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Patel V, Keniston A, McBeth L, Arogyaswamy S, Callister C, Dayton K, Mistry N, Mann S, Burden M. Impact of Clinical Demands on the Educational Mission in Hospital Medicine at 17 Academic Medical Centers : A Qualitative Analysis. Ann Intern Med 2023; 176:1526-1535. [PMID: 37956429 DOI: 10.7326/m23-1497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Clinical growth is outpacing the growth of traditional educational opportunities at academic medical centers (AMCs). OBJECTIVE To understand the impact of clinical growth on the educational mission for academic hospitalists. DESIGN Qualitative study using semistructured interviews that were analyzed using a mixed inductive and deductive method at the semantic level. SETTING Large AMCs across the United States that experienced clinical growth in the past 5 years. PARTICIPANTS Division heads, section heads, and other hospital medicine (HM) leaders who oversaw and guided academic and clinical efforts of HM programs. MEASUREMENTS Themes and subthemes. RESULTS From September 2021 to January 2022, HM leaders from 17 AMCs participated in the interviews, and 3 key themes emerged. First, AMCs' disproportionate clinical growth highlighted the tension between clinical and educational missions. This included a mismatch in supply and demand for traditional teaching time, competing priorities, and clinical growth being seen as both an opportunity and a threat. Second, amid the shifting landscape of high clinical demands and evolving educational opportunities, hospitalists still strongly prefer traditional teaching. To address this mismatch, HM groups have had to alter recruitment strategies and create innovative solutions to help build academic careers. Third, participants noted a need to reimagine the role and identity of an academic hospitalist, emphasizing tailored career pathways and educational roles spanning well beyond traditional house staff teaching teams. LIMITATION The study focused on large AMCs. CONCLUSION Although HM groups have implemented many creative strategies to address clinical growth and keep education front and center, challenges remain, particularly heavy clinical workloads and a continued dilution of traditional teaching opportunities. PRIMARY FUNDING SOURCE Society of Hospital Medicine Student Scholar Grant.
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Affiliation(s)
- Vishruti Patel
- University of Colorado School of Medicine, Aurora, Colorado (V.P.)
| | - Angela Keniston
- Division of Hospital Medicine, University of Colorado School of Medicine, Aurora, Colorado (A.K., L.M., C.C., K.D., N.M., S.M., M.B.)
| | - Lauren McBeth
- Division of Hospital Medicine, University of Colorado School of Medicine, Aurora, Colorado (A.K., L.M., C.C., K.D., N.M., S.M., M.B.)
| | - Sagarika Arogyaswamy
- California University of Science and Medicine School of Medicine, and Department of Psychiatry, Arrowhead Regional Medical Center, Colton, California (S.A.)
| | - Catherine Callister
- Division of Hospital Medicine, University of Colorado School of Medicine, Aurora, Colorado (A.K., L.M., C.C., K.D., N.M., S.M., M.B.)
| | - Khooshbu Dayton
- Division of Hospital Medicine, University of Colorado School of Medicine, Aurora, Colorado (A.K., L.M., C.C., K.D., N.M., S.M., M.B.)
| | - Neelam Mistry
- Division of Hospital Medicine, University of Colorado School of Medicine, Aurora, Colorado (A.K., L.M., C.C., K.D., N.M., S.M., M.B.)
| | - Sarah Mann
- Division of Hospital Medicine, University of Colorado School of Medicine, Aurora, Colorado (A.K., L.M., C.C., K.D., N.M., S.M., M.B.)
| | - Marisha Burden
- Division of Hospital Medicine, University of Colorado School of Medicine, Aurora, Colorado (A.K., L.M., C.C., K.D., N.M., S.M., M.B.)
