Journal of hospital medicine : an official publication of the Society of Hospital Medicine
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Characterizing electronic messaging use among hospitalists and its association with patient volumes.
Secure electronic messaging is increasingly being utilized for communications in healthcare settings. While it likely increases efficiency, it has also been associated with interruptions, high message volumes, and risk of errors due to multitasking. ⋯ Secure messaging volumes may be higher than previously reported, which may affect hospitalist workload and workflow and have unintended effects on interruptions, multitasking, and medical errors. Additional work should be done to better understand local messaging patterns and opportunities to optimize volume of work and distractions.
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Hospital readmission rates are used for quality and pay-for-performance initiatives. To identify readmissions from administrative data, two commonly employed methods are focusing either on unplanned readmissions (used by the Centers for Medicare & Medicaid Services, CMS) or potentially avoidable readmissions (used by commercial vendors such as SQLape or 3 M). However, it is not known which of these methods has higher criterion validity and can more accurately identify actually avoidable readmissions. ⋯ Thus, the CMS method has both higher criterion validity and greater sensitivity for identifying actually avoidable readmissions, compared with the SQLape method. Consequently, the CMS method should primarily be used for quality initiatives.
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Text messaging has emerged as a popular strategy to engage patients after hospital discharge. Little is known about how patients use these programs and what types of needs are addressed through this approach. ⋯ The needs identified via an automated texting program were concentrated in three areas relevant to primary care practice and within nursing scope of practice. This program can serve as a model for health systems looking to support transitions through an operationally efficient approach, and the findings of this analysis can inform future iterations of this type of program.
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Burnout and lagging academic productivity are pressing challenges in hospital medicine, leading to stagnation and attrition. Mentoring shapes professional identity formation and enhances faculty vitality and retention, but has not been optimized among academic hospitalists. ⋯ Mentoring fosters academic thriving and retention in academic hospitalists. Access to effective mentoring remains lacking due to few senior mentors in the relatively new field of hospital medicine and reticence in academic identity, among other factors. Mentoring training, impact on underrepresented minority hospitalists, and integration into institutional culture should be considered for enhancing the career development of academic hospitalists.