Journal of hospital medicine : an official publication of the Society of Hospital Medicine
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Editorial Comment
Surgical Comanagement for Hip Fracture: Time for a Randomized Trial.
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Rarely, if ever, does a national healthcare system experience such rapid and marked change as that seen with the COVID-19 pandemic. In March 2020, the president of the United States declared a national health emergency, enabling the Department of Health & Human Services authority to grant temporary regulatory waivers to facilitate efficient care delivery in a variety of healthcare settings. ⋯ This so-called Three Midnight Rule, dating back to the 1960s as part of the Social Security Act, is being scrutinized more than half a century later given the rise in observation hospital stays. Despite the tragic emergency circumstances prompting waivers, the Centers for Medicare & Medicaid Services and Congress now have a unique opportunity to evaluate potential improvements revealed by COVID-19 regulatory relief and should consider permanent reform of the Three Midnight Rule.
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Hip fractures are a significant cause of morbidity and mortality among elderly patients. Coordinated multidisciplinary care is required to optimize medical outcomes. ⋯ An Integrated Fragility Hip Fracture Program using multidisciplinary care, physician and nursing engagement, evidence-based protocols, data tracking with feedback, and accountability can reduce mortality and improve clinical outcomes in patients with hip fractures.
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Authors of clinical reasoning exercises analyze diagnostic dilemmas and serve as role models of clinical excellence. We investigated the percentage of women authors in the clinical problem-solving series of three general medicine journals from the inaugural article in each series until July 2019. ⋯ While the percentage of women among first and all authors has increased, women still constituted <40% of all authors and ≤25% of last authors, and there have been no significant increases in women last authors in any of the three journals. Including more women in clinical reasoning exercises is an opportunity to amplify the voices of women as master clinicians.