hospital medicine

Hospitals and health systems face several economic and logistical challenges due to low rates of flu vaccination. Fortunately, there are policies, programs, and initiatives that can be implemented in health system environments and at the community level to increase flu vaccination rates. Learn more with Drs. Darvin Scott Smith and John Russell. Dr. Smith is an Infectious Disease Consultant of Public Health Works, LLC in Northern California, and Dr. Russell is a family medicine physician at Jefferson Health System in Abington, Pennsylvania.

Hospitals and health systems face several economic and logistical challenges due to low rates of flu vaccination. Fortunately, there are policies, programs, and initiatives that can be implemented in health system environments and at the community level to increase flu vaccination rates. Learn more with Drs. Darvin Scott Smith and John Russell. Dr. Smith is an Infectious Disease Consultant of Public Health Works, LLC in Northern California, and Dr. Russell is a family medicine physician at Jefferson Health System in Abington, Pennsylvania.

Influenza can increase the risk of hospitalization and disease severity, specifically for high-risk patients. Fortunately, the influenza vaccine can help combat this. Join Dr. Natalia Castillo Almeida, an Assistant Professor in the Division of Infectious Diseases at the University of Nebraska School of Medicine, as she shares key data on hospitalization rates and recommendations for vaccination.

Influenza can increase the risk of hospitalization and disease severity, specifically for high-risk patients. Fortunately, the influenza vaccine can help combat this. Join Dr. Natalia Castillo Almeida, an Assistant Professor in the Division of Infectious Diseases at the University of Nebraska School of Medicine, as she shares key data on hospitalization rates and recommendations for vaccination.

Influenza can increase the risk of hospitalization and disease severity, specifically for high-risk patients. Fortunately, the influenza vaccine can help combat this. Join Dr. Natalia Castillo Almeida, an Assistant Professor in the Division of Infectious Diseases at the University of Nebraska School of Medicine, as she shares key data on hospitalization rates and recommendations for vaccination.

The burden of malnutrition across the globe is very high, with hospitals and care teams being directly impacted. Here with Dr. Mary Katherine Cheeley to share what we need to know about the relationship between nutritional deficiencies and health economics in the hospital is Ms. Shelby Yaceczko, an Assistant Clinical Professor in the Department of Nutrition at the University of the Pacific in Sacramento, California.

The No Surprises Act aims to protect consumers from surprise medical bills. But how exactly does it go about doing that, and what’s the current status of its implementation? Joining Dr. Charles Turck to share progress and challenges associated with the No Surprises Act is Ms. Emily Carroll, a senior legislative attorney for the American Medical Association's Advocacy Resource Center.

The No Surprises Act aims to protect consumers from surprise medical bills. But how exactly does it go about doing that, and what’s the current status of its implementation? Joining Dr. Charles Turck to share progress and challenges associated with the No Surprises Act is Ms. Emily Carroll, a senior legislative attorney for the American Medical Association's Advocacy Resource Center.

The No Surprises Act aims to protect consumers from surprise medical bills. But how exactly does it go about doing that, and what’s the current status of its implementation? Joining Dr. Charles Turck to share progress and challenges associated with the No Surprises Act is Ms. Emily Carroll, a senior legislative attorney for the American Medical Association's Advocacy Resource Center.

The No Surprises Act aims to protect consumers from surprise medical bills. But how exactly does it go about doing that, and what’s the current status of its implementation? Joining Dr. Charles Turck to share progress and challenges associated with the No Surprises Act is Ms. Emily Carroll, a senior legislative attorney for the American Medical Association's Advocacy Resource Center.

Evaluating the need for therapy escalation can be challenging. So joining Dr. Charles Turck to help us understand how to escalate treatment for patients with chronic obstructive pulmonary disease is Dr. Hassan Bencheqroun, Assistant Professor of Medicine at the University of California Riverside School of Medicine.