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Kennedy K, Briggs H, Tuck M. Finding your niche as a generalist: A niche is not your identity. J Hosp Med 2023; 18:274-277. [PMID: 36573402 DOI: 10.1002/jhm.13036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 12/13/2022] [Accepted: 12/14/2022] [Indexed: 12/28/2022]
Affiliation(s)
- Kierstin Kennedy
- Hospital Medicine, University of Alabama, Birmingham, Alabama, USA
| | - Heather Briggs
- Division of Hospital Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Matthew Tuck
- Medical Service, VA Medical Center, Washington, District of Columbia, USA
- Department of Medicine, George Washington University, Washington, District of Columbia, USA
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Watari T, Nakano Y, Gupta A, Kakehi M, Tokonami A, Tokuda Y. Research Trends and Impact Factor on PubMed Among General Medicine Physicians in Japan: A Cross-Sectional Bibliometric Analysis. Int J Gen Med 2022; 15:7277-7285. [PMID: 36133913 PMCID: PMC9483137 DOI: 10.2147/ijgm.s378662] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 09/01/2022] [Indexed: 11/26/2022] Open
Abstract
Background Japan created a specialty system for general medicine in 2018. However, Japanese academic generalists’ contribution to research remains unclear. This study examines the popularity of Japanese general medicine research, the characteristics of journal publications, annual trends, and the characteristics/differences among publications in journals with an impact factor (IF). Methods This bibliometric analysis extracted international, English-language, journal articles published on PubMed between January 1, 2015, and December 31, 2020. Analysis included articles with either the first, second, or last author in general medicine. We classified articles according to publication or article type and field of research. We obtained standard descriptive statistics for each publication type. Chi-squared test or Fisher’s exact test was used to compare nominal variables. For continuous variables, t-tests or Wilcoxon rank-sum tests were used, as appropriate. Results Of the 2372 articles analyzed, original articles were most common (56.3%), followed by case reports (30.1%), reviews (7.63%), and letters/others (5.9%). Publication volume increased 2.64-fold annually over 5 years. Clinical research (60.5%) was most common among original articles, followed by basic experimental research (17.5%) and public health/epidemiology (12.7%). Medical quality and safety (4.1%), medical and clinical education (3.1%), and health services (1.42%) received comparatively little attention. Eighty percent of articles were published in journals with IF; however, these journals rarely published case reports. Among original articles, the likelihood of publishing in journals with IF was high for basic laboratory medicine articles with higher IF (median IF 3.83, OR 1.71, 95% CI 2.20–5.95, p=0.044) and lower for clinical education research with the lowest IF (median IF 1.83, OR 0.56, 95% CI 01.8–0.75, p<0.001). Discussion General medicine physicians’ international research output is increasing in Japan; however, research achievements have not been generalized, but rather much influenced by clinical subspecialty backgrounds. This will likely continue unless an academic generalist discipline is established.
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Affiliation(s)
- Takashi Watari
- General Medicine Center, Shimane University Hospital, Izumo, Shimane, Japan
- Department of Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
- Medicine Service, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
- Correspondence: Takashi Watari, Shimane University Hospital, General Medicine Center, 89-1, Enya-cho, Izumo, Shimane, 693-8501, Japan, Tel +81-853-20-2005, Fax +81-853-20-2375, Email
| | - Yasuhisa Nakano
- Faculty of Medicine, Shimane University, Izumo, Shimane, Japan
| | - Ashwin Gupta
- Department of Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
- Medicine Service, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
| | - Minami Kakehi
- Faculty of Medicine, Shimane University, Izumo, Shimane, Japan
| | - Ayuko Tokonami
- Faculty of Medicine, Shimane University, Izumo, Shimane, Japan
| | - Yasuharu Tokuda
- Muribushi Okinawa Clinical Training Center, Urasoe, Okinawa, Japan
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Tago M, Hirata R, Watari T, Shikino K, Sasaki Y, Takahashi H, Shimizu T. Future Research in General Medicine Has Diverse Topics and is Highly Promising: Opinions Based on a Questionnaire Survey. Int J Gen Med 2022; 15:6381-6386. [PMID: 35942291 PMCID: PMC9356371 DOI: 10.2147/ijgm.s369856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 07/12/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Masaki Tago
- Department of General Medicine, Saga University Hospital, Saga, Japan
- Correspondence: Masaki Tago, Department of General Medicine, Saga University Hospital, 5-1-1 Nabeshima, Saga, 849-8501, Japan, Tel +81 952 34 3238, Fax +81 952 34 2029, Email
| | - Risa Hirata
- Department of General Medicine, Saga University Hospital, Saga, Japan
| | - Takashi Watari
- General Medicine Center, Shimane University Hospital, Shimane, Japan
| | - Kiyoshi Shikino
- Department of General Medicine, Chiba University Hospital, Chiba, Japan
| | - Yosuke Sasaki
- Department of General Medicine and Emergency Care, Toho University School of Medicine, Tokyo, Japan
| | - Hiromizu Takahashi
