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Hospitalist Leadership Connection

This e-mail newsletter focuses on hospitalist management issues. Look for it each week to bring you regulatory news, research, hot topics, and long-term trends in the field of inpatient care.

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Hospitalist Leadership Connection

Issue 51, December 26, 2007

• Hospitalist effectiveness studies change focus

  In a December 20 editorial published in The New England Journal of Medicine, Laurence F. McMahon...

• Results are in on largest study of hospitalist benefits

  A study examining the outcome of care provided to hospitalized patients by various physician...

• FL may abandon plan to send emergency patients to closest specialist

  Palm Beach county, FL, has spent two years developing a plan to divert any emergency patients who...

Issue 50, December 19, 2007

• AMA supports industry shift on physician performance measurement

  The American Medical Association (AMA) released a statement this week favoring improved initiatives...

• Take the wait out of waiting room

  Patients don't always have patience in a waiting room, but now, thanks to Robin Zee, a nurse from...

• Physicians know ethics but don't always practice professionalism

  A recent survey in the Dec. 4 issue of the Annals of Internal Medicine, shows that of the more than...

Issue 49, December 12, 2007

• AHRQ releases toolkits to help prevent medical errors

  Patient safety experts from the Agency for Healthcare Research and Quality (AHRQ) have developed 17...

• Study shows elderly ER visits could double over next five years

  A new study published in the Annals of Emergency Medicine says that between 1993 and 2003...

• CMS could identify inefficient physicians by mid-2008

  The Center for Medicare & Medicaid Services (CMS) may have the ability to identify and target...

Issue 48, November 28, 2007

• Identify hospitalist program ROI factors

  On October 31, Robert Bessler, MD, president and CEO of Sound InPatient Physicians joined Leslie...

• Leadership responsibility: Acting on competency data

  As hospitalists take on medical staff leadership roles and get involved in monitoring physician...

• Study finds children's hospitals benefit from rapid response teams

  Children's hospitals with a rapid response team (RRT) can reduce the rates of patient deaths, heart...

Issue 47, November 21, 2007

• Use physicians on staff as mentors

  When it comes to teaching new hospitalists what they need to know to succeed in your organization...

• Call for abstracts

  Abstracts are now being accepted for the Society of Hospital Medicine’s 2008 "Research...

• Plan early to retain staff

  One of the reasons hospitalist programs may fail is due to an inability to retain quality...

Issue 46, November 14, 2007

• Joint Commission and AHRQ release special report

  The Agency for Healthcare Research and Quality (AHRQ) and The Joint Commission released findings...

• Does your hospitalist program have the right staffing, scheduling, and planning it takes to succeed?

  Developing a hospitalist schedule is a unique process for each program. It is based on the...

• An unhealthy trend

  The future of physician services could be heading for a path of higher spending and declining...

Issue 45, November 6, 2007

• SHM launches annual hospitalist survey

  The Society of Hospital Medicine’s (SHM) has launched its bi-annual ’Survey on the...

• Beware of roadblocks for evaluating hospitalist program’s performance

  The successful design and implementation of a performance feedback system requires time, energy...

• Strengthen your discharge planning process

  Running an efficient hospitalist discharge process can positively affect clinical outcomes and...

• SHM launches annual hospitalist survey

  The Society of Hospital Medicine’s (SHM) has launched its bi-annual ’Survey on the...

• Strengthen your discharge planning process

  Running an efficient hospitalist discharge process can positively affect clinical outcomes and...

Issue 44, October 31, 2007

• Premier survey shows hospitals see HAIs as serious threat

  Tracking healthcare associated infections throughout the hospital is the most challenging infection...

• Running a successful hospitalist program

  Forming a successful hospitalist program, or running an existing one, requires a significant amount...

• Pediatric pre-and post-surgery care in the spotlight

  An October 22 article in Physician’s Weekly placed the spotlight on the importance of...

Issue 43, October 24, 2007

• Effective transition at hospital discharge

  An October 12 article published in The Journal of Hospital Medicine put the spotlight on the...

• Go beyond the average recruitment process

  Hospitalist candidates undoubtedly are focused on exploring the job-related characteristics of...

• Competition among hospitalists heats up

  As the field of hospitalists grows, so does the competition, according to an October article...

Issue 42, October 17, 2007

• Keep job descriptions current to ensure successful recruitment, retention

  Today’s rapidly changing healthcare environment mandates that job descriptions and on-the-job...

