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[PMID]:28459909
[Au] Autor:Theisen-Toupal J; Ronan MV; Moore A; Rosenthal ES
[Ad] Endereço:Medical Service, VA Medical Center, Washington, DC; George Washington University School of Medicine and Health Sciences, Washington, DC; Uniformed Services University of the Health Sciences, Bethesda, MD.
[Ti] Título:Inpatient Management of Opioid Use Disorder: A Review for Hospitalists.
[So] Source:J Hosp Med;12(5):369-374, 2017 May.
[Is] ISSN:1553-5606
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The United States is experiencing an epidemic of nonmedical opioid use and opioid overdose-related deaths. As a result, there have been a number of public health interventions aimed at addressing this epidemic. However, these interventions fail to address care of individuals with opioid use disorder during hospitalizations and, therefore, miss a key opportunity for intervention. The role of hospitalists in managing hospitalized patients with opioid use disorder is not established. In this review, we discuss the inpatient management of individuals with opioid use disorder, including the treatment of withdrawal, benefits of medication-assisted treatment, and application of harm-reduction strategies. Journal of Hospital Medicine 2017;12:369-374.
[Mh] Termos MeSH primário: Gerenciamento Clínico
Medicina Hospitalar/métodos
Médicos Hospitalares
Hospitalização
Transtornos Relacionados ao Uso de Opioides/terapia
Papel do Médico
[Mh] Termos MeSH secundário: Seres Humanos
Transtornos Relacionados ao Uso de Opioides/diagnóstico
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE
[do] DOI:10.12788/jhm.2731


  2 / 1690 MEDLINE  
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[PMID]:28459902
[Au] Autor:Najafi N; Harrison JD; Duong J; Greenberg A; Cheng HQ
[Ad] Endereço:Division of Hospital Medicine, University of California San Francisco, San Francisco, CA.
[Ti] Título:It All Just Clicks: Development of an Inpatient E-Consult Program.
[So] Source:J Hosp Med;12(5):332-334, 2017 May.
[Is] ISSN:1553-5606
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Although the use of electronic consultations (e-consults) in the outpatient setting is commonplace, there is little evidence of their use in the inpatient setting. Often, the only choice hospitalists have is between requesting a time-consuming in-person consultation or requesting an informal, undocumented "curbside" consultation. For a new, remote hospital in our healthcare system, we developed an e-consult protocol that can be used to address simple consultation questions. In the first year of the program, 143 e-consults occurred; the top 5 consultants were infectious disease, hematology, endocrinology, nephrology, and cardiology. Over the first 4 months, no safety issues were identified in chart review audits; to date, no safety issues have been identified through the hospital's incident reporting system. In surveys, hospitalists were universally pleased with the quality of e-consult recommendations, though only 43% of consultantsagreed. With appropriate care for patient selection, e-consults can be used to safely and efficiently provide subspecialty expertise to a remote inpatient site Journal of Hospital Medicine 2017;12:332-334.
[Mh] Termos MeSH primário: Hospitais Universitários/tendências
Desenvolvimento de Programas/métodos
Encaminhamento e Consulta/tendências
Telemedicina/métodos
Telemedicina/tendências
[Mh] Termos MeSH secundário: Medicina Hospitalar/métodos
Medicina Hospitalar/tendências
Médicos Hospitalares/tendências
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE
[do] DOI:10.12788/jhm.2740


  3 / 1690 MEDLINE  
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[PMID]:27776902
[Au] Autor:Chimento GF
[Ad] Endereço:Department of Orthopaedic Surgery, Ochsner Clinic Foundation, New Orleans, Louisiana; Ochsner Clinical School, School of Medicine, The University of Queensland, New Orleans, Louisiana. Electronic address: gchimento@ochsner.org.
[Ti] Título:Reply to Letter to the Editor on 'The Effects of a Hospitalist Comanagement Model for Joint Arthroplasty Patients in a Teaching Facility'.
[So] Source:J Arthroplasty;32(2):698-699, 2017 02.
[Is] ISSN:1532-8406
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Artroplastia
Médicos Hospitalares
[Mh] Termos MeSH secundário: Seres Humanos
Tempo de Internação
[Pt] Tipo de publicação:LETTER; COMMENT
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171225
[Lr] Data última revisão:
171225
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161026
[St] Status:MEDLINE