- Department of General Medicine, Faculty of Medicine, Juntendo University, Tokyo, Japan
| | - Taro Shimizu
- Department of Diagnostic and Generalist Medicine, Dokkyo Medical University, Tochigi, Japan
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Elias RM, Fischer KM, Coons T, Kashiwagi D. Successful recruitment and retention of academic physicians: hiring for longevity, productivity, and leadership in hospital medicine. Hosp Pract (1995) 2022; 50:42-48. [PMID: 34933645 DOI: 10.1080/21548331.2021.2022329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Considerable resources are expended by hospitals to recruit and retain physicians that will be successful. Healthcare managers lack data to guide these decisions. In that vacuum, suppositions regarding what attributes contribute to physician success predominate. OBJECTIVES To evaluate the relationship between candidate factors known at the time of hiring and subsequent longevity and success of physicians in an academic division of hospital internal medicine. RESEARCH DESIGN A retrospective review of all physicians hired in an academic hospital internal medicine division. Measures of longevity, research productivity, academic promotion and division leadership roles were compared to personal and professional characteristics at the time of hiring. Success was quantified in those four domains and associations explored for between success and hiring factors. RESULTS Female physicians had greater longevity at the institution. Physicians from the hospital region were no more likely to stay long-term as compared to those from other regions. United States medical graduates were more likely to attain leadership positions than international graduates. There was an inverse relationship between research productivity and administrative leadership. CONCLUSIONS Factors commonly sought by academic healthcare institutions were not associated with long term success in academic hospital medicine. Less research productivity was associated with greater divisional leadership involvement, suggesting that scholarship and administrative leadership may represent separate tracks for physicians at academic institutions.
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Affiliation(s)
- Richard M Elias
- Division of Hospital Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Karen M Fischer
- Health Sciences Research Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Mn, USA
| | - Trevor Coons
- Division of Hospital Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Deanne Kashiwagi
- Division of Hospital Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, USA
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Hod R, Maimon O, Zimlichman E. Measuring the academic value of academic medical centers: describing a methodology for developing an evaluation model at one Academic Medical Center. Isr J Health Policy Res 2019; 8:65. [PMID: 31383017 PMCID: PMC6681484 DOI: 10.1186/s13584-019-0334-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 07/28/2019] [Indexed: 11/20/2022] Open
Abstract
Background Academic Medical Centers (AMCs) must simultaneously serve different purposes: Delivery of high quality healthcare services to patients, as the main mission, supported by other core missions such as academic activities, i.e., researching, teaching and tutoring, while maintaining solvency. This study aims to develop a methodology for constructing models evaluating the academic value provided by AMCs and implementing it at the largest AMC in Israel. Methods Thirty five practiced educators and researchers, academic experts, faculty members and executives, all employed by a metropolitan 1500-bed AMC, were involved in developing academic quality indicators. First, an initial list of AMCs’ academic quality indicators was drafted, using a literature review and consulting scholars. Afterwards, additional data and preferences were collected by conducting semi-structured interviews, complemented by a three-round Delphi Panel. Finally, the methodology for constructing a model evaluating the academic value provided by the AMC was developed. Results The composite academic quality indicators methodology consists of nine indicators (relative weight in parentheses): ‘Scientific Publications Value’ (18.7%), ‘Completed Studies’ (13.5%), ‘Authors Value’ (13.0%), ‘Residents Quality’ (11.3%), ‘Competitive Grants Budget’ (10.2%), ‘Academic Training’ (8.7%), ‘Academic Positions’ (8.3%), ‘Number of Studies’ (8.3%) and ‘Academic Supervision’ (8.0%). These indicators were grouped into three core categories: ‘Education’, ‘Research’ and ‘Publications’, having almost the same importance on a scale from zero to one (0–1), i.e., 0.363, 0.320, and 0.317, respectively. The results demonstrated a high level of internal consistency (Cronbach-alpha range: 0.79–0.86). Conclusions We have found a gap in the ability to measure academic value provided by AMCs. The main contribution of this research is the development of methodology for constructing evaluation models for AMCs academic performance. Further studies are needed to further test the validity and reliability of the proposed methodology at other sites. Electronic supplementary material The online version of this article (10.1186/s13584-019-0334-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Rafael Hod
- Chaim Sheba Medical Center, Tel-Hashomer, 5265601, Ramat Gan, Israel. .,Department of Industrial Engineering at The Iby and Aladar Fleischman Faculty of Engineering, Tel Aviv University, 6997801, Tel Aviv, Israel.
