#JHMChat Transcript
Healthcare social media transcript of the #JHMChat hashtag.
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| Profile | Tweet |
|---|---|
 | Amy Melnick @AmyMelnick1 RT @SHMLive: There's still time to read the article on improving #qualityofcare for seriously ill #patients before #JHMChat begins in half… |
 | Society of Hospital Medicine @SocietyHospMed #JHMChat begins NOW! Join the conversation, then claim #CME: https://t.co/uXxkRn3Szr https://t.co/0NZBac2oRn |
 | Journal of Hospital Medicine @JHospMedicine Good evening, I'm @WrayCharles your moderator for tonight's #JHMChat. Go ahead and introduce yourself while we wait for others to join. With a special welcome to our #PalliativeCare / #hpm colleagues, tonight! |
 | Diane E. Meier @DianeEMeier Hi everybody, @dianeemeier here, co-author of the recent JHM article on #palliative care and #hospitalists and director of @capcpalliative, an organization devoted to increasing access to quality serious illness care. #JHMChat |
 | Robin Fail @refailsafe Hi, I'm Robin Fail, a program manager at the Center to Advance Palliative care and co-author of the article we are discussing tonight. Glad to be here! #JHMchat |
| Journal of Hospital Medicine @JHospMedicine Don't forget to tag your tweets with #JHMChat - as this allows everyone to follow along. Topic 1 up in a moment… |
 | Vinny Arora MD MAPP @FutureDocs RT @DianeEMeier: Hi everybody, @dianeemeier here, co-author of the recent JHM article on #palliative care and #hospitalists and director of… |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: Good evening, I'm @WrayCharles your moderator for tonight's #JHMChat. Go ahead and introduce yourself while we wait for… |
 | Jeremy Topin MD @JTopinMD #jhmchat |
 | Robert J. Mahoney, MD @mahoneyr @JHospMedicine @WrayCharles Academic hospitalist, joining #JHMChat from delightful St. Louis, Missouri |
| Journal of Hospital Medicine @JHospMedicine Special thanks to our partners @SHMLive @CostsofCare @ABIMFoundation 4 bringing you #JHMChat tonight - another #CME edition! |
 | Grace Farris MD @gracefarris Grace Farris, hospitalist in NYC here #jhmchat |
| Journal of Hospital Medicine @JHospMedicine We welcome Robin E. Fail, MPP (@refailsafe) & Diane E. Meier, MD, FACP (@DianeEMeier) as our guest authors, where we'll be discussing their paper “Improving Quality of Care #JHMChat |
| Vinny Arora MD MAPP @FutureDocs Lurking on #JHMChat while sick 😷 so maybe quieter than usual - @WrayCharles you got this! |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: Don't forget to tag your tweets with #JHMChat - as this allows everyone to follow along. Topic 1 up in a moment… |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: Special thanks to our partners @SHMLive @CostsofCare @ABIMFoundation 4 bringing you #JHMChat tonight - another #CME edit… |
| Journal of Hospital Medicine @JHospMedicine @JTopinMD Happy you can join, Jeremy #jhmchat |
| Jeremy Topin MD @JTopinMD Lets try this agin.. Hello, Im Jeremy Topin, Pulm CC in Chicago #jhmchat |
| Vinny Arora MD MAPP @FutureDocs RT @SHMLive: There's still time to read the article on improving #qualityofcare for seriously ill #patients before #JHMChat begins in half… |
| Journal of Hospital Medicine @JHospMedicine Let's get started with Topic 1. Don't forget to tag your tweets with: #JHMChat https://t.co/6X0PP5HqIB |
| Robert J. Mahoney, MD @mahoneyr @JTopinMD Medicine is easy. Tweet chats are hard. #JHMChat |
 | @HyungChoMD @HyungChoMD #jhmchat hello everyone! Harry Cho, hospitalist at @MountSinaiNYC |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: Let's get started with Topic 1. Don't forget to tag your tweets with: #JHMChat https://t.co/6X0PP5HqIB |
 | Carol Sieger @carolsieger RT @JHospMedicine: We welcome Robin E. Fail, MPP (@refailsafe) & Diane E. Meier, MD, FACP (@DianeEMeier) as our guest authors, where we'll… |
 | Paul S @postscriptmd #hpm physician and hospitalist at @medicalcollege #JHMChat |
| Journal of Hospital Medicine @JHospMedicine Great having you on-board, Harry! #JHMChat https://t.co/b598PeFngV |
| Journal of Hospital Medicine @JHospMedicine RT @JHospMedicine: We welcome Robin E. Fail, MPP (@refailsafe) & Diane E. Meier, MD, FACP (@DianeEMeier) as our guest authors, where we'll… |
| Carol Sieger @carolsieger RT @SHMLive: #JHMChat begins NOW! Join the conversation, then claim #CME: https://t.co/uXxkRn3Szr https://t.co/0NZBac2oRn |
| Amy Melnick @AmyMelnick1 Thanks #jhmchat for hosting this tweet chat. I'm @AmyMelnick1 from the @CoalitionHPC - always looking for new partners to increase access/awareness of #palliative care. |
 | Palliative Dork @PCDorkClub Hello! We are an informal club for anyone who loves #hpm! #JHMChat |
 | Elizabeth Gundersen @Top_Gundersen Hi All, I’m Liz, former hospitalist & current inpatient palliative care doc, joining you from my couch in south Florida with my puppy and all his toys. Excited to be here! #JHMChat #hpm https://t.co/FWINJZVoS4 |
| Diane E. Meier @DianeEMeier Nobody knows better than #hospitalists which patients are suffering; which patients don't understand what to expect; which patients are being tossed like ping pong balls from specialist to specialist from test to test. #JHMChat |
| Robert J. Mahoney, MD @mahoneyr @JHospMedicine T1 It seems like, for a variety of reasons, hospitalists are the first to identify that whatever has been going on so far medically has not been working. #JHMChat |
| Society of Hospital Medicine @SocietyHospMed #JHMChat T1 is live! Join the discussion and don't forget to claim #CME! https://t.co/N3Jchf9Xqu |
| Vinny Arora MD MAPP @FutureDocs RT @DianeEMeier: Nobody knows better than #hospitalists which patients are suffering; which patients don't understand what to expect; which… |
| Vinny Arora MD MAPP @FutureDocs RT @mahoneyr: @JHospMedicine T1 It seems like, for a variety of reasons, hospitalists are the first to identify that whatever has been goin… |
| Journal of Hospital Medicine @JHospMedicine @AmyMelnick1 @CoalitionHPC We're here to help. Glad you could join us and look forward to hearing your thoughts on tonight's #JHMChat |
| Robin Fail @refailsafe #JHMchat For patients who may not need specialist palliative care, hospitalists are well-positioned to engage patients and families in goals of care conversations and manage pain and symptoms, all of which have been shown to reduce readmissions. |
| Diane E. Meier @DianeEMeier what an adorable puppy! jealous... #JHMChat |
| Palliative Dork @PCDorkClub Earlier consults. Palliative care is an added layer of support for patients, families, and medical teams. Also educational opportunities for primary Palliative care. #JHMchat #hpm https://t.co/kRRkNGpZB1 |
| Vinny Arora MD MAPP @FutureDocs RT @refailsafe: #JHMchat For patients who may not need specialist palliative care, hospitalists are well-positioned to engage patients and… |
| Journal of Hospital Medicine @JHospMedicine @Top_Gundersen We knew you'd (both) be here! You'll definitely bring some great insights, Liz #jhmchat |
| Journal of Hospital Medicine @JHospMedicine RT @DianeEMeier: Nobody knows better than #hospitalists which patients are suffering; which patients don't understand what to expect; which… |
 | Sonia Malhotra,MD,MS @SoniaMKhunkhun @JHospMedicine hello from #nola-#palliativecare #hpm at UMC NOLA/Tulane SOM! Past Chair of @EarlyCareerSIG #JHMChat |