• Physician organizations cry foul over Medicare payment decrease

  An October 22 American Medical News (AMNews) article reported that Medicare premiums for outpatient...

• Conflict management for hospitalists

  Effective communication is essential to the success of any hospitalist program-and the professional...

Issue 41, October 10, 2007

• Understand and overcome language, cultural barriers

  Understand and overcome language, cultural barriersLanguage barriers are not just frustrating for...

• FDA considers new non-prescription category of drugs

  The Food and Drug Administration (FDA) said it may create a new category of drugs that would be...

• Malpractice cap leads more physicians to relocate to Texas

  An October 5 New York Times article placed the spotlight on the recent influx of physicians to the...

• What should not trigger a fair hearing?

  Dear medical staff leader: Last month we talked about the actions that should trigger a fair...

Issue 40, October 2, 2007

• Study: Number, cost of U.S. hospital infections on the rise

  A new study of inpatient data from United States hospitals found that the number of infections...

• Retention starts in the job interview

  You might be surprise to learn that the retention process actually begins during a hospitalist...

• Patience satisfaction key to hospitalist program success

  Some medical experts are concerned that patients will not accept hospitalists. However, current...

Issue 39, September 26, 2007

• Hospitalist care leads to faster patient discharge

  The Medpage Today reported September 24 on research that found that inpatients under the care of...

• Marketing outreach for starting and expanding a hospitalist program

  Although inpatient medicine is in its second decade, many patients and their families have not yet...

• Hospitalist shortage? Family practice physicians may meet your staffing needs and bring new skills

  Any director of a growing hospitalist practice knows how hard it is to find adequately qualified...

Issue 38, September 19, 2007

• An in-depth look at hospitalists in the U.S.

  A September 11 article in The Washington Post examined the recent growth in the hospital medicine...

• Communication between hospitalist and primary care physician suboptimal

  With the increase in the number of hospitalists, the transfer of patient information to primary...

• New York City puts hospital error data online

  The New York City Health and Hospitals Corporation, the nation’s largest public health...

Issue 37, September 11, 2007

• Researchers identify new risk factor for DVT

  Britain’s Journal of Thrombosis and Haemostasis recently published the results of a...

• Patient communication: How to use your words

  Do patients understand what your hospitalists tell them? A recent report found that nearly half of...

• Hospitalist company goes public

  IPC The Hospitalist Co., a patient-care company based in North Hollywood, CA, recently filed for an...

Issue 36, September 5, 2007

• Number of formal hospitalist comanagement programs growing

  Developing a program whereby hospitalists comanage surgical patients can add value to your...

• MDs sometimes discount complaints of side effects

  A recent survey of 650 patients published in the August issue of Drug Safety shows that a majority...

• Study: Physicians shifting into specialty practices

  The proportion of U.S. physicians in solo or dual practices during 1996 to 2005 dropped by 20...

Issue 35, August 29, 2007

• Researchers urge decrease in use of beta-blockers

  Researchers are urging physicians to use alternatives to beta-blockers for patient treatments...

• MI hospitals opt to list procedure prices online

  Beginning in January 2008, Michigan’s nonprofit hospitals will list the prices for various...

• Hospitalist company starts psychiatric hospitalist program

  A North Hollywood, CA-based hospitalist company has established a psychiatric hospitalist program...

Issue 34, August 22, 2007

• IN hospital collaboration improves patient safety

  The six hospitals of the Indianapolis Coalition for Patient Safety have seen improvements in key...

• Physician behavior: praise in public, chastise in private

  When expressing appreciation for physicians who have demonstrated behavior you want to encourage...

• ABIM approves formal credential for hospitalists

  According to a Society of Hospital Medicine breaking news alert dated August 2, the American Board...

Issue 33, August 15, 2007

• Hospitals strategize to increase patient volume

  Increasing efficiency, a top item on every hospital administrator's agenda, can only go so far...

• Specialty clinics affect hospitals' business

  Physician-owned facilities that offer medical services (e.g., radiology and outpatient surgery...

• SHM announces new quality improvement award

  The Society of Hospital Medicine (SHM) announced that, beginning in 2008, it will present the Team...

Issue 32, August 8, 2007

• Physicians recruited from abroad face screening hurdles

  Because rural areas are hard-hit by physician shortages, more hospitals in underserved areas...

• Ask the Expert

  Q: For a subsequent day, we occasionally see instances where both a nurse practitioner (NP) and a...