| | - Oded Maimon
- Department of Industrial Engineering at The Iby and Aladar Fleischman Faculty of Engineering, Tel Aviv University, 6997801, Tel Aviv, Israel
| | - Eyal Zimlichman
- Chaim Sheba Medical Center, Tel-Hashomer, 5265601, Ramat Gan, Israel.,The Sackler Faculty of Medicine, Tel Aviv University, 6997801, Tel Aviv, Israel
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Abolbashari S, Moonaghi HK, Bazzaz MM. Medical faculties' view about the importance of educational roles. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2018; 9:417-422. [PMID: 29922104 PMCID: PMC5995282 DOI: 10.2147/amep.s163218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND Changes in medical education have drawn attention to student-based learning. It is necessary that teachers' educational roles be redefined to conform to these changes. While numerous educational activities are listed for medical teachers, it seems that they involve themselves in only some of these roles. We conducted this study to assess the importance of different educational roles in the view of medical faculties. METHODS A questionnaire that consisted of a total of 12 roles classified into six categories including information provider, role model, facilitator, examiner, planner, and resource developer was prepared. Faculty members were asked to score the importance of each role using a 1-10 scale. RESULTS Participants assigned the highest score to "on-the-job role model" (9.47) and the lowest score to "curriculum planner" (8.31) from their own point of view. They also assigned the highest score to "planning or participating in student exams" (8.10) and the lowest score to "learning facilitator" (6.51) from the perspective of the importance of roles in their school's programs. CONCLUSION Faculty members are generally familiar with different educational roles but they need to be informed about some of the roles which have gained lower scores in this study.
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Affiliation(s)
- Samaneh Abolbashari
- Department of Medical Education, Medical Faculty, Mashhad University of Medical Sciences, Mashhad, Iran
- Students Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hossein Karimi Moonaghi
- Evidence – Based Caring Research Center, Department of Medical Surgical Nursing, School of Nursing and Midwifery
- Department of Medical Education, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mojtaba Mousavi Bazzaz
- Department of Community Medicine, Medical Faculty, Mashhad University of Medical Sciences, Mashhad, Iran
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Cumbler E, Rendón P, Yirdaw E, Kneeland P, Pierce R, Jones CD, Herzke C. Keys to career success: resources and barriers identified by early career academic hospitalists. J Gen Intern Med 2018; 33:588-589. [PMID: 29423628 PMCID: PMC5910353 DOI: 10.1007/s11606-018-4336-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Ethan Cumbler
- University of Colorado School of Medicine, Aurora, CO, USA.