 | Rab Razzak @rabrazzak RT @DianeEMeier: Nobody knows better than #hospitalists which patients are suffering; which patients don't understand what to expect; which… |
| Journal of Hospital Medicine @JHospMedicine @SoniaMKhunkhun @EarlyCareerSIG Welcome, Sonia #JHMChat |
| Grace Farris MD @gracefarris Q1, A1 this is sometimes how I feel #jhmchat #GraphicMedicine #medtwitter #MedTwitterRocks #PalliativeCare https://t.co/CjF7lennHg |
 | Gretchen Diemer @gretchendiemer Gretchen Diemer hospitalist in Philly. T1 Seems like they should go together like chocolate and peanut butter. We should probably set a low threshold to involve palliative care (like second admission in 6 months for same chronic illness) #JHMChat https://t.co/ULtn4GgKgj |
| Grace Farris MD @gracefarris @mahoneyr @JTopinMD So true! #JHMchat |
| Robert J. Mahoney, MD @mahoneyr @JHospMedicine T1 (cont'd) And it seems that hospital medicine and palliative care both have a particular sensitivity to care that does not promote the entire interest of the patient. #JHMChat |
| Diane E. Meier @DianeEMeier #palliative care reduces #readmissions, hospital mortality, and improves patient experience of care #HCAHPS #JHMChat |
 | Linda M Valentino RN @LindaVRN RT @DianeEMeier: Nobody knows better than #hospitalists which patients are suffering; which patients don't understand what to expect; which… |
 | Maggie Rogers @magthenomad RT @JHospMedicine: We welcome Robin E. Fail, MPP (@refailsafe) & Diane E. Meier, MD, FACP (@DianeEMeier) as our guest authors, where we'll… |
| Grace Farris MD @gracefarris RT @DianeEMeier: Nobody knows better than #hospitalists which patients are suffering; which patients don't understand what to expect; which… |
| Robin Fail @refailsafe @PCDorkClub Yes indeed, earlier consults are so important. In studies with cancer patients, they've been found to reduce length of stay, reduce symptom burden, and in some cases extend length of life! #JHMchat |
| Jeremy Topin MD @JTopinMD From an ICU perspective, helping w/ continuity. Both with transfers in and out but also weekends. The three hospitals I work at do not have pal care service available on weekends! #jhmchat |
| Palliative Dork @PCDorkClub RT @DianeEMeier: #palliative care reduces #readmissions, hospital mortality, and improves patient experience of care #HCAHPS #JHMChat |
 | Christian Sinclair, MD, FAAHPM @ctsinclair RT @PCDorkClub: Hello! We are an informal club for anyone who loves #hpm! #JHMChat |
| Palliative Dork @PCDorkClub RT @refailsafe: @PCDorkClub Yes indeed, earlier consults are so important. In studies with cancer patients, they've been found to reduce l… |
 | Claire Sevov @ClaireSevovMD Hi, Med-peds hospitalist at @OSUWexMed, #jhmchat T1: As hospitalists we are often the next step after ICU, when the results of surviving critical illness become apparent. |
| @HyungChoMD @HyungChoMD @gracefarris #jhmchat discharge before noon |
| Diane E. Meier @DianeEMeier chocolate and peanut butter...yum! you're making me hungry! #JHMChat |
| Sonia Malhotra,MD,MS @SoniaMKhunkhun T1: knowing that #teamwork makes the dream work. 1 md or team cannot do what the collaboration of #HPM can do with other teams #JHMChat |
| Gretchen Diemer @gretchendiemer @gracefarris Agree. I adore watching our palliative specialists navigate the more challenging family meetings though. I have learned so much from them! #jhmchat |
| Grace Farris MD @gracefarris Agree #jhmchat https://t.co/oqZ7j6l8sm |
| Linda M Valentino RN @LindaVRN RT @DianeEMeier: #palliative care reduces #readmissions, hospital mortality, and improves patient experience of care #HCAHPS #JHMChat |
| Paul S @postscriptmd T1 Primary Palliative Care education for hospitalists can be challenging when physicians are 7-on/7-off, and it's hard to assemble for more than a half hour at a time (tweeted as a #Hospitalist) #JHMChat |
| Robert J. Mahoney, MD @mahoneyr @gretchendiemer Hospitalists do tend to be confronted with this truth a bit more directly than some of our outpatient colleagues who have office visits twice per year. #JHMChat |
| Rab Razzak @rabrazzak RT @DianeEMeier: #palliative care reduces #readmissions, hospital mortality, and improves patient experience of care #HCAHPS #JHMChat |
| Gretchen Diemer @gretchendiemer RT @DianeEMeier: #palliative care reduces #readmissions, hospital mortality, and improves patient experience of care #HCAHPS #JHMChat |
| Maggie Rogers @magthenomad 👋🏻 Maggie Rogers here! Senior Research Manager @CAPCpalliative and colleague to the wonderful @DianeEMeier and @refailsafe. Excited to join #JHMChat #hpm |
 | Sri Lekha Tummalapalli, MD, MBA @LTummalapalli Are there proposed indications for an inpatient palliative care consult? Certain diagnoses - late-stage CHF, COPD, cancer, symptom burden. Usually hospitalists do a great job of consulting early (esp. @DOMSinaiNYC) but wonder whether role for flagging #jhmchat |
| Grace Farris MD @gracefarris RT @DianeEMeier: #palliative care reduces #readmissions, hospital mortality, and improves patient experience of care #HCAHPS #JHMChat |
| Christian Sinclair, MD, FAAHPM @ctsinclair Hello #JHMChat! I'm a #palliative care doc at @KUcancercenter & @PalliCareKU, and editor of @Pallimed, moderator of @hpmchat Excited that you are hosting a palliative care themed chat tonight! |
| Palliative Dork @PCDorkClub RT @SoniaMKhunkhun: T1: knowing that #teamwork makes the dream work. 1 md or team cannot do what the collaboration of #HPM can do with othe… |
| Journal of Hospital Medicine @JHospMedicine Excellent point, Jeremy. @DianeEMeier, any data on #PalliativeCare effects on inpatient continuity of care? #JHMChat https://t.co/lK3dSy1UhQ |
| Diane E. Meier @DianeEMeier see recent meta-analysis in last week's JAMA IM on economics of hospital #palliative care https://t.co/HJtUItdZvR #JHMChat |
| Grace Farris MD @gracefarris @HyungChoMD Or discharge before tomorrow at noon! #jhmchat |
| Sonia Malhotra,MD,MS @SoniaMKhunkhun T1: It's also talking about serious illness care - making sure #goals are met & actually addressed! #hpm #JHMChat #PalliativeCare |
| Journal of Hospital Medicine @JHospMedicine RT @LTummalapalli: Are there proposed indications for an inpatient palliative care consult? Certain diagnoses - late-stage CHF, COPD, cance… |
| Maggie Rogers @magthenomad 1: We know that over half of #PalliativeCare referrals in hospitals are coming from hospitalists. For patients with serious illness this interaction and referral is a huge step to getting the care you need! #JHMChat #hpm |
 | SystematicReviewBot @EvidenceRobot RT @DianeEMeier: see recent meta-analysis in last week's JAMA IM on economics of hospital #palliative care https://t.co/HJtUItdZvR #JHMChat |
| @HyungChoMD @HyungChoMD RT @DianeEMeier: see recent meta-analysis in last week's JAMA IM on economics of hospital #palliative care https://t.co/HJtUItdZvR #JHMChat |
 | Corey Kennard @PastorCorey #JHMChat @PalliativeCare makes sure that all disciplines are involved from the very beginning of the consult. |
| Journal of Hospital Medicine @JHospMedicine @LTummalapalli @DOMSinaiNYC Great point! What are people's indicators for calling #PalliativeCare? or is it "I know it when I see it? #jhmchat |
| Journal of Hospital Medicine @JHospMedicine RT @DianeEMeier: see recent meta-analysis in last week's JAMA IM on economics of hospital #palliative care https://t.co/HJtUItdZvR #JHMChat |