This is a non-promotional, non-CME disease state disease education podcast series brought to you by American College of CHEST Physicians in collaboration with and paid for by GSK.

Join Drs. Madhukar Trivedi and Steven Shoptaw as they discuss the evolving landscape of pharmacologic intervention for methamphetamine use disorder. Their focus will be on evidence from the ADAPT-2 clinical trial supporting the combination of extended release naltrexone and high dose bupropion to reduce methamphetamine use for patients with moderate to severe methamphetamine addiction. These important data from ADAPT-2 offer a significant therapeutic advance for methamphetamine use disorder that can be taken into the clinic.

There’s no denying that healthcare professionals across all specialties went above and beyond the call of duty during the COVID-19 pandemic. And cardiologists were no exception. That’s why Dr. Matthew Sorrentino is calling attention to those cardiologists who were nominated by their peers for ReachMD’s Heroes in Healthcare initiative.

A sedative commonly used in anesthesia, dexmedetomidine hydrochloride has been the subject of many news reports over the past few months. But most recently, the FDA announced approval for Aurobindo Pharma’s dexmedetomidine hydrochloride in 0.9% sodium chloride injection. In this episode of The Drug Report, Dr. Linda Bernstein reviews recent approvals of dexmedetomidine hydrochloride on initially intubated and mechanically ventilated patients.

Published December 17, 2020

There are numerous factors that contribute to an overall wellness of patients with of NTM refractory MAC lung disease. Listen in as Megan Carreon, Assistant Professor with the Division of Respiratory Care at UT Health San Antonio, Texas, sits down with pulmonary nurse practitioner Amy Levinger from NYU Langone Health and Dr. Tim Aksamit, Associate Professor of Pulmonary and Critical Care Medicine at Mayo Clinic.

For more information and to access clinician & patient tools about NTM and MAC Lung Disease, click here to visit the CHEST Foundation NTM webpage.

This program is produced in partnership with the American College of CHEST Physicians, and is sponsored by Insmed Incorporated.

The emergence of blood clotting and clogged equipment for vascular procedures is a more recent—and troubling—phenomenon that’s emerged from the COVID-19 pandemic. Tune in as Dr. Anil Agarwal from the Ohio State University Wexner Medical Center discusses these two challenges and strategies for overcoming them.

Published August 13, 2020

A few weeks before COVID-19 swept across the world, we had a chance to sit down with Dr. Arpana Vidyarthi, to capture her career story. She specializes in hospital medicine and now is on the frontline of the pandemic, making this episode especially timely. 

The focus of the interview was on how she built a career that pulls together her passions and interests in internal medicine, quality and safety, teaching, and leadership. Because the interview was done just before the pandemic began, she wasn't asked any questions about the crisis. She recently gave us an update and we share this at the end of the interview.

Meet the Guest
Dr. Arpana Vidyarthi, MD, Professor of Medicine, UCSF,  has two decades of experience as an Academic Medicine leader in the United States and Singapore with expertise in quality/safety, leadership development and education.

She is passionate about enabling individuals and organizations to transform and thrive. She is a thought leader in hospital system transformation and has operational experience in creating and implementing novel care models and programs. As a seasoned leadership development expert and executive coach, Arpana cultivates the best in individuals and empowers teams to navigate effectively through change. Her deep experience in the US and Singapore over 20 years as academic medicine leader with involvements throughout South and Southeast Asia, Europe, and the Middle East make her uniquely able to navigate across cultures. 

Arpana received her undergraduate degree from Macalester College (Ethnic Relations) and her medical degree from the University of Minnesota. She completed Residency and Chief Residency in Internal Medicine at Cambridge Health Alliance, Harvard Medical School, and a Fellowship in Hospital Medicine and Clinical Research at UCSF. She is a Diplomat of the American Board of Internal Medicine, with a Focused Practice in Hospital Medicine.  She holds a master’s degree in Individual and Organizational Psychology (Executive Masters in Change) from INSEAD. She is an alumnus of the Harvard Macy Program for Leaders in Healthcare Education, the California Healthcare Foundation Leadership Program, and the Global Health Leadership Forum. She has published more than 50 peer-review articles.