| | | | - Essey Yirdaw
- University of Colorado School of Medicine, Aurora, CO, USA
| | | | - Read Pierce
- University of Colorado School of Medicine, Aurora, CO, USA
| | | | - Carrie Herzke
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Auerbach AD. The next 20 years of hospital medicine: Continuing to foster the mind, heart, and soul of our field. J Hosp Med 2016; 11:892-893. [PMID: 27373963 DOI: 10.1002/jhm.2631] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Accepted: 06/03/2016] [Indexed: 11/11/2022]
Affiliation(s)
- Andrew D Auerbach
- Department of Medicine, UCSF School of Medicine, San Francisco, California
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Mookherjee S, Monash B, Wentworth KL, Sharpe BA. Faculty development for hospitalists: structured peer observation of teaching. J Hosp Med 2014; 9:244-50. [PMID: 24446215 DOI: 10.1002/jhm.2151] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Revised: 12/13/2013] [Accepted: 12/22/2013] [Indexed: 11/09/2022]
Abstract
BACKGROUND Hospitalists provide much of the clinical teaching in internal medicine, yet formative feedback to improve their teaching is rare. METHODS We developed a peer observation, assessment, and feedback program to improve attending hospitalist teaching. Participants were trained to identify 10 optimal teaching behaviors using a structured observation tool that was developed from the validated Stanford Faculty Development Program clinical teaching framework. Participants joined year-long feedback dyads and engaged in peer observation and feedback on teaching. Pre- and post-program surveys assessed confidence in teaching, performance of teaching behaviors, confidence in giving and receiving feedback, attitudes toward peer observation, and overall satisfaction with the program. RESULTS Twenty-two attending hospitalists participated, averaging 2.2 years (± 2.1 years standard deviation [SD]) experience; 15 (68%) completed pre- and post-program surveys. Confidence in giving feedback, receiving feedback, and teaching efficacy increased (1 = strongly disagree, 5 = strongly agree, mean ± SD): "I can accurately assess my colleagues' teaching skills," (pre = 3.2 ± 0.9 vs post = 4.1 ± 0.6, P < 0.01), "I can give accurate feedback to my colleagues" (pre = 3.4 ± 0.6 vs post = 4.2 ± 0.6, P < 0.01), and "I am confident in my ability to teach students and residents" (pre = 3.2 ± 0.9 vs post = 3.7 ± 0.8, P = 0.026). CONCLUSIONS Peer observation and feedback of teaching increases hospitalist confidence in several domains that are essential for optimizing teaching. Further studies are needed to examine if educational outcomes are improved by this program.
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Affiliation(s)
- Somnath Mookherjee
- Department of Medicine, Division of General Internal Medicine, University of Washington, Seattle, Seattle, Washington
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Taylor BB, Parekh V, Estrada CA, Schleyer A, Sharpe B. Documenting quality improvement and patient safety efforts: the quality portfolio. A statement from the academic hospitalist taskforce. J Gen Intern Med 2014; 29:214-8. [PMID: 23807726 PMCID: PMC3889978 DOI: 10.1007/s11606-013-2532-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2013] [Revised: 06/04/2013] [Accepted: 06/10/2013] [Indexed: 11/30/2022]
Abstract
Physicians increasingly investigate, work, and teach to improve the quality of care and safety of care delivery. The Society of General Internal Medicine Academic Hospitalist Task Force sought to develop a practical tool, the quality portfolio, to systematically document quality and safety achievements. The quality portfolio was vetted with internal and external stakeholders including national leaders in academic medicine. The portfolio was refined for implementation to include an outlined framework, detailed instructions for use and an example to guide users. The portfolio has eight categories including: (1) a faculty narrative, (2) leadership and administrative activities, (3) project activities, (4) education and curricula, (5) research and scholarship, (6) honors, awards, and recognition, (7) training and certification, and (8) an appendix. The authors offer this comprehensive, yet practical tool as a method to document quality and safety activities. It is relevant for physicians across disciplines and institutions and may be useful as a standalone document or as an adjunct to traditional promotion documents. As the Next Accreditation System is implemented, academic medical centers will require faculty who can teach and implement the systems-based practice requirements. The quality portfolio is a method to document quality improvement and safety activities.
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Affiliation(s)
- Benjamin B Taylor
- University of Alabama at Birmingham and Birmingham Veterans Affairs Quality Scholars Program, Birmingham, AL, USA
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Paciorkowski N, Pruitt C, Lashly D, Hrach C, Harrison E, Srinivasan M, Turmelle M, Carlson D. Development of performance tracking for a pediatric hospitalist division. Hosp Pediatr 2013; 3:118-128. [PMID: 24340412 DOI: 10.1542/hpeds.2012-0064] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVES Our goal was to develop a comprehensive performance tracking process for a large pediatric hospitalist division. We aimed to use established dimensions and theory of health care quality to identify measures relevant to common inpatient diagnoses, reflective of current standards of clinical care, and applicable to individual physician performance. We also sought to implement a reproducible data collection strategy that minimizes manual data collection and measurement bias. METHODS Washington University Division of Pediatric Hospital Medicine provides clinical care in 17 units within 3 different hospitals. Hospitalist services were grouped into 5 areas, and a task group was created of divisional leaders representing clinical services. The group was educated on the health care quality theory and tasked to search clinical practice standards and quality resources. The groups proposed a broad spectrum of performance questions that were screened for electronic data availability and modified into measurable formulas. RESULTS Eighty-seven performance questions were identified and analyzed for their alignment with known clinical guidelines and value in measuring performance. Questions were distributed across quality domains, with most addressing safety. They reflected structure, outcome, and, most commonly, process. Forty-seven questions were disease specific, and 79 questions reflected individual physician performance; 52 questions had electronically available data. CONCLUSIONS We describe a systematic approach to the development of performance indicators for a pediatric hospitalist division that can be used to measure performance on a division and physician level. We outline steps to develop a broad-spectrum quality tracking process to standardize clinical care and build invaluable resources for quality improvement research.