| Diane E. Meier @DianeEMeier Ideally all #hospitalists have core palliative care knowledge and skills and call for specialty consultation only on the most difficult or complex patients, just like in cardiology or ID #JHMChat |
| Robert J. Mahoney, MD @mahoneyr @magthenomad Worth noting that at least a large percentage of those referrals were likely at the bedside nurse's prompting #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @ctsinclair: Hello #JHMChat! I'm a #palliative care doc at @KUcancercenter & @PalliCareKU, and editor of @Pallimed, moderator of @hpmcha… |
| Sonia Malhotra,MD,MS @SoniaMKhunkhun @postscriptmd So true the education is very much needed yet challenging to deliver #PalliativeCare #hpm #jhmchat -we are looking at unique ways to do |
| Palliative Dork @PCDorkClub RT @PastorCorey: #JHMChat @PalliativeCare makes sure that all disciplines are involved from the very beginning of the consult. |
| Journal of Hospital Medicine @JHospMedicine RT @DianeEMeier: Ideally all #hospitalists have core palliative care knowledge and skills and call for specialty consultation only on the m… |
| Gretchen Diemer @gretchendiemer RT @DianeEMeier: see recent meta-analysis in last week's JAMA IM on economics of hospital #palliative care https://t.co/HJtUItdZvR #JHMChat |
| Palliative Dork @PCDorkClub RT @DianeEMeier: Ideally all #hospitalists have core palliative care knowledge and skills and call for specialty consultation only on the m… |
| Claire Sevov @ClaireSevovMD @DianeEMeier #jhmchat Proof of concept for clinicians but I worry that with the wrong PR this headline could twist patient perceptions of involving palliative care |
| Grace Farris MD @gracefarris RT @JHospMedicine: @LTummalapalli @DOMSinaiNYC Great point! What are people's indicators for calling #PalliativeCare? or is it "I know it w… |
| Christian Sinclair, MD, FAAHPM @ctsinclair @gracefarris I think that it is important to recognize that challenge hospitality face. As a PC consultant, I often wonder if my role is needed as an expert on a complex topic or as a service to help manage the undue burdens my colleagues face. Both are important to address. #JHMChat |
| Palliative Dork @PCDorkClub RT @mahoneyr: @magthenomad Worth noting that at least a large percentage of those referrals were likely at the bedside nurse's prompting #J… |
| Sonia Malhotra,MD,MS @SoniaMKhunkhun RT @DianeEMeier: see recent meta-analysis in last week's JAMA IM on economics of hospital #palliative care https://t.co/HJtUItdZvR #JHMChat |
| Journal of Hospital Medicine @JHospMedicine Fantastic discussion so far...Let me throw this one out there for Topic 2... #JHMChat https://t.co/WFVGHrKUPG |
| Corey Kennard @PastorCorey #JHMChat #PalliativeCare makes sure that all disciplines are involved from the very beginning of the consult. |
| @HyungChoMD @HyungChoMD T1 Hospitalists are now managing much of the inpatient services, such as oncology that are in high need of #palliative care, #jhmchat |
| Sri Lekha Tummalapalli, MD, MBA @LTummalapalli Does teaching vs. non-teaching services make a difference in utility of consults? Trainees may have more time with patients (this may vary) but less equipped to handle complex symptom management and goals of care #jhmchat |
| Grace Farris MD @gracefarris @ctsinclair I do think I rely on both tbh #jhmchat |
| Diane E. Meier @DianeEMeier criteria for eligibility for palliative care- in addn to diagnosis, look at prior utilization (eg >1 hospitalization or ED visit) in last 6 months and functional and/or cognitive impairment--> risk factors for family caregiver exhaustion and using 911, ED, hospital. #JHMChat |
 | Nicole DePace @NicD610 RT @DianeEMeier: Ideally all #hospitalists have core palliative care knowledge and skills and call for specialty consultation only on the m… |
| Christian Sinclair, MD, FAAHPM @ctsinclair @gracefarris Of course 'hospitalists' auto-corrected to 'hospitality.' And at my very first #JHMChat.. SMH Someday I will figure out Twitter. |
| Carol Sieger @carolsieger RT @magthenomad: 1: We know that over half of #PalliativeCare referrals in hospitals are coming from hospitalists. For patients with seriou… |
| Sonia Malhotra,MD,MS @SoniaMKhunkhun @JHospMedicine @LTummalapalli @DOMSinaiNYC I like the surprise question as it is sensitive to include a lot - this can be challenging for small #HPM #PalliativeCare teams #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @LTummalapalli: Does teaching vs. non-teaching services make a difference in utility of consults? Trainees may have more time with patie… |
| Corey Kennard @PastorCorey #JHMChat the lack of knowledge that #patients and their families have about #palliativecare can be a struggle. |
| Gretchen Diemer @gretchendiemer @JHospMedicine Weekend coverage, esp for active symptom management! Not enough pall care docs/NPs to go around! #JHMchat |
| Robert J. Mahoney, MD @mahoneyr @JHospMedicine T2 Not speaking specifically for my institution, but the temptation to do "more, better, faster" to treat serious illness seems to be rampant in medicine. HPM is the only way to hold this somewhat in check. #JHMChat |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: Fantastic discussion so far...Let me throw this one out there for Topic 2... #JHMChat https://t.co/WFVGHrKUPG |
| Carol Sieger @carolsieger RT @DianeEMeier: Ideally all #hospitalists have core palliative care knowledge and skills and call for specialty consultation only on the m… |
 | Charlie M. Wray, DO, MS @WrayCharles RT @DianeEMeier: Nobody knows better than #hospitalists which patients are suffering; which patients don't understand what to expect; which… |
| Grace Farris MD @gracefarris @HyungChoMD Yes so true #jhmchat |
| Carol Sieger @carolsieger RT @DianeEMeier: see recent meta-analysis in last week's JAMA IM on economics of hospital #palliative care https://t.co/HJtUItdZvR #JHMChat |
| Vinny Arora MD MAPP @FutureDocs RT @DianeEMeier: Ideally all #hospitalists have core palliative care knowledge and skills and call for specialty consultation only on the m… |
| Christian Sinclair, MD, FAAHPM @ctsinclair RT @DianeEMeier: criteria for eligibility for palliative care- in addn to diagnosis, look at prior utilization (eg >1 hospitalization or E… |
| Gretchen Diemer @gretchendiemer RT @DianeEMeier: criteria for eligibility for palliative care- in addn to diagnosis, look at prior utilization (eg >1 hospitalization or E… |
| Society of Hospital Medicine @SocietyHospMed #JHMChat T2 - Join the conversation! https://t.co/VzZsUQwUtQ |
 | Nirav Patel, MD @NiravPatelMD RT @refailsafe: #JHMchat For patients who may not need specialist palliative care, hospitalists are well-positioned to engage patients and… |
| Maggie Rogers @magthenomad RT @HyungChoMD: T1 Hospitalists are now managing much of the inpatient services, such as oncology that are in high need of #palliative care… |
| Christian Sinclair, MD, FAAHPM @ctsinclair RT @JHospMedicine: Fantastic discussion so far...Let me throw this one out there for Topic 2... #JHMChat https://t.co/WFVGHrKUPG |
| Elizabeth Gundersen @Top_Gundersen @SoniaMKhunkhun @postscriptmd Sometimes awareness is half the battle. When I was a junior hospitalist I didn't pause to consider goals of care until the patient had days to weeks to live. I look back now and wince at all the missed opportunities for person-centered care. #jhmchat #hpm |