  4 / 1690 MEDLINE  
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[PMID]:29197305
[Au] Autor:Tan EK; Loh KP; Goff SL
[Ad] Endereço:From the Department of Endocrinology, Diabetes and Metabolism Research Institute, City of Hope National Medical Center, Duarte, California, the Division of Hematology/Oncology, James P. Wilmot Cancer Institute, University of Rochester/Strong Memorial Hospital, Rochester, New York, and the Department of Medicine, Tufts University School of Medicine, Springfield, Massachusetts.
[Ti] Título:Internal Medicine Hospitalists' Perceived Barriers and Recommendations for Optimizing Secondary Prevention of Osteoporotic Hip Fractures.
[So] Source:South Med J;110(12):749-753, 2017 Dec.
[Is] ISSN:1541-8243
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: Osteoporosis is a major public health concern affecting an estimated 10 million people in the United States. To the best of our knowledge, no qualitative study has explored barriers perceived by medicine hospitalists to secondary prevention of osteoporotic hip fractures. We aimed to describe these perceived barriers and recommendations regarding how to optimize secondary prevention of osteoporotic hip fracture. METHODS: In-depth, semistructured interviews were performed with 15 internal medicine hospitalists in a tertiary-care referral medical center. The interviews were analyzed with directed content analysis. RESULTS: Internal medicine hospitalists consider secondary osteoporotic hip fracture prevention as the responsibility of outpatient physicians. Identified barriers were stratified based on themes including physicians' perception, patients' characteristics, risks and benefits of osteoporosis treatment, healthcare delivery system, and patient care transition from the inpatient to the outpatient setting. Some of the recommendations include building an integrated system that involves a multidisciplinary team such as the fracture liaison service, initiating a change to the hospital policy to facilitate inpatient care and management of osteoporosis, and creating a smooth patient care transition to the outpatient setting. CONCLUSIONS: Our study highlighted how internal medicine hospitalists perceive their role in the secondary prevention of osteoporotic hip fractures and what they perceive as barriers to initiating preventive measures in the hospital. Inconsistency in patient care transition and the fragmented nature of the existing healthcare system were identified as major barriers. A fracture liaison service could remove some of these barriers.
[Mh] Termos MeSH primário: Acesso aos Serviços de Saúde/organização & administração
Fraturas do Quadril/prevenção & controle
Médicos Hospitalares/psicologia
Fraturas por Osteoporose/prevenção & controle
Prevenção Secundária/métodos
[Mh] Termos MeSH secundário: Adulto
Feminino
Fraturas do Quadril/psicologia
Seres Humanos
Medicina Interna/métodos
Masculino
Meia-Idade
Fraturas por Osteoporose/psicologia
Equipe de Assistência ao Paciente
Percepção
Pesquisa Qualitativa
Centros de Atenção Terciária
Cuidado Transicional
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171207
[Lr] Data última revisão:
171207
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171203
[St] Status:MEDLINE
[do] DOI:10.14423/SMJ.0000000000000735


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[PMID]:29065023
[Au] Autor:Bowen JL; Ilgen JS; Irby DM; Ten Cate O; O'Brien BC
[Ad] Endereço:J.L. Bowen is professor, Department of Medicine, Oregon Health & Science University, Portland, Oregon. J.S. Ilgen is associate professor, Division of Emergency Medicine, Department of Medicine, and associate director, Center for Leadership & Innovation in Medical Education, University of Washington, School of Medicine, Seattle, Washington. D.M. Irby is professor, Department of Medicine, University of California, San Francisco, San Francisco, California. O. ten Cate is professor, Center for Research and Development of Education, University Medical Center Utrecht, Utrecht, the Netherlands, and adjunct professor, Department of Medicine, University of California, San Francisco, San Francisco, California. B.C. O'Brien is associate professor, Department of Medicine, University of California, San Francisco, San Francisco, California.
[Ti] Título:"You Have to Know the End of the Story": Motivations to Follow Up After Transitions of Clinical Responsibility.
[So] Source:Acad Med;92(11S Association of American Medical Colleges Learn Serve Lead: Proceedings of the 56th Annual Research in Medical Education Sessions):S48-S54, 2017 Nov.
[Is] ISSN:1938-808X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Physicians routinely transition responsibility for patient care to other physicians. When transitions of responsibility occur before the clinical outcome is known, physicians may lose opportunities to learn from the consequences of their decision making. Sometimes curiosity about patients does not end with the transition and physicians continue to follow them. This study explores physicians' motivations to follow up after transitioning responsibilities. METHOD: Using a constructivist grounded theory approach, the authors conducted 18 semistructured interviews in 2016 with internal medicine hospitalist and resident physicians at a single tertiary care academic medical center. Constant comparative methods guided the qualitative analysis, using motivation theories as sensitizing constructs. RESULTS: The authors identified themes that characterized participants' motivations to follow up. Curiosity about patients' outcomes determined whether or not follow-up occurred. Insufficient curiosity about predictable clinical problems resulted in the choice to forgo follow-up. Sufficient curiosity due to clinical uncertainty, personal attachment to patients, and/or concern for patient vulnerability motivated follow-up to fulfill goals of knowledge building and professionalism. The authors interpret these findings through the lenses of expectancy-value (EVT) and self-determination (SDT) theories of motivation. CONCLUSIONS: Participants' curiosity about what happened to their patients motivated them to follow up. EVT may explain how participants made choices in time-pressured work settings. SDT may help interpret how follow-up fulfills needs of relatedness. These findings add to a growing body of literature endorsing learning environments that consider task-value trade-offs and support basic psychological needs of autonomy, competency, and relatedness to motivate learning.
[Mh] Termos MeSH primário: Assistência ao Convalescente
Médicos Hospitalares
Medicina Interna/educação
Internato e Residência
Corpo Clínico Hospitalar
Motivação
Transferência de Pacientes
[Mh] Termos MeSH secundário: Feminino
Teoria Fundamentada
Seres Humanos
Masculino
Pesquisa Qualitativa
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171030
[Lr] Data última revisão:
171030
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171025
[St] Status:MEDLINE
[do] DOI:10.1097/ACM.0000000000001919