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Affiliation(s)
- Natalia Paciorkowski
- Washington University, St Louis School of Medicine, Department of Pediatrics, Division of Hospitalist Medicine, St Louis, Missouri 63110, USA
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Leykum LK, Parekh VI, Sharpe B, Boonyasai RT, Centor RM. Tried and true: a survey of successfully promoted academic hospitalists. J Hosp Med 2011; 6:411-5. [PMID: 21916004 DOI: 10.1002/jhm.894] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Academic hospital medicine is a new and rapidly growing field. Hospitalist faculty members often fill roles not typically held by other academic faculty, maintain heavy clinical workloads, and participate in nontraditional activities. Because of these differences, there is concern about how academic hospitalists may fare in the promotions process. OBJECTIVE To determine factors critical to the promotion of successfully promoted hospitalists who have achieved the rank of either associate professor or professor. DESIGN A cross-sectional survey. PARTICIPANTS Thirty-three hospitalist faculty members at 22 academic medical centers promoted to associate professor rank or higher between 1995 and 2008. MEASUREMENTS Respondents were asked to describe their institution, its promotions process, and the activities contributing to their promotion. We identified trends across respondents. RESULTS Twenty-six hospitalists responded, representing 20 institutions (79% response rate). Most achieved promotion in a nontenure track (70%); an equal number identified themselves as clinician-administrators and clinician educators (40%). While hospitalists were engaged in a wide range of activities in the traditional domains of service, education, and research, respondents considered peer-reviewed publication to be the most important activity in achieving promotion. Qualitative responses demonstrated little evidence that being a hospitalist was viewed as a hindrance to promotion. CONCLUSIONS Successful promotion in academic hospital medicine depends on accomplishment in traditional academic domains, raising potential concerns for academic hospitalists with less traditional roles. This study may provide guidance for early-career academic hospitalists and program leaders.
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Affiliation(s)
- Luci K Leykum
- Department of Medicine, South Texas Veterans Health Care System, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA.
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Abstract
OBJECTIVE To assess the current state of research productivity, goals, obstacles, and needs of pediatric hospitalists. METHODS The American Academy of Pediatrics Section on Hospital Medicine performed a cross-sectional online survey of pediatric hospitalists. Questions assessed demographics, research productivity, system-level factors, research interests, goals and obstacles, and the perceived need for research training and support. RESULTS Two hundred twenty pediatric hospitalists in the United States completed the survey. Of these, 56% had presented at a national meeting, 24% were first authors of an article in a peer-reviewed journal, 8% had more than publications, and 12% had secured external grant support. While 90% of respondents had spent 10% or less time in research, 64% had an academic appointment at the assistant professor level or above. Nearly 40% felt that their institution expected them to do research, and 56% were interested and another 27% were very interested in conducting research. The main research interest was quality improvement (QI) evaluation. Common obstacles to research were lack of time, mentorship, and resources. CONCLUSIONS Pediatric hospitalists want to conduct research to improve the quality of inpatient care but face significant obstacles including lack of dedicated time for research and mentorship. Coordinated efforts to improve access to academic resources are important for career development and academic growth of the field. National organizations and hospital programs interested in improving the quality of care for hospitalized children can provide support to meet the field's professional needs for research.
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Affiliation(s)
- Arpi Bekmezian
- Department of Pediatrics, University of California, San Francisco, CA
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