Hospitalists Share Patient Care Tips, Strategies at HM14 Annual RIV Competition

The Hospitalist. 2014 May;2014(05):

May 1, 2014|Breast Cancer ICYMI

“How translatable is it?” Dr. Hunt says, listing off judging criteria. “How applicable is it to the general hospitalist population? Community hospitalists? Academic hospitalists? How will this help them provide better care for their patients, better job satisfaction, better training? Some of the ones that didn’t win are still great ideas.”

Take the project presented by a trio of hospitalists from Rush University Medical Center in Chicago. The poster, “Guidelines, Education, and Email Alerts Can Decrease Transfusions in General Medicine Patients,” explained a project to “increase adherence to a restrictive transfusion guideline for patients admitted to general medicine floors.” The intervention suggested a transfusion threshold of Hgb<7 in upper GI bleed patients, except in cases of hemodynamic instability. In all other indications, the threshold was Hgb<8.

The research found that when samples from three months before the intervention were compared with samples collected three months post-intervention, the number of transfused units dropped to 273 from 481. In the pre-intervention sample, there were 95 units of blood delivered with a pre-transfusion Hgb>8; in the post-intervention group, only 18 units were delivered.

But Rush hospitalist Jisu Kim, MD, FHM, isn’t stopping with a poster. “This is one of the endpoints,” Dr. Kim says. “We want to see how much further we can go. Can this be a publishable paper? What’s the next step for our other projects? We’re getting motivated by it.”

Dr. Kim believes that in addition to sharing information, getting the next generation of physicians involved in the poster competition inspires young physicians to further engage in their specialty. To that end, residents Manya Gupta, MD, and Lesley Schmaltz, MD, say they are grateful to be part of the presentation.

“It’s very rewarding because it makes you want to keep moving forward and keep making those improvements,” says Dr. Schmaltz. “That’s why I think we all do our posters and presentations: to help the greater good of all physicians throughout the country.”

“It’s been a really great learning experience to get your feet wet,” Dr. Gupta says. “You just have to try it out once and find out what it’s like; otherwise it seems so daunting. Then you realize, ‘We can do this.’”

Poster Winners

Research: “Comparative Effectiveness of Hospital-Based Educational Interventions for Patients with Asthma or COPD.” Valerie Press, MD, MPH, University of Chicago Medical Center

Innovations: “The Palliative Care Quality Network: A Quality Improvement Initiative for Palliative Care Services.” Steven Pantilat, MD, University of California at San Francisco

Clinical Vignette, Pediatric: “Why Can’t a Previously Healthy Child Be Weaned Off the Ventilator?” Joanna Parga, MD, Children’s Hospital Los Angeles

Clinical Vignette, Adult: “Abdominal Pain Following

Lap-Sleeve Gastrectomy: A Case of Post-Operative Portal Vein Thrombosis.” Anisha Advani, MD, Brigham and Women’s Hospital, Boston

Research, Trainee: “Pediatric Hospitalist Circumcision Service: Analysis of Rate of Complications.” Corinne Hamvas, MD, Washington University, St. Louis, Mo.

Innovations, Trainee: “Careweb Messenger: A Facebook/Twitter/Paging Hybrid for Collaborative Care.” Lekshmi Santhosh, MD, University of California at San Francisco

Clinical Vignette: A Visitor with a Virus.” Arul Thangavel, MD, University of California at San Francisco

Clinical Vignette: “Crohn’s No Longer: The Importance of Biopsies.” Chirayu Shah, MD, Baylor College of Medicine, Houston

Oral Abstract, Research: “Unintended Consequences of Increasing Pharmacologic Venous Thromboembolic Prophylaxis in Hospitalized Medical Patients.” Scott Kaatz, DO, FACP, FHM, Hurley Medical Center, Flint, Mich.

Oral Abstract, Innovations: “Innovations In Data Visualization To Drive Down Unnecessary Transfusions.” A. R. Rajkomar, MD, University of California at San Francisco