 | Alz Girl Lori @AlzGirlLori Hi everyone, @AlzGirlLori here. Happy to be part of the #JHMChat this evening. |
| Journal of Hospital Medicine @JHospMedicine @ctsinclair @gracefarris someday... :) #JHMChat |
| Gretchen Diemer @gretchendiemer RT @Top_Gundersen: @SoniaMKhunkhun @postscriptmd Sometimes awareness is half the battle. When I was a junior hospitalist I didn't pause to… |
| Sonia Malhotra,MD,MS @SoniaMKhunkhun @DianeEMeier tougher in areas where #HPM is new or not taught. It becomes a free for all for consultation. Why #palliativecare #meded needed #jhmchat |
| Journal of Hospital Medicine @JHospMedicine RT @mahoneyr: @JHospMedicine T2 Not speaking specifically for my institution, but the temptation to do "more, better, faster" to treat seri… |
| Palliative Dork @PCDorkClub T2 Continuity of care. A patient can get great inpatient Palliative care but may suffer if there is no opportunity for outpatient follow up. #JHMchat #hpm https://t.co/FdU0gQZn50 |
| Carol Sieger @carolsieger RT @DianeEMeier: Nobody knows better than #hospitalists which patients are suffering; which patients don't understand what to expect; which… |
| Journal of Hospital Medicine @JHospMedicine RT @DianeEMeier: criteria for eligibility for palliative care- in addn to diagnosis, look at prior utilization (eg >1 hospitalization or E… |
| Carol Sieger @carolsieger RT @DianeEMeier: #palliative care reduces #readmissions, hospital mortality, and improves patient experience of care #HCAHPS #JHMChat |
| Grace Farris MD @gracefarris @magthenomad @ctsinclair You just gotta ride the twitter chat 🌊#JHMchat |
| Diane E. Meier @DianeEMeier #JHMChat great paper by @akelleymd on predictors for hospitalization and mortality: dx+utilization+fn'l impairment = 50% risk hospitalization and 22% risk death in next 12 months. https://t.co/CScxsVJhKq |
| Gretchen Diemer @gretchendiemer RT @PCDorkClub: T2 Continuity of care. A patient can get great inpatient Palliative care but may suffer if there is no opportunity for outp… |
 | Nancy H Stewart DO, MS @nvhstewart @KellyCawcuttMD Yes. This. #jhmchat |
| Robert J. Mahoney, MD @mahoneyr @magthenomad Beside family members, nurses are most keenly aware of the toll that medical care takes on patients - and their families. #JHMChat |
| Sonia Malhotra,MD,MS @SoniaMKhunkhun RT @DianeEMeier: criteria for eligibility for palliative care- in addn to diagnosis, look at prior utilization (eg >1 hospitalization or E… |
| Alz Girl Lori @AlzGirlLori How does your hospital handle #mentalhealth and #BehavioralHealth patients in the ED, esp with no designated BH department? #JHMChat |
| Grace Farris MD @gracefarris RT @DianeEMeier: #JHMChat great paper by @akelleymd on predictors for hospitalization and mortality: dx+utilization+fn'l impairment = 50%… |
| Claire Sevov @ClaireSevovMD #jhmchat T2 Hands down biggest challenge is lack of continuity. Some of our hospitalist service patients have a different attending 5 days in a row. Hard to even remember their name much less have a firm grasp of their medical course. |
| Journal of Hospital Medicine @JHospMedicine Great point, Sonia. Most trainees don't get a lot of #PalliativeCare exposure. Most of us here would probably agree that needs to change #JHMChat https://t.co/I9zRZSWGdJ |
| Journal of Hospital Medicine @JHospMedicine Great point, Sonia. Most trainees don't get a lot of #PalliativeCare exposure. Most of us here would probably agree that needs to change #JHMChat https://t.co/I9zRZSWGdJ https://t.co/I9zRZSWGdJ |
| Gretchen Diemer @gretchendiemer RT @DianeEMeier: #JHMChat great paper by @akelleymd on predictors for hospitalization and mortality: dx+utilization+fn'l impairment = 50%… |
| Corey Kennard @PastorCorey @JessicaZitter Are you on on the #JHMchat? |
 | Petra Dolman, M.D.🇨🇦 @petradMD RT @PCDorkClub: T2 Continuity of care. A patient can get great inpatient Palliative care but may suffer if there is no opportunity for outp… |
| Journal of Hospital Medicine @JHospMedicine RT @DianeEMeier: #JHMChat great paper by @akelleymd on predictors for hospitalization and mortality: dx+utilization+fn'l impairment = 50%… |
| Christian Sinclair, MD, FAAHPM @ctsinclair @JHospMedicine At @KUHospital and @KUcancercenter we have a quickly growing outpatient service. Biggest challenge is we are only seeing 10% of need. And we are just now starting to focus more on transitional care post discharge. So I'm going to go with workforce as biggest challenge. #JHMChat |
 | Edgar V. Lerma 🇵🇭 @edgarvlermamd Utility of the "Surprise" Question: A trigger for palliative care evaluation and advanced care planning #Nephpearls #JHMChat 👉🏼 https://t.co/YYMltXATTX https://t.co/11Te0ESHtD |
| Palliative Dork @PCDorkClub RT @mahoneyr: @magthenomad Beside family members, nurses are most keenly aware of the toll that medical care takes on patients - and their… |
| Elizabeth Gundersen @Top_Gundersen @gracefarris @ctsinclair When I was a hospitalist and palliative was just starting as a service line, the #palliative docs came to us & said, "we know you don't have time; call us instead." That has the pitfall of not developing primary palliative care skills, but I appreciated it at the time. #jhmchat |
| Maggie Rogers @magthenomad T2: We hear a lot about not knowing when to refer to palliative care. When is the patient or symptom burden complex enough? When is the illness serious enough? Yes hospitalists refer, but is it early enough to have an impact? Just non-clinician-spaining 💁🏼♀️ #JHMChat |
| Charlie M. Wray, DO, MS @WrayCharles RT @mahoneyr: @magthenomad Beside family members, nurses are most keenly aware of the toll that medical care takes on patients - and their… |
| Christian Sinclair, MD, FAAHPM @ctsinclair RT @DianeEMeier: #JHMChat great paper by @akelleymd on predictors for hospitalization and mortality: dx+utilization+fn'l impairment = 50%… |
| Sonia Malhotra,MD,MS @SoniaMKhunkhun T2:outpatient #PalliativeCare super important.Bandwidth an issue for small #HPM teams.tough to get to all the patients who need us #JHMChat |
| Carol Sieger @carolsieger RT @SHMLive: There's still time to read the article on improving #qualityofcare for seriously ill #patients before #JHMChat begins in half… |
| Journal of Hospital Medicine @JHospMedicine RT @edgarvlermamd: Utility of the "Surprise" Question: A trigger for palliative care evaluation and advanced care planning #Nephpearls #JHM… |
| Sonia Malhotra,MD,MS @SoniaMKhunkhun RT @JHospMedicine: Great point, Sonia. Most trainees don't get a lot of #PalliativeCare exposure. Most of us here would probably agree that… |
| Robin Fail @refailsafe #JHMchat This article sums up barriers for hospitalists including lack of time (no surprise there), difficulty finding records, and frequent handoffs. All things you all know too well! https://t.co/MmvbkZ2vHK |
| Diane E. Meier @DianeEMeier seems like hospitalists are so crazy busy, hard to find time to sit down and talk with patients and their families about their understanding of their illness and what matters most to them in the context of those realities. #JHMChat |
| Corey Kennard @PastorCorey #JHMChat #PalliativeCare to me is simply what General Hospital Care should be in the first place, right? Sad that it has become a specialty. |
| Gretchen Diemer @gretchendiemer We are fortunate enough to have an outpt palliative care clinic which has encouraged me to consult earlier in disease process. #jhmchat https://t.co/oVqfmxsYYI |
