Academic Track
Key session: “Keys to a Successful Academic Hospitalist Program” presented by Robert M. Wachter, MD, University of California, San Francisco; Brian P. Lucas, MD, MS, Cook County Hospital, Chicago; and Adrienne L. Bennett, MD, PhD, Ohio State University Medical Center, Columbus.
Take-away points: These academic hospitalist leaders stressed research in this session. Research is critical to the success of hospital medicine. You can support research by building research expertise among your staff and creating (or borrowing) an infrastructure for research. Get your entire group involved, with the goal of producing at least two scholarly works a year. Invite other subspecialists and institutions to participate in your research. You also must offer salary support for dedicated scholarship time.
Precourses and clinical sessions offered a variety of real-world solutions to hospital medicine issues.
Quality Track
Key session: “Improving Quality and Safety during Transitions of Care” presented by Eric Coleman, MD, MPH, University of Colorado, Denver; Jeffrey Greenwald, MD, Boston University Medical Campus; Lakshmi Halasyamani, MD, St. Joseph Mercy Medical Center, Ann Arbor, Mich.; and Mark V. Williams, MD, Northwestern University’s Feinberg School of Medicine in Chicago.
Take-away points: Retitled “BOOSTing Care Transitions,” this session focused on problems with discharging patients and outlined Project BOOST: Better Outcomes for Older adults through Safe Transitions. The BOOST toolkit includes resources for identifying high-risk patients; preparation for the patient and caregiver including follow-up plans; and a discharge summary communication. Specific tools include GRATE, a Geriatric Risk Adjusted Transition Evaluation; a 6P Risk Scale to be used on admit and discharge; a Risk Adjusted Checklist; and GAP, Geriatric Assessment of Preparedness for on admit, near discharge and at discharge. The toolkit is available online in the SHM Resource Rooms at www.hospitalmedicine.org.
Pediatric Track
Key session: “Surveys Say … Current Reports on Pediatric Hospitalist Workload and Compensation” presented by Jack Percelay, MD, MPH, FAAP, ELMO Pediatrics, Livingston, N.J., and David Zipes, MD, FAAP, St. Vincent Children’s Hospital, Indianapolis, Ind.
Take-away points: Relevant data from the “Society of Hospital Medicine 2007-08 Survey: The Authoritative Source on the State of the Hospitalist Movement” were reviewed, with many caveats noted as the pediatric portion still is being analyzed. Pediatric hospitalists make less money than their adult-patient counterparts, with a total compensation of $144,600 compared with $183,900. They reported fewer patient encounters and work fewer hours overall. These differences are subject to closer examination. “Is this really a decrease in productivity and the work that we do, or does this reflect the fact that virtually no ‘private practice hospitalists’ responded?” Dr. Percelay asked.
Key session: “Clinical Pathways on a Budget” presented by Steve Narang, MD, Our Lady of the Lake Regional Medical Center, Baton Rouge, La.
Take-away points: To help fill the gap in information on pediatric care, Dr. Narang designed a clinical pathway for admitting an increasing number of pediatric patients with skin and soft-tissue infection (abscess) based on evidence and expert opinion. This pathway was shared with 100 pediatric providers in Louisiana. The results of implementing the pathway in his institution showed a reduction in other, less efficient treatments and tests, a 25% decrease in length of stay for these patients and a 20% decrease in cost—both in three years.