• As more hospitals publicize MD data, accuracy problems arise

  While insurance companies, regulators, the general public, and hospitals more closely scrutinize...

Issue 31, August 1, 2007

• Correction to last week's Ask the Expert feature

  Q: If a nurse practitioner does not have discharge privileges but has done the discharge summary...

• Protect your facility in the face of disaster

  With the devastation of Hurricane Katrina still fresh in our minds and a new hurricane season upon...

• Patient outcomes best in hospitals ranked highest in quality

  A new study finds that hospitals with the best quality rankings experience the fewest patient...

Issue 30, July 25, 2007

• Ask the Expert

  Q: If a nurse practitioner performed a history and physical (H&P) or completed the discharge...

• Technology helps San Antonio hospitals reduce IV medication errors

  Nurses and medical staff at Christus Santa Rosa Hospital in San Antonio, TX, are using computerized...

• Report examines rise of hospitalists in CA

  The California HealthCare Foundation (CHCF), an independent organization dedicated to improving...

Issue 29, July 18, 2007

• Use of

  According to a July 11 article in The Wall Street Journal, many large academic medical centers are...

• Grant to help NJ hospitals improve quality of care

  The Healthcare Foundation of New Jersey awarded a $125,000 grant to the New Jersey Hospital Quality...

• Leading hospitalist joins Google's health advisory council

  Robert Wachter, MD, a professor of medicine at the University of California at San Francisco and...

Issue 28, July 11, 2007

• Managing risk helps hospitalists protect patients, their programs

  As a young specialty, hospital medicine hasn't had the same exposure to malpractice issues that...

• Palliative care programs help patients, lower costs

  Palliative care programs, which incorporate some aspects of the hospice philosophy while continuing...

• Best practices in discharge planning aid customer service, market share

  Pricing and quality transparency are now buzzwords with long-reaching financial implications for...

Issue 27, July 4, 2007

• The Joint Commission announces new National Patient Safety Goals

  Healthcare organizations will face one new National Patient Safety Goal (NPSG) in 2008 that...

• Government grades hospitals' heart care

  A new government report grades hospitals for their ability to care for heart patients. The report...

• PA acts on legislation targeting hospital infections

  The Pennsylvania House and Senate acted on separate legislation to reduce the number of potentially...

Issue 26, June 27, 2007

• Hospitals look for ways to align with MDs

  Physicians and hospital administrators historically have clashed over a variety of factors, often...

• Avoid coding pitfalls to receive proper reimbursement

  Mention coding to just about any physician and the response will likely be a groan. It is a task...

• 2007-2008 SHM president takes office

  Russell Holman, MD, has taken office as the president of the Society of Hospital Medicine (SHM) for...

Issue 25, June 20, 2007

• Focus on supplemental compensation when recruiting physicians

  Developing a compensation package that will attract physicians to your facility involves more than...

• AHRQ lists statistics of hospitalized patients with mental health disorders

  The Agency for Healthcare Research and Quality (AHRQ) found that almost 7.6 million adult hospital...

• Physicians question CMS' "pay for reporting" program

  It hasn’t even started yet, but some physicians are already questioning the long-term...

Issue 24, June 13, 2007

• Causes of disruptive physician behavior

  Few institutions have adopted clear, written expectations of physician behavior. However, many are...

• Hospitals must re-examine their operating models

  Many hospitals are at a breaking point with regard to their financial health. Even with stable or...

Issue 23, June 6, 2007

• Survey: MDs say patient flow affects quality of care

  Physician leaders say that one of the most pervasive problems affecting quality of care is patient...

• Don't forget CEO input in the MD and nursing supply debate

  When it comes to physician supply, healthcare policy analysts and academics are divided into two...

• Internists demand right to review quality ratings

  The American College of Physicians (ACP) adopted a set of principles at its April annual meeting...

Issue 22, May 30, 2007

• CMS to post hospitals' heart-related death rates

  The Centers for Medicare and Medicaid Services (CMS) has announced that it will begin posting broad...

• Proposed Joint Commission revisions available for feedback

  The Joint Commission has posted the proposed revisions to the Infection Control standards chapter...

• Hospital networks develop standardized patient safety practices

  Wellmont, Novant, and Adventist Health systems have started the Safest Hospital Alliance, an...