  6 / 1690 MEDLINE  
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[PMID]:28783766
[Au] Autor:Hickner J
[Ad] Endereço:The Journal of Family Practice, Editor-in-Chief.
[Ti] Título:Getting it right at the end of life.
[So] Source:J Fam Pract;66(8):486, 2017 Aug.
[Is] ISSN:1533-7294
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:As medical care has become more sophisticated, there is a great deal more we can do to keep people alive as they approach the end of life, and a great many more decisions to be made. Additionally, people are much less likely today to be cared for in their dying days by a family physician who knows them, their wishes, and their family well. Now, most dying hospitalized patients are cared for by hospitalists who may be meeting the patient for the first time.
[Mh] Termos MeSH primário: Empatia
Médicos Hospitalares/normas
Cuidados Paliativos/normas
Relações Médico-Paciente
Assistência Terminal/normas
Doente Terminal
[Mh] Termos MeSH secundário: Idoso
Aconselhamento
Seres Humanos
Consentimento Livre e Esclarecido
Assistência Terminal/métodos
[Pt] Tipo de publicação:EDITORIAL
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170904
[Lr] Data última revisão:
170904
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170808
[St] Status:MEDLINE


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[PMID]:28707548
[Au] Autor:Bryson C; Boynton G; Stepczynski A; Garb J; Kleppel R; Irani F; Natanasabapathy S; Stefan MS
[Ad] Endereço:a Department of Medicine, Division of Hospital Medicine , Baystate Medical Center , Springfield , MA , USA.
[Ti] Título:Geographical assignment of hospitalists in an urban teaching hospital: feasibility and impact on efficiency and provider satisfaction.
[So] Source:Hosp Pract (1995);45(4):135-142, 2017 Oct.
[Is] ISSN:2154-8331
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To evaluate whether implementation of a geographic model of assigning hospitalists is feasible and sustainable in a large hospitalist program and assess its impact on provider satisfaction, perceived efficiency and patient outcomes. METHODS: Pre (3 months) - post (12 months) intervention study conducted from June 2014 through September 2015 at a tertiary care medical center with a large hospitalist program caring for patients scattered in 4 buildings and 16 floors. Hospitalists were assigned to a particular nursing unit (geographic assignment) with a goal of having over 80% of their assigned patients located on their assigned unit. Satisfaction and perceived efficiency were assessed through a survey administered before and after the intervention. RESULTS: Geographic assignment percentage increased from an average of 60% in the pre-intervention period to 93% post-intervention. The number of hospitalists covering a 32 bed unit decreased from 8-10 pre to 2-3 post-intervention. A majority of physicians (87%) thought that geography had a positive impact on the overall quality of care. Respondents reported that they felt that geography increased time spent with patient/caregivers to discuss plan of care (p < 0.001); improved communication with nurses (p = 0.0009); and increased sense of teamwork with nurses/case managers (p < 0.001). Mean length of stay (4.54 vs 4.62 days), 30-day readmission rates (16.0% vs 16.6%) and patient satisfaction (79.9 vs 77.3) did not change significantly between the pre- and post-implementation period. The discharge before noon rate improved slightly (47.5% - 54.1%). CONCLUSIONS: Implementation of a unit-based model in a large hospitalist program is feasible and sustainable with appropriate planning and support. The geographical model of care increased provider satisfaction and perceived efficiency; it also facilitated the implementation of other key interventions such as interdisciplinary rounds.
[Mh] Termos MeSH primário: Atitude do Pessoal de Saúde
Médicos Hospitalares/organização & administração
Avaliação de Processos e Resultados (Cuidados de Saúde)
Equipe de Assistência ao Paciente/organização & administração
Satisfação do Paciente
Centros de Atenção Terciária/organização & administração
[Mh] Termos MeSH secundário: Eficiência Organizacional
Unidades Hospitalares/recursos humanos
Unidades Hospitalares/organização & administração
Médicos Hospitalares/psicologia
Hospitais de Ensino/recursos humanos
Hospitais de Ensino/organização & administração
Seres Humanos
Relações Interprofissionais
Satisfação no Emprego
Tempo de Internação/estatística & dados numéricos
Massachusetts
Modelos Organizacionais
Readmissão do Paciente/normas
Readmissão do Paciente/tendências
Admissão e Escalonamento de Pessoal/organização & administração
Centros de Atenção Terciária/recursos humanos
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171003
[Lr] Data última revisão:
171003
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170715
[St] Status:MEDLINE
[do] DOI:10.1080/21548331.2017.1353884