| Christian Sinclair, MD, FAAHPM @ctsinclair @PCDorkClub Yes! This! Effective care through transitions is full-contact #palliative care! Need collaboration between hospitalists and palliative care. #JHMChat |
| Sonia Malhotra,MD,MS @SoniaMKhunkhun @ctsinclair @JHospMedicine @KUHospital @KUcancercenter Agree! We stared outpatient first (free standing pal clinic)before inpatient & it has been wildly successful #HPM #PalliativeCare #JHMChat |
| Amy Melnick @AmyMelnick1 RT @DianeEMeier: #JHMChat great paper by @akelleymd on predictors for hospitalization and mortality: dx+utilization+fn'l impairment = 50%… |
| Journal of Hospital Medicine @JHospMedicine RT @refailsafe: #JHMchat This article sums up barriers for hospitalists including lack of time (no surprise there), difficulty finding reco… |
 | Shalini Vallabhan @ShaliniVall RT @DianeEMeier: Ideally all #hospitalists have core palliative care knowledge and skills and call for specialty consultation only on the m… |
| Shalini Vallabhan @ShaliniVall RT @DianeEMeier: #palliative care reduces #readmissions, hospital mortality, and improves patient experience of care #HCAHPS #JHMChat |
| Maggie Rogers @magthenomad @ctsinclair I try to make a joke and spell “splaining” wrong on my first #JHMchat - feeling like you! |
| Journal of Hospital Medicine @JHospMedicine RT @refailsafe: #JHMchat This article sums up barriers for hospitalists including lack of time (no surprise there), difficulty finding reco… |
| Sonia Malhotra,MD,MS @SoniaMKhunkhun @Top_Gundersen @gracefarris @ctsinclair This helps new programs in tough areas of buy-in as well. Has worked well in #nola #JHMChat #PalliativeCare #hpm |
| Robert J. Mahoney, MD @mahoneyr @magthenomad If you have seen a patient admitted 2, 3, or 4 times for the same issue and discharged essentially unchanged, it may be time for a new plan (or, admittedly, maybe a new hospital). #JHMChat |
 | Kim Ang @Kim_angbn RT @DianeEMeier: seems like hospitalists are so crazy busy, hard to find time to sit down and talk with patients and their families about t… |
| @HyungChoMD @HyungChoMD T2 We have one outpatient palliative care clinic at Sinai. So overbooked - we desperately need more. #jhmchat |
| Grace Farris MD @gracefarris @DianeEMeier This is true but also so demoralizing #jhmchat |
| Kim Ang @Kim_angbn RT @DianeEMeier: #JHMChat great paper by @akelleymd on predictors for hospitalization and mortality: dx+utilization+fn'l impairment = 50%… |
 | Robert Gerard @rhgerard RT @DianeEMeier: Nobody knows better than #hospitalists which patients are suffering; which patients don't understand what to expect; which… |
| Kim Ang @Kim_angbn RT @DianeEMeier: #palliative care reduces #readmissions, hospital mortality, and improves patient experience of care #HCAHPS #JHMChat |
| Gretchen Diemer @gretchendiemer @JHospMedicine But to @gracefarris point, make sure palliative care team includes trainees in the conversation (not just consulting to do the work for them) so they can see how the best of the best do it! #jhmchat |
| Edgar V. Lerma 🇵🇭 @edgarvlermamd Palliative approach to dialysis care #Nephpearls #JHMChat 👉🏼 https://t.co/Ggz6UkHuUJ https://t.co/v33TFryFqs |
 | HPM Chat @hpmchat #JHMChat is hopping with #hpm facts tonight! ♥ it! https://t.co/iZMFkWyAtU |
| Charlie M. Wray, DO, MS @WrayCharles Topic 3 coming your way shortly...What a great #JHMChat tonight! |
| Charlie M. Wray, DO, MS @WrayCharles RT @edgarvlermamd: Palliative approach to dialysis care #Nephpearls #JHMChat 👉🏼 https://t.co/Ggz6UkHuUJ https://t.co/v33TFryFqs |
| Maggie Rogers @magthenomad @mahoneyr What’s the quote? Insanity is doing the same thing over and over again and expecting different results. Definitely time for a new plan! #JHMchat |
| Kim Ang @Kim_angbn RT @DianeEMeier: Ideally all #hospitalists have core palliative care knowledge and skills and call for specialty consultation only on the m… |
| Journal of Hospital Medicine @JHospMedicine RT @hpmchat: #JHMChat is hopping with #hpm facts tonight! ♥ it! https://t.co/iZMFkWyAtU |
| Sonia Malhotra,MD,MS @SoniaMKhunkhun @PastorCorey I think this is how many specialties have https://t.co/6cvTuJ8i3A docs used to do all the deliveries but now we have ob's. #JHMChat |
| Kim Ang @Kim_angbn RT @DianeEMeier: see recent meta-analysis in last week's JAMA IM on economics of hospital #palliative care https://t.co/HJtUItdZvR #JHMChat |
| Diane E. Meier @DianeEMeier by the way #hospitalists- you have influence- tell your CMO and other administrators that there is desperate need for more palliative care resources- they will listen to you more than they will listen to the palliative care team... #JHMChat |
| Grace Farris MD @gracefarris @magthenomad @mahoneyr But isn’t the “index hospitalization” the best time to consult #PalliativeCare #JHMChat |
| Grace Farris MD @gracefarris RT @DianeEMeier: by the way #hospitalists- you have influence- tell your CMO and other administrators that there is desperate need for mor… |
| Sonia Malhotra,MD,MS @SoniaMKhunkhun @HyungChoMD This is our situation as well and we are looking to expand #HPM #PalliativeCare #JHMchat |
| Elizabeth Gundersen @Top_Gundersen @JHospMedicine We have no outpatient palliative care. When I do inpatient consults I often struggle with the internal pressure of an artificially accelerated inpatient timeline knowing there probably won't be adequate follow-up of goals of care conversations. #jhmchat |
| Journal of Hospital Medicine @JHospMedicine Let's keep it rolling with Topic #3 for tonight's #JHMChat... https://t.co/ZG1qLzEefa |
| Kim Ang @Kim_angbn RT @gracefarris: Q1, A1 this is sometimes how I feel #jhmchat #GraphicMedicine #medtwitter #MedTwitterRocks #PalliativeCare https://t.co/… |
| Sonia Malhotra,MD,MS @SoniaMKhunkhun RT @hpmchat: #JHMChat is hopping with #hpm facts tonight! ♥ it! https://t.co/iZMFkWyAtU |
| Corey Kennard @PastorCorey @HyungChoMD #JHMchat truly evidence that if we care about #patients, more investment needs to be made to support this crucial aspect of #Healthcare |
 | Sneha @sp1881 RT @JHospMedicine: Let's keep it rolling with Topic #3 for tonight's #JHMChat... https://t.co/ZG1qLzEefa |
| Kim Ang @Kim_angbn RT @WrayCharles: To all my #hospitalmedicine & #hpm friends out there! Jump in the #JHMChat conversation tonight at 9PM EST w/@DianeEMeier… |
 | Aditya Pawar @renalranger RT @edgarvlermamd: Palliative approach to dialysis care #Nephpearls #JHMChat 👉🏼 https://t.co/Ggz6UkHuUJ https://t.co/v33TFryFqs |
| Robert J. Mahoney, MD @mahoneyr @JHospMedicine T2 For me, personally, the hardest part is the fortitude to say "we have done everything we should." There's always one more antibiotic, one more consult, one more pressor. #JHMChat |
| Maggie Rogers @magthenomad @refailsafe @PCDorkClub And for those business minded folks.... reduce costs! Ding, ding, ding! #JHMchat #hpm |
| Sri Lekha Tummalapalli, MD, MBA @LTummalapalli As consultants (speaking from the renal perspective), it's often either "Why are you calling me now?" vs. "Why didn't you call me earlier?" Curious, do palliative care folks often feel they are called too late? #jhmchat |
| Alz Girl Lori @AlzGirlLori Curious if anyone here (or close family) has been a patient in need of #PalliativeCare. Did that change your view of the care you provide? #JHMChat |