Issue 21, May 23, 2007

• Competition causes revenue decline for hospital-affiliated MDs

  Physicians and hospitals traditionally have had symbiotic, if strained, relationships. But market...

• Strategies for leading a hospitalist program

  Often, hospitalist program directors, sometimes simply called lead hospitalists, are selected for...

• Hospitals increase service options to better serve patients

  In many parts of the country, hospitals are striving to maintain a competitive edge by offering...

Issue 20, May 16, 2007

• Survey: physicians cite obstacles to improving patient safety

  A recent survey conducted by the American College of Physician Executives (ACPE) uncovered hurdles...

• SHM marks National Stroke Awareness Month

  Hospitalists are becoming the primary and often sole providers of hospital care for stroke...

• When hand antiseptics won't cut it

  They’re less drying than soap and water, but hand sanitizers cannot kill three main...

Issue 19, May 9, 2007

• Articles examine medication reconciliation, patient handoffs

  Separate articles in the May issue of Academic Emergency Medicine examine medication reconciliation...

• MDs often choose where patients will have surgery

  A national survey of 500 Medicare patients found that in nearly a third of cases, physicians were...

• Study: Hospital vaccination programs are cost effective

  A study published in the February 9 issue of Vaccine found that standing order programs (SOPs) are...

Issue 18, May 2, 2007

• Hospitals improve care in 2006, but patient complaints persist

  Patient satisfaction with hospitals nationwide increased in 2006, according to a survey released...

• More MDs teaching patients about lifestyle choices

  A growing movement encouraging physicians to inform patients about the importance of lifestyle...

• Creating an ideal discharge process

  Most hospitalists agree that the time immediately after discharge is one of the most vulnerable for...

Issue 17, April 25, 2007

• MDs often fail to consider patients' out-of-pocket fees

  Only four in 10 physicians routinely consider their patients out-of-pocket costs when they...

• Can a consult by a hospitalist at admission suffice as an H&P

  Q: In some cases, PCPs affiliated with our facility who use hospitalists only for night coverage...

• UConn hospital staffers use good catches to prevent errors

  Staff members at John Dempsey Hospital at the University of Connecticut (UConn) use a "good catch...

Issue 16, April 18, 2007

• CMS moves toward full severity-adjusted DRG system

  In its proposed rule updating the hospital inpatient prospective payment system (IPPS) for fiscal...

• Hospital test results often sent to PCP's office too late

  An April 10 article in The Washington Post reports on findings that roughly 85% of patients visit...

• Consider these methods to improve patient flow

  A recent survey conducted by the American College of Emergency Physicians (ACEP) and...

Issue 15, April 11, 2007

• Discharge data delays lead to safety concerns in UK

  A National Health Service (NHS) survey shows that hospitals in the United Kingdom are not sending...

• Study: 250,000 preventable deaths occurred in 2003-2005

  A new HealthGrades study shows that there were 247,662 potentially preventable deaths in U.S...

• CEO: Hospitals must hire own physicians

  Because fewer physicians are interested in setting up private practices, hospitals are being...

Issue 14, April 4, 2007

• Hospitalist company moves headquarters to Nashville

  Irvine, CA-based Cogent Healthcare, one of the nation's largest hospitalist companies, plans to...

• Physician extenders ease MD shortages

  Nurse practitioners (NPs) and physician assistants (PAs) may be the answer to the physician...

• MD authors detail the deficiencies of medicine

  Two new books are part of a trend of physicians who detail for the public the deficiencies of...

Issue 13, March 28, 2007

• Q&A: Are there any independent methods to judge a physician's efficiency?

  A: On March 6, 2007, the director of healthcare for the Government Accountability Office (GAO...

• Learning to juggle key to physician satisfaction

  Ask hospitalists what bothers them most at their job, and you're likely to hear a different answer...

• Joint Commission releases hospital quality performance report

  The Joint Commission has released a new report tracking patient safety and quality performance...

Issue 12, March 21, 2007

• MDs, hospitalized patients define medical errors differently

  The March 2007 issue of Hospitalist Management Advisor, published by HCPro, reports on study...

• System speeds hospital capacity checks

  A new program in Rhode Island enables emergency workers to instantly track patient capacity at...

• Article provides tips for hospitalist job-seekers

  An article in the March 2007 issue of Today's Hospitalist says that while hospitalists now enjoy...

Issue 11, March 14, 2007

• Physicians should not shy away from making recommendations

  A column in the March 5 Boston Globe hails today's patient-centered decision-making process in...

