (31.9%) had relative contraindications to pharmacologic prophylaxis. Accounting for contraindications to anticoagulation, the overall rate of pharmacologic thromboprophylaxis was 74.2% (95% CI, 70.4% to 78.0%; 392 of 528 patients). Among the patients with cancer without contraindications for anticoagulation, individuals hospitalized with nonhematologic malignancies were significantly more likely to receive pharmacologic thromboprophylaxis than those with hematologic malignancies (odds ratio [OR], 2.34; 95% CI, 1.43 to 3.82; P = .007). Patients with cancer admitted for cancer therapy were significantly less likely to receive pharmacologic thromboprophylaxis than those admitted for other reasons (OR, 0.37; 95% CI, 0.22 to 0.61; P < .001). Sixty-three percent of patients with cancer classified as low risk, as determined by the Padua Scoring System, received anticoagulant thromboprophylaxis. Among the 136 patients who did not receive anticoagulation, 58.8% were considered to be high risk by the Padua Scoring System. Conclusion We conclude that pharmacologic thromboprophylaxis is frequently administered to hospitalized patients with cancer but that nearly one third of patients are considered to have relative contraindications for prophylactic anticoagulation. Pharmacologic thromboprophylaxis in hospitalized patients with cancer is commonly prescribed without regard to the presence or absence of concomitant risk factors for VTE.

scholarly journals 2540. Targeting ID Education for Advanced Practice Providers: A Growing Learning Group in Academic Medical Centers

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S883-S883
Author(s):  
Matthew S L Lee ◽  
Wendy Stead
Keyword(s):  
Patient Care ◽  
Educational Intervention ◽  
Educational Background ◽  
Educational Opportunities ◽  
Academic Medical Centers ◽  
Online Video ◽  
Advanced Practice ◽  
Post Intervention ◽  
Medical Centers ◽  
Academic Medical

Abstract Background Advanced Practice Providers (APPs), including nurse practitioners (NPs) and physician assistants (PAs), increasingly provide patient care in inpatient settings at academic medical centers. However, little is known about their medical education. We sought to describe current APP educational experiences at our institution and to implement and evaluate an educational intervention aimed at decreasing inappropriate antimicrobial use for asymptomatic bacteriuria (ASB) amongst this group. Methods 33 inpatient-based APPs participated in the educational intervention consisting of in-person sessions and an online video reviewing diagnosis and management of ASB. Pre- and post-intervention surveys assessed knowledge before and after the intervention. Surveys also assessed APP’s educational background, opportunities, and barriers. Results 17 APPs completed the pre-intervention survey. 59% estimated less than 10 hours of antimicrobial education during their training. 88% reported that the majority of their current learning is independent. All APPs reported desiring more educational opportunities. 76% felt current opportunities are designed for medical students or housestaff. Commonly reported barriers included patient care, rounding obligations, and lack of protected time. 8 APPs attended the in-person sessions and there were 21 views of the online video. 10 APPs completed the post-intervention survey. All reported interest in similar sessions in the future. 70% planned to prescribe fewer antimicrobials for ASB; however, the same number also reported “Attending or fellow decision” as the main barrier to decreasing prescriptions. Mean knowledge scores significantly increased after the intervention from 2.5 to 4.125 (P < 0.05). Conclusion APPs within an academic medical center have unique educational backgrounds and needs. APPs identified current educational opportunities as student/resident directed and incompatible with their work schedules. More APPs utilized the video session than attended in-person lectures. This intervention improved immediate knowledge acquisition; however, retention and impact on clinical outcomes are still being evaluated. Disclosures All authors: No reported disclosures.

scholarly journals Publication and reporting of clinical trial results: cross sectional analysis across academic medical centers

BMJ ◽  
2016 ◽  
pp. i637 ◽  
Author(s):  
Ruijun Chen ◽  
Nihar R Desai ◽  
Joseph S Ross ◽  
Weiwei Zhang ◽  
Katherine H Chau ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Academic Medical Centers ◽  
Cross Sectional ◽  
Cross Sectional Analysis ◽  
Medical Centers ◽  
Academic Medical ◽  
Clinical Trial Results ◽  
Sectional Analysis

scholarly journals Hospital Ward Adaptation During the COVID-19 Pandemic: A National Survey of Academic Medical Centers

2020 ◽  
Vol 15 (8) ◽  
pp. 483-488 ◽  
Author(s):  
Andrew Auerbach ◽  
Kevin J O'Leary ◽  
S Ryan Greysen ◽  
James D Harrison ◽  
Sunil Kripalani ◽  
...  
Keyword(s):  
Hospital Medicine ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Medical Centers ◽  
Use Of Technology ◽  
Academic Medical ◽  
Critical Approaches ◽  
Medical Wards ◽  
Or Team ◽  
Team Types

IMPORTANCE: Although intensive care unit (ICU) adaptations to the coronavirus disease of 2019 (COVID-19) pandemic have received substantial attention , most patients hospitalized with COVID-19 have been in general medical units. OBJECTIVE: To characterize inpatient adaptations to care for non-ICU COVID-19 patients. DESIGN: Cross-sectional survey. SETTING: A network of 72 hospital medicine groups at US academic centers. MAIN OUTCOME MEASURES: COVID-19 testing, approaches to personal protective equipment (PPE), and features of respiratory isolation units (RIUs). RESULTS: Fifty-one of 72 sites responded (71%) between April 3 and April 5, 2020. At the time of our survey, only 15 (30%) reported COVID-19 test results being available in less than 6 hours. Half of sites with PPE data available reported PPE stockpiles of 2 weeks or less. Nearly all sites (90%) reported implementation of RIUs. RIUs primarily utilized attending physicians, with few incorporating residents and none incorporating students. Isolation and room-entry policies focused on grouping care activities and utilizing technology (such as video visits) to communicate with and evaluate patients. The vast majority of sites reported decreases in frequency of in-room encounters across provider or team types. Forty-six percent of respondents reported initially unrecognized non–COVID-19 diagnoses in patients admitted for COVID-19 evaluation; a similar number reported delayed identification of COVID-19 in patients admitted for other reasons. CONCLUSION: The COVID-19 pandemic has required medical wards to rapidly adapt with expanding use of RIUs and use of technology emerging as critical approaches. Reports of unrecognized or delayed diagnoses highlight how such adaptations may produce potential adverse effects on care. Journal of Hospital Medicine 2020;15:XXXXXX. © 2020 Society of Hospital Medicine

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