Journal of hospital medicine : an official publication of the Society of Hospital Medicine
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Comparative Study
A national comparison of burnout and work-life balance among internal medicine hospitalists and outpatient general internists.
General internists suffer higher rates of burnout and lower satisfaction with work-life balance than most specialties, but the impact of inpatient vs outpatient practice location is unclear. ⋯ Burnout was common among both hospitalists and outpatient general internists, although hospitalists were more satisfied with work-life balance. A better understanding of the causes of distress and identification of solutions for all internists is needed.
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Medical supervisors struggle to find meaningful ways to evaluate the preparedness of trainees to independently perform patient care tasks. The aim of this study was to describe the factors that influence how attending and resident physician perceptions of trust impact decision making. ⋯ Factors influencing trust in a trainee are related to the supervisor, trainee, their relationship, task, and the environment. Attending physicians note early interactions and language cues as markers of trustworthiness. Attending physicians reported using perceived confidence as a gauge of the trainee's true ability and comfort. Attendings noted trainee absences, even those that comply with regulation, negatively affected willingness to entrust. Future studies are needed to develop better assessment instruments to understand how entrustment decisions for independent practice are made.
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Geographic localization of physicians to patient care units may improve communication, decrease interruptions, and reduce resident workload. This study examines whether interns on geographically localized patient care units receive fewer pages than those on teams that are not. ⋯ Geographic localization of resident teams to patient care units was associated with significantly fewer pages received by interns during the day. Such patient care models may improve resident workload in part by decreasing pages, and consequently has important implications for patient safety and medical education.
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Multicenter Study Observational Study
Prevalence and characteristics of hospitalized adults on chronic opioid therapy.
As chronic opioid therapy (COT) becomes more common, complexity of pain management in the inpatient setting increases; little is known about medical inpatients on COT. ⋯ COT is common among medical inpatients. Patients on COT differ from patients without COT beyond dissimilarities in pain and cancer diagnoses. Occasional and chronic opioid use are associated with increased risk of hospital readmission, and COT is associated with increased risk of death. Additional research relating COT to hospitalization outcomes is warranted.