Links
To access articles Arpana has authored, follow these links:

• Understanding the Singapore COVID-19 Experience: Implications for Hospital Medicine
• Understanding Medical Students’ Experience with Stress and Its Related Constructs: A Focus Group Study from Singapore
• Bridging Leadership Roles in Quality and Patient Safety: Experience of 6 US Academic Medical Centers
• The impact of duty hours on resident self reports of errors

To donate to UCSF, visit: UCSF COVID-19 (Coronavirus) Response Fund

Real-world Pattern of Biologic Use in Patients With Inflammatory Bowel Disease: Treatment Persistence, Switching, and Importance of Concurrent Immunosuppressive Therapy

Chao Chen, PhD, Abraham G Hartzema, PhD, Hong Xiao, PhD, Yu-Jung Wei, PhD, Naueen Chaudhry, MD, Ofor Ewelukwa, MD, Sarah C Glover, DO, Ellen M Zimmermann, MD

BACKGROUND AND AIMS:
Medication persistence, defined as the time from drug initiation to discontinuation of therapy, has been suggested as a proxy for real-world therapeutic benefit and safety. This study seeks to compare the persistence of biologic drugs among patients with inflammatory bowel disease (IBD).

METHODS:
Patients with newly diagnosed IBD were included in a retrospective study using Truven MarketScan database. Treatment persistence and switching was compared among biologic medications including infliximab, adalimumab, certolizumab, golimumab, and vedolizumab. Predictors for discontinuation and switching were evaluated using time-dependent proportional hazard regression.

RESULTS:
In total, 5612 patients with Crohn's disease (CD) and 3533 patients with ulcerative colitis (UC) were included in this analysis. Less than half of the patients continued using their initial biologic treatment after 1 year (48.48% in CD cohort; 44.78% …

Improving the Quality of Inpatient Ulcerative Colitis Management: Promoting Evidence-Based Practice and Reducing Care Variation With an Inpatient Protocol

Sara M Lewin, MD, Ryan A McConnell, MD, Roshan Patel, MD, Suzanne R Sharpton, MD, MAS, Fernando Velayos, MD, MPH, Uma Mahadevan, MD

BACKGROUND:
Hospitalization for ulcerative colitis is a high-risk period associated with increased risk of Clostridium difficile infection, thromboembolism, and opiate use. The study aim was to develop and implement a quality-improvement intervention for inpatient ulcerative colitis management that standardizes gastroenterology consultant recommendations and improves delivery of evidence-based care.

METHODS:
All adult patients hospitalized for ulcerative colitis between July 1, 2014, and December 31, 2017, who received intravenous corticosteroids were included. On July 1, 2016, the UCSF Inpatient Ulcerative Colitis Protocol was implemented, featuring standardized core recommendations and a daily checklist for gastroenterology consultant notes, a bundled IBD electronic order set, and an opiate awareness campaign. The composite primary outcome was adherence to all 3 evidence-based care metrics: C. difficile testing performed, pharmacologic venous thromboembolism (VTE) prophylaxis ordered, and opiates avoided.

RESULTS:
Ninety-three ulcerative colitis hospitalizations occurred, including 36 preintervention and 57 …

After surviving a critical illness, many patients look forward to their lives returning to normal, but unfortunately, that’s not always possible.

To uncover the far-reaching impacts of delirium, Dr. Matt Birnholz is joined by Dr. Wes Ely, Professor of Medicine and Co-Director of the Center for Critical Illness, Brain Dysfunction and Survivorship Center at Vanderbilt University’s School of Medicine which focuses on improving the lives and care of patients in the intensive care unit to ensure both physical and cognitive rehabilitation.