| Christian Sinclair, MD, FAAHPM @ctsinclair @SoniaMKhunkhun @PastorCorey And it is important to recognize how complex hospital medicine has become. There is so much info for hospitalists to stay up to date, that communication and coordination doesn't always get prioritized by the system. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @DianeEMeier: by the way #hospitalists- you have influence- tell your CMO and other administrators that there is desperate need for mor… |
| Jeremy Topin MD @JTopinMD T2 Just like coordination btwn "traditional" consult serv needs 2 be coordination of who initiates palliative care comm / goals. Often in ICU, we discuss who will be best to do so. (hospitalist/pal car/intensivist) Who has the time? who has made a connection w/ family #jhmchat |
 | Amy @giffordgirl1222 RT @WrayCharles: To all my #hospitalmedicine & #hpm friends out there! Jump in the #JHMChat conversation tonight at 9PM EST w/@DianeEMeier… |
| Maggie Rogers @magthenomad RT @LTummalapalli: As consultants (speaking from the renal perspective), it's often either "Why are you calling me now?" vs. "Why didn't yo… |
| Kim Ang @Kim_angbn RT @edgarvlermamd: Palliative approach to dialysis care #Nephpearls #JHMChat 👉🏼 https://t.co/Ggz6UkHuUJ https://t.co/v33TFryFqs |
| Sonia Malhotra,MD,MS @SoniaMKhunkhun @DianeEMeier Our #HPM #palliativecare team was the #1 thing requested by the med staff and the csuite invested in it #JHMChat |
| Robert J. Mahoney, MD @mahoneyr @magthenomad If this is true, we practice so much insanity. #JHMChat |
| Paul S @postscriptmd T2: Lack of GOC documentation, T3: document the conversations you *have* participated in. #JHMChat |
| Corey Kennard @PastorCorey #JHMChat moving #palliativecare consults more upstream will make a difference. |
| Christian Sinclair, MD, FAAHPM @ctsinclair @SoniaMKhunkhun @PastorCorey And it is kind of interesting how #palliative med and hospital med grew up as specialties during the same time. Many of our current palliative care staff also are hospitalists at @PalliCareKU @KUInternalMed #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @AlzGirlLori: Curious if anyone here (or close family) has been a patient in need of #PalliativeCare. Did that change your view of the… |
 | LiberalOldGuy @FriedRAllan RT @DianeEMeier: Nobody knows better than #hospitalists which patients are suffering; which patients don't understand what to expect; which… |
| Alz Girl Lori @AlzGirlLori RT @DianeEMeier: Nobody knows better than #hospitalists which patients are suffering; which patients don't understand what to expect; which… |
| Journal of Hospital Medicine @JHospMedicine RT @LTummalapalli: As consultants (speaking from the renal perspective), it's often either "Why are you calling me now?" vs. "Why didn't yo… |
| Robert J. Mahoney, MD @mahoneyr @gracefarris @magthenomad The problem is figuring out which one is the "index admission". Too often you only know that in hindsight. The rest of the time, it's a one-time thing. #JHMChat |
| Maggie Rogers @magthenomad @LTummalapalli From conversations with folks participating in the National Palliative Care Registry, they definitely feel that referrals are coming too late! Pal care teams might respond to a referral ASAP but that’s moot if the referral didn’t happen early enough! #hpm #JHMchat |
 | Maria T. Carney MD, FACP @MCarneyMD RT @DianeEMeier: by the way #hospitalists- you have influence- tell your CMO and other administrators that there is desperate need for mor… |
| Corey Kennard @PastorCorey #JHMChat also, setting to stage for #PalliativeCare consults come in the form of those doing the consulting seeing themselves as an extension of PC. |
| Sonia Malhotra,MD,MS @SoniaMKhunkhun @LTummalapalli Yes!!!!! Esp if outpatient #hpm #palliativecare can be provided. #seriousillnesscare needs to be upstream #JHMChat |
| Diane E. Meier @DianeEMeier setting the stage involves saying to a patient, I am calling in a colleague to help us figure out how best to meet your +your families' needs. Odd that we feel we need patient permission to call in #palliative care- we do not ask permission to call in ID or cards or onc. #JHMChat |
| Robin Fail @refailsafe Have any hospitalists out there worked with your palliative care team to build a documentation template that you share? Curious about standards for writing notes, and how to address the difficulty finding records in all the handoffs. #JHMchat |
| Sonia Malhotra,MD,MS @SoniaMKhunkhun @AlzGirlLori It made me realize how poorly my family knew what I did in the #hpm #palliativecare world. It's not just about end of life #JHMChat |
 | TOdoc @CacoMj @JHospMedicine So, we’re often the ones who actually introduce the concept of what palliative care actually means. There are pitfalls there - “it means giving up” “it means pulling the plug” “euthanasia” -that are hard to undo later. #jhmchat |
| Society of Hospital Medicine @SocietyHospMed #JHMChat T3 https://t.co/LCu1Lwnzao |
| Charlie M. Wray, DO, MS @WrayCharles As hospitalist, we're constantly put in this position. Anecdotally, I've NEVER regretted calling a #PalliativeCare consult in my career... #JHMchat https://t.co/OTPvuDlspA |
| Grace Farris MD @gracefarris I use “Would I be surprised if...” a lot (Q2) #GraphicMedicine #JHMChat #PalliativeCare #medtwitter #MedTwitterRocks https://t.co/1k4QbXxq4G |
 | Eileen Barrett MD MPH (she/her) @EileenBarrettNM @JHospMedicine When there is disagreement within the team or between teams on if additional aggressive interventions will make a meaningful difference #JHMChat |
| @HyungChoMD @HyungChoMD How about we just find better systems of co-managing patients with #palliativecare and hospitalist? #jhmchat https://t.co/rD0244p4oT |
| Gretchen Diemer @gretchendiemer @JHospMedicine Setting the stage "I'm going to ask my experts in symptom management to come help us. Before they get here, I want you to think about what is most important to you as you live with this disease" #jhmchat #dontsayhospice |
| Kim Ang @Kim_angbn RT @DianeEMeier: by the way #hospitalists- you have influence- tell your CMO and other administrators that there is desperate need for mor… |
| Maggie Rogers @magthenomad RT @WrayCharles: As hospitalist, we're constantly put in this position. Anecdotally, I've NEVER regretted calling a #PalliativeCare consult… |
| Robert J. Mahoney, MD @mahoneyr @ctsinclair @SoniaMKhunkhun @PastorCorey And, sometimes, fixing the short-term problem is easier than delving into the long-term plan. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @gretchendiemer: @JHospMedicine Setting the stage "I'm going to ask my experts in symptom management to come help us. Before they get he… |
| Vinny Arora MD MAPP @FutureDocs RT @WrayCharles: As hospitalist, we're constantly put in this position. Anecdotally, I've NEVER regretted calling a #PalliativeCare consult… |
 | Allison Silvers @SilversAllison Don't forget about caregiver burden - a quick assessment (Zarit) can reveal a high-risk family #JHMChat |
| Amy Melnick @AmyMelnick1 To the non-clinician here (me)...I am puzzled/frustrated. Seems to be some 'obvious' type solutions here. #hospitalists working more closely w #palliative care teams & advocating for larger PC services. Good for patient care & bottom line. Why is this hard? #hpm #JHMChat https://t.co/FG6VSXM4MT |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: Let's keep it rolling with Topic #3 for tonight's #JHMChat... https://t.co/ZG1qLzEefa |