  8 / 1690 MEDLINE  
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[PMID]:28701436
[Au] Autor:Yousefi V
[Ad] Endereço:Vancouver, BC.
[Ti] Título:Hospitalists reduce harm and improve care for hospitalized patients.
[So] Source:Can Fam Physician;63(7):510-511, 2017 07.
[Is] ISSN:1715-5258
[Cp] País de publicação:Canada
[La] Idioma:eng
[Mh] Termos MeSH primário: Médicos Hospitalares
Pacientes
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:LETTER; COMMENT
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170811
[Lr] Data última revisão:
170811
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170714
[St] Status:MEDLINE


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[PMID]:28615389
[Au] Autor:Doré M
[Ad] Endereço:Guelph, Ont.
[Ti] Título:Hospitalists and family physicians.
[So] Source:Can Fam Physician;63(6):429, 2017 06.
[Is] ISSN:1715-5258
[Cp] País de publicação:Canada
[La] Idioma:eng
[Mh] Termos MeSH primário: Médicos Hospitalares
Médicos de Família
[Mh] Termos MeSH secundário: Medicina de Família e Comunidade
Seres Humanos
Qualidade da Assistência à Saúde
[Pt] Tipo de publicação:LETTER; COMMENT
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170811
[Lr] Data última revisão:
170811
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170616
[St] Status:MEDLINE


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[PMID]:28407994
[Au] Autor:Hatz MH; Sonnenschein T; Blankart CR
[Ad] Endereço:Hamburg Center for Health Economics, Universität Hamburg, Hamburg, Germany.
[Ti] Título:The PMA Scale: A Measure of Physicians' Motivation to Adopt Medical Devices.
[So] Source:Value Health;20(4):533-541, 2017 Apr.
[Is] ISSN:1524-4733
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Studies have often stated that individual-level determinants are important drivers for the adoption of medical devices. Empirical evidence supporting this claim is, however, scarce. At the individual level, physicians' adoption motivation was often considered important in the context of adoption decisions, but a clear notion of its dimensions and corresponding measurement scales is not available. OBJECTIVES: To develop and subsequently validate a scale to measure the motivation to adopt medical devices of hospital-based physicians. METHODS: The development and validation of the physician-motivation-adoption (PMA) scale were based on a literature search, internal expert meetings, a pilot study with physicians, and a three-stage online survey. The data collected in the online survey were analyzed using exploratory factor analysis (EFA), and the PMA scale was revised according to the results. Confirmatory factor analysis (CFA) was conducted to test the results from the EFA in the third stage. Reliability and validity tests and subgroup analyses were also conducted. RESULTS: Overall, 457 questionnaires were completed by medical personnel of the National Health Service England. The EFA favored a six-factor solution to appropriately describe physicians' motivation. The CFA confirmed the results from the EFA. Our tests indicated good reliability and validity of the PMA scale. CONCLUSIONS: This is the first reliable and valid scale to measure physicians' adoption motivation. Future adoption studies assessing the individual level should include the PMA scale to obtain more information about the role of physicians' motivation in the broader adoption context.
[Mh] Termos MeSH primário: Atitude do Pessoal de Saúde
Comportamento de Escolha
Equipamentos e Provisões
Conhecimentos, Atitudes e Prática em Saúde
Médicos Hospitalares/psicologia
Motivação
Inquéritos e Questionários
[Mh] Termos MeSH secundário: Adulto
Idoso
Cognição
Inglaterra
Equipamentos e Provisões/efeitos adversos
Análise Fatorial
Feminino
Seres Humanos
Masculino
Meia-Idade
Segurança do Paciente
Papel do Médico
Projetos Piloto
Padrões de Prática Médica
Reprodutibilidade dos Testes
Medição de Risco
Medicina Estatal
[Pt] Tipo de publicação:JOURNAL ARTICLE; VALIDATION STUDIES
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170424
[Lr] Data última revisão:
170424
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170415
[St] Status:MEDLINE



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