Journal of hospital medicine : an official publication of the Society of Hospital Medicine
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Multicenter Study
Educational impact of using smartphones for clinical communication on general medicine: more global, less local.
Medical trainees increasingly use smartphones in their clinical work. Similar to other information technology implementations, smartphone use can result in unintended consequences. This study aimed to examine the impact of smartphone use for clinical communication on medical trainees' educational experiences. ⋯ We summarized the impact of a rapidly emerging information technology-smartphones-on the educational experience of medical trainees. Smartphone use increase connectedness and allow trainees to be more globally available for patient care but creates interruptions that cause trainees to be less present in their local interactions with staff during teaching sessions. Educators should be aware of these findings and need to develop curriculum to address the negative impacts of smartphone use in the clinical training environment.
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Multicenter Study
Hospitalist experiences, practice, opinions, and knowledge regarding peripherally inserted central catheters: a Michigan survey.
Peripherally inserted central catheters (PICCs) are commonly inserted during hospitalization for a variety of clinical indications. ⋯ Hospitalist experiences, practice, opinions, and knowledge related to PICCs appear to be variable. Because PICC use is growing and is often associated with complications, examining the impact of such variation is necessary. Hospitals and health systems should consider developing and implementing mechanisms to monitor PICC use and adverse events.
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Multicenter Study
Development of a handoff evaluation tool for shift-to-shift physician handoffs: the Handoff CEX.
Increasing frequency of shift-to-shift handoffs coupled with regulatory requirements to evaluate handoff quality make a handoff evaluation tool necessary. ⋯ This handoff evaluation tool was easily used by trainees and attendings, had high internal consistency, and performed similarly across institutions. Because peers consistently provided higher scores than external evaluators, this tool may be most appropriate for external evaluation.
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Multicenter Study
Where do you want to spend your last days of life? Low concordance between preferred and actual site of death among hospitalized adults.
Death in the U.S. frequently occurs in institutions despite the overwhelming majority of persons who state that they prefer to die at home. Little research to date has examined how well individual preferences compare to actual site of death. ⋯ Concordance between preferred and actual site of death is low and female gender was the sole patient level variable associated with concordance.
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Multicenter Study Comparative Study
Pediatric observation status: are we overlooking a growing population in children's hospitals?
Inpatient administrative datasets often exclude observation stays, as observation is considered to be outpatient care. The extent to which this status is applied to pediatric hospitalizations is not known. ⋯ Children admitted under observation status make up a substantial proportion of acute care hospitalizations. Analyses of inpatient administrative databases that exclude observation stays likely result in an underestimation of hospital resource utilization for children.