| Diane E. Meier @DianeEMeier @cacomj #JHMChat #palliative care is NOT giving up or what we do when there is nothing more that we can do. misconception that keeps patients from the care and quality of life they deserve thru the whole course of an illness |
| Vinny Arora MD MAPP @FutureDocs RT @DianeEMeier: setting the stage involves saying to a patient, I am calling in a colleague to help us figure out how best to meet your +y… |
| Claire Sevov @ClaireSevovMD #jhmchat T3: Stage is set by the illness, let them tell you their story, then reflect back to them all the suffering they have already been through. |
| Edgar V. Lerma 🇵🇭 @edgarvlermamd Barriers and facilitators to conservative management of CKD in the elderly #Nephpearls #JHMChat 👉🏼 https://t.co/7Z8SnZj4dR https://t.co/6KoIzqiUu5 |
| Sonia Malhotra,MD,MS @SoniaMKhunkhun T3:learn how to describe #HPM #PalliativeCare to patients and trainees.helps set stage upstream for serious illness care #teamwork #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @AmyMelnick1: To the non-clinician here (me)...I am puzzled/frustrated. Seems to be some 'obvious' type solutions here. #hospitalists wo… |
| Carol Sieger @carolsieger RT @refailsafe: #JHMchat This article sums up barriers for hospitalists including lack of time (no surprise there), difficulty finding reco… |
 | Clay Anderson @AnglerMD RT @JHospMedicine: Let's keep it rolling with Topic #3 for tonight's #JHMChat... https://t.co/ZG1qLzEefa |
 | Adam Rodman @AdamRodmanMD RT @gracefarris: I use “Would I be surprised if...” a lot (Q2) #GraphicMedicine #JHMChat #PalliativeCare #medtwitter #MedTwitterRocks http… |
| Christian Sinclair, MD, FAAHPM @ctsinclair I would love to do this! #hpm #DocumentationDesign #JHMChat https://t.co/9Tyf4ZXpW5 |
| Grace Farris MD @gracefarris RT @SilversAllison: Don't forget about caregiver burden - a quick assessment (Zarit) can reveal a high-risk family #JHMChat |
 | Laura Lawler, MD @DocLauraLawler @gracefarris @DianeEMeier Agree, this often seems to be the case. BUT we must find a way to #DoBetter! #JHMChat Does talking w/ patients/families increase pt’s understanding and improve compliance & health? If this is evidenced based approach, we must advocate for systems to support our time w/ patients. |
| Maggie Rogers @magthenomad T3: ALL hospitalists and, lets be honest... ALL clinicians should have basic skills in communication, delivering serious news, symptom and pain management, what we call “primary #PalliativeCare skills”... I’d say that’s a start! #JHMchat #hpm |
| Elizabeth Gundersen @Top_Gundersen @SoniaMKhunkhun @LTummalapalli Absolutely. I consistently see patients die in ways they say they don't want because we are consulted late. Patients with chronic diseases such as COPD, CHF, dementia can benefit from goals of care discussions and symptom management plans many months earlier. #jhmchat |
| Journal of Hospital Medicine @JHospMedicine If you're not paying attention, there's some incredible words of wisdom regarding #PalliativeCare / #hpm being dropped in tonights #JHMChat |
| Eileen Barrett MD MPH (she/her) @EileenBarrettNM @JHospMedicine @LTummalapalli @DOMSinaiNYC This is *such* a great question. Frailty + when it seems they’ve fallen through the cracks to discuss the implications of their frailty with their PCP or family. I don’t want to flood the amazing #palliativecare team, but it’s nice to get ahead of a terrible admission #JHMChat |
| Robert J. Mahoney, MD @mahoneyr @gretchendiemer @JHospMedicine I remember a hospital pastor telling me one time, "You don't have to tell the patient that you're calling me. Sometimes it's just better for me to show up and explain why I'm there." I wonder if the same is true for palliative medicine? #JHMChat |
| Journal of Hospital Medicine @JHospMedicine Final Topic on its way... #JHMChat |
| Sonia Malhotra,MD,MS @SoniaMKhunkhun @AmyMelnick1 Time, knowledge, challenging existing status quo some of the challenges for #HPM #PalliativeCare #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @ctsinclair: I would love to do this! #hpm #DocumentationDesign #JHMChat https://t.co/9Tyf4ZXpW5 |
| Journal of Hospital Medicine @JHospMedicine RT @refailsafe: Have any hospitalists out there worked with your palliative care team to build a documentation template that you share? Cur… |
| Sonia Malhotra,MD,MS @SoniaMKhunkhun RT @DianeEMeier: @cacomj #JHMChat #palliative care is NOT giving up or what we do when there is nothing more that we can do. misconceptio… |
| Diane E. Meier @DianeEMeier T3. look at @getpalliativecare.org for audience research tested language on describing palliative care in a manner meaningful to patients/families. #JHMChat |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: If you're not paying attention, there's some incredible words of wisdom regarding #PalliativeCare / #hpm being dropped i… |
| Robert J. Mahoney, MD @mahoneyr Repeat for T3 #JHMChat https://t.co/1bTAhB498Q |
| Journal of Hospital Medicine @JHospMedicine We've touched on it a bit, but here you go...Topic #4 for tonights #JHMChat... https://t.co/qnUOZOFzrY |
 | Matthew Loxton @mloxton Lurking on #jhmchat |
| Journal of Hospital Medicine @JHospMedicine RT @DianeEMeier: T3. look at @getpalliativecare.org for audience research tested language on describing palliative care in a manner meaning… |
 | Pallimed @Pallimed RT @PCDorkClub: T2 Continuity of care. A patient can get great inpatient Palliative care but may suffer if there is no opportunity for outp… |
| Pallimed @Pallimed RT @DianeEMeier: Ideally all #hospitalists have core palliative care knowledge and skills and call for specialty consultation only on the m… |
| Pallimed @Pallimed RT @JHospMedicine: We've touched on it a bit, but here you go...Topic #4 for tonights #JHMChat... https://t.co/qnUOZOFzrY |
| Elizabeth Gundersen @Top_Gundersen @SoniaMKhunkhun @LTummalapalli Of course it doesn't have to be palliative care docs having goals of care discussions or doing symptom management. I'm a big supporter of all clinicians doing palliative care as part of good person-centered care! First GOC talk I saw as an intern was by a nephrologist. #jhmchat |
| Gretchen Diemer @gretchendiemer @mahoneyr @JHospMedicine I tell them about every consult I'm calling and why. Not sure if it's necessary but seems important so they understand the plan. And my consultants don't stumble into irritable patient! #jhmchat |
| Eileen Barrett MD MPH (she/her) @EileenBarrettNM @JHospMedicine I can’t say it better! Specifically, though, I do believe #hospitalists & #palliativecare teams should have semi structured interactions outside of consults - so we know each other as people, support each other, have a relationship before tough conversations #JHMChat |
 | Kelly Cawcutt MD MS @KellyCawcuttMD RT @JHospMedicine: If you're not paying attention, there's some incredible words of wisdom regarding #PalliativeCare / #hpm being dropped i… |
| Sonia Malhotra,MD,MS @SoniaMKhunkhun @Top_Gundersen @LTummalapalli I describe plan a of serious illness care as all the medical stuff while prepping for plan b which is complementary to a (acp,etc) #JHMChat |
 | Stephanie M. Lape, MD @stephanieMlape @mloxton Also guilty. #JHMChat |
| Society of Hospital Medicine @SocietyHospMed Don't forget to claim #CME after tonight's #JHMChat! https://t.co/40h6vEvGX9 |