• Hire specialists to expand your hospitalist program

  An article in the March issue of Hospitalist Program Weekly, published by HCPro Inc., focuses on...

• The business case for hospital case management

  A feature co-authored by a hospital case management consultant and a physician published in...

Issue 10, March 7, 2007

• MA hospitals react to data publication challenge

  Hospitals in Boston say they will not make central-line infection data publicly available until the...

• Article portrays a day in the life of a hospital

  A Boston Globe article on February 25 portrayed a day in the life of a typical hospital, focusing...

• Use hospitalists for evidence-based treatment of MI patients

  A recent "Tip of the Week" published by HCPro’s Hospitalist Management Advisor states that...

Issue 9, February 28, 2007

• Proposed 2008 budget forebodes Medicare cuts

  A breaking news alert from the Society of Hospital Medicine (SHM) on February 8 reported that...

• More hospitals welcome technology

  According to an article in the February 18 Chicago Tribune, today’s hospitals increasingly...

Issue 8, February 21, 2007

• MDs’ values affect treatment recommendations

  study published in the February 8 issue of the New England Journal of Medicine found that a...

• Many seniors flout physicians’ orders

  A study published in the January 2007 issue of the Journal of General Internal Medicine asserts...

Issue 7, February 14, 2007

• Family medicine-trained hospitalists battle bias

  An article in the February issue of Hospitalist Management Advisor addresses the issue of bias...

• Survey uncovers MDs, patients biggest complaints

  A February 3 article in The Washington Post discusses a survey of 39,000 patients and 335 primary...

• Physicians cite civic issues important to them

  A study of 1,662 physicians published in the November 22, 2006 issue of the Journal of the American...

Issue 6, February 7, 2007

• Palliative care treats more than physical symptoms

  An article in the January 29 issue of Physician’s Weekly offers tips for improving palliative...

• SHM campaign targets acute heart failure

  The Society of Hospital Medicine (SHM) reported in its February e-newsletter the launch of a...

• Initiative aims to avoid deaths due to poor handwriting

  Physicians’ sloppy handwriting on prescriptions has long been a safety concern, and was even...

Issue 5, January 26, 2007

• Three steps to setting up a security risk assessment

  Although the Health Insurance Portability and Accountability Act of 1996 (HIPAA) requires that...

• Phone consults with the ED expedites admissions

  An innovative process used at Johns Hopkins Bayview Medical Center in Baltimore connects emergency...

• Web Site offers non-pharmaceutical-sponsored CME

  Staff members at Georgetown University School of Medicine launched a Web site called PharmedOut...

• Many factors affect MD-patient relationship

  In a perspective piece in the January 23 New York Times, one physician ruminates about how changes...

Issue 4, January 24, 2007

• Web site provides MD-only forum for drug info

  A new, free Web site called Sermo (www.sermo.com) provides a forum for physicians to discuss...

• Hospital medicine field continues to grow

  A January 10 article in The Cincinnati Enquirer reported on the proliferation of hospitalists...

• Unpaid hospital bills mount as more uninsured seek care

  The volume of unpaid bills is increasing at Minnesota hospitals as more uninsured patients seek...

Issue 3, January 17, 2007

• Clearly define PAs’, NPs’ roles in your hospitalist program

  Physician assistants (PA) or nurse practitioners (NP) can ease hospitalists' chronically heavy...

• State targets hospital-acquired infections

  Massachusetts state officials plan to scrutinize hospital-acquired infections to lower their...

Issue 2, January 10, 2007

• CMS bonus for reporting quality data raises concern

  Congress passed a measure on December 8, 2006 that gives a 1.5% pay increase to physicians who...

• Simple measures cut hospital infections

  Basic steps by healthcare practitioners, such as hand washing and removing catheters in a timely...

• Checklist focuses on discharge of elderly

  An article in the November/December 2006 issue of The Journal of Hospital Medicine outlines a...

Issue 1, January 3, 2007

• Communication essential to hospitalist model

  Many clinicians now recognize that hospitalists can better attend to the needs of their inpatients...

• Pay system must be simple, flexible

  The best compensation plans for hospitalists are simple and flexible according to an article in the...

• Pay system must be simple, flexible

  The best compensation plans for hospitalists are simple and flexible according to an article in the...

• Pay system must be simple, flexible

  The best compensation plans for hospitalists are simple and flexible according to an article in the...