Journal of hospital medicine : an official publication of the Society of Hospital Medicine
-
Multicenter Study Observational Study
Caring about prognosis: a validation study of the caring criteria to identify hospitalized patients at high risk for death at 1 year.
Identifying patients, at the time of hospital admission, who are at high risk for 1-year mortality is an ideal opportunity to introduce palliative interventions into the hospital care plan. The CARING (C = primary diagnosis of cancer, A = ≥ 2 admissions to the hospital for a chronic illness within the last year; R = resident in a nursing home; I = intensive care unit admission with multiorgan failure, NG = noncancer hospice guidelines [meeting ≥ 2 of the National Hospice and Palliative Care Organization's guidelines] criteria is a practical prognostic index developed and validated in the Veteran's Administration hospital setting that identifies patients at high risk of death within 1 year, although its effectiveness in a broader patient population is unknown. ⋯ The CARING criteria are a practical prognostic tool validated in a broad inpatient population that can be utilized on hospital admission to estimate risk of death in 1 year, with the goal of identifying patients who may benefit most from incorporating palliative interventions into their hospital plan of care. Journal of Hospital Medicine 2013;8:696-701. © 2013 Society of Hospital Medicine.
-
Access to hand-carried ultrasound technology for noncardiologists has increased significantly, yet development and evaluation of training programs are limited. ⋯ After a brief training program, hospitalists acquired adequate skills to perform and interpret hand-carried ultrasound IVC images and retained these skills in the near term. Though calculation of the IVC collapsibility index is more accurate, coupling a qualitative assessment with the IVC maximum diameter measurement may be acceptable in aiding bedside estimation of CVP.
-
Although hospitalists may improve efficiency and quality of inpatient care, their effect on healthcare-worker communication and education has been less well-studied. ⋯ Academic hospitalists working within a systems redesign intervention were able to improve healthcare-worker communication and enhance learner education without increasing patient length of stay or readmission rates.