| Robin Fail @refailsafe @CAPCpalliative @vitaltalk and @AriadneLabs have teamed up with offerings for serious illness communication training. Check out the new website for more info on the offerings: https://t.co/0Md3A67SCU #JHMchat |
| Journal of Hospital Medicine @JHospMedicine @stephanieMlape @mloxton We don't mind. Glad you're here! #JHMCHat |
| Journal of Hospital Medicine @JHospMedicine RT @refailsafe: @CAPCpalliative @vitaltalk and @AriadneLabs have teamed up with offerings for serious illness communication training. Check… |
| Journal of Hospital Medicine @JHospMedicine RT @SHMLive: Don't forget to claim #CME after tonight's #JHMChat! https://t.co/40h6vEvGX9 |
 | Alex Meraz (he/him) @NephroGuy RT @edgarvlermamd: Utility of the "Surprise" Question: A trigger for palliative care evaluation and advanced care planning #Nephpearls #JHM… |
| Maggie Rogers @magthenomad RT @HyungChoMD: How about we just find better systems of co-managing patients with #palliativecare and hospitalist? #jhmchat https://t.co/r… |
| Robert J. Mahoney, MD @mahoneyr @gretchendiemer @JHospMedicine This is definitely true for some consults - especially if considering hospice. But for symptom management/goals of care, I wonder if it's more approachable for patients if it is part of the treatment plan, not a separate "specialist" coming to give a separate "opinion" #JHMChat |
| Carol Sieger @carolsieger RT @DianeEMeier: setting the stage involves saying to a patient, I am calling in a colleague to help us figure out how best to meet your +y… |
| Sonia Malhotra,MD,MS @SoniaMKhunkhun @AlzGirlLori Thank you! Why I love my #hospitalist colleagues!! #jhmchat and #PalliativeCare #hpm |
| Alex Meraz (he/him) @NephroGuy RT @edgarvlermamd: Palliative approach to dialysis care #Nephpearls #JHMChat 👉🏼 https://t.co/Ggz6UkHuUJ https://t.co/v33TFryFqs |
| Maggie Rogers @magthenomad RT @DianeEMeier: by the way #hospitalists- you have influence- tell your CMO and other administrators that there is desperate need for mor… |
| Pallimed @Pallimed RT @EileenBarrettNM: @JHospMedicine @LTummalapalli @DOMSinaiNYC This is *such* a great question. Frailty + when it seems they’ve fallen thr… |
| Pallimed @Pallimed RT @JHospMedicine: If you're not paying attention, there's some incredible words of wisdom regarding #PalliativeCare / #hpm being dropped i… |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: We've touched on it a bit, but here you go...Topic #4 for tonights #JHMChat... https://t.co/qnUOZOFzrY |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: We've touched on it a bit, but here you go...Topic #4 for tonights #JHMChat... https://t.co/qnUOZOFzrY |
| Robin Fail @refailsafe SHM's implementation guide on improving communication about serious illness is another great place to start for #hospitalists #JHMchat |
| Journal of Hospital Medicine @JHospMedicine @KellyCawcuttMD love having this perspectiv, Kelly #JHMChat |
| Diane E. Meier @DianeEMeier I wish hospitalists knew that #palliative care is an added layer of support for the most complex and high need patients and families+that consult within the first 2-3 days of an admission has huge impact #JHMChat |
 | UofUPalliativeCare @UofUPalliCare RT @DianeEMeier: Ideally all #hospitalists have core palliative care knowledge and skills and call for specialty consultation only on the m… |
| Journal of Hospital Medicine @JHospMedicine RT @DianeEMeier: I wish hospitalists knew that #palliative care is an added layer of support for the most complex and high need patients an… |
| Robin Fail @refailsafe #JHMchat https://t.co/h6hX6EQBNe |
| Gretchen Diemer @gretchendiemer @EileenBarrettNM @JHospMedicine I say "aggressive" as often as I can when talking about palliative care! "Aggressive symptom management", "aggressive control of pain" etc. #jhmchat |
| Maggie Rogers @magthenomad RT @refailsafe: #JHMchat https://t.co/h6hX6EQBNe |
| Diane E. Meier @DianeEMeier I also wish #hospitalists knew that the training (on symptoms, on communication, on family caregiver burden, on options for care) we did not get in med school/residency is now available to us- our patients need us to have these skills. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine We have about 10 min left in tonight's #JHMChat. So much great stuff in tonights discussion. Feel free to throw out any final thoughts on the intersection of #PalliativeCare & #hospitalmedicine |
 | Abraham E. Gracia R. @Abraham_RMI RT @edgarvlermamd: Palliative approach to dialysis care #Nephpearls #JHMChat 👉🏼 https://t.co/Ggz6UkHuUJ https://t.co/v33TFryFqs |
| Charlie M. Wray, DO, MS @WrayCharles This is great, I'm gonna steal this one... #JHMChat https://t.co/Wwqu3sWkp3 |
 | Mark Cheong @markcheongwl RT @edgarvlermamd: Palliative approach to dialysis care #Nephpearls #JHMChat 👉🏼 https://t.co/Ggz6UkHuUJ https://t.co/v33TFryFqs |
| Grace Farris MD @gracefarris A4 wait, is this not the correct style? #GraphicMedicine #medtwitter #jhmchat https://t.co/P26n7yKARl |
| TOdoc @CacoMj @gretchendiemer @EileenBarrettNM @JHospMedicine You mean you ❤️this aggressively? #jhmchat |
| Sonia Malhotra,MD,MS @SoniaMKhunkhun T4:#hpm is a recognized subspecialty of medicine that needs to be taught to all & #palliativecare recognized by all subspecialists #jhmchat |
| Elizabeth Gundersen @Top_Gundersen @gretchendiemer @mahoneyr @JHospMedicine I like when the patient is informed I am coming but often need to explain my role again once I'm there. Even if they have misgivings, are scared or are angry, I appreciate the chance to get in the door. We can usually reassure patients once we're there. #jhmchat |
| Sonia Malhotra,MD,MS @SoniaMKhunkhun RT @WrayCharles: As hospitalist, we're constantly put in this position. Anecdotally, I've NEVER regretted calling a #PalliativeCare consult… |
| Maggie Rogers @magthenomad @gretchendiemer @EileenBarrettNM @JHospMedicine That’s such an interesting tactic to fight the end of life connotation!! Using “aggressive” when describing symptom management definitely doesn’t make the mind go to end of life care. #JHMchat #HPM |
| @HyungChoMD @HyungChoMD RT @gracefarris: A4 wait, is this not the correct style? #GraphicMedicine #medtwitter #jhmchat https://t.co/P26n7yKARl |
| Edgar V. Lerma 🇵🇭 @edgarvlermamd Conceptual framework for supportive care in CKD #Nephpearls #JHMChat 👉🏼 https://t.co/qE5eKe4BQt https://t.co/ijkPGLdeSf |
| Robert J. Mahoney, MD @mahoneyr @JHospMedicine T4 It's surprising how lonely it feels as a provider telling a patient and his/her family that there are no other treatment options we expect to succeed - especially when there are treatment options we suspect will fail. In that moment, that it is nice to have support #JHMCHat |
| Journal of Hospital Medicine @JHospMedicine As we wrap up tonight's discussion, want to give @refailsafe & @DianeEMeier of a huge "Thank You" for joining us as special guests on tonights #JHMChat @CAPCpalliative |
| Sonia Malhotra,MD,MS @SoniaMKhunkhun Often our #Hospitalist colleagues can get us into the inner circle where #palliativecare has been slow to gain acceptance #jhmchat #hpm |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: We have about 10 min left in tonight's #JHMChat. So much great stuff in tonights discussion. Feel free to throw out any… |
| Journal of Hospital Medicine @JHospMedicine RT @SoniaMKhunkhun: T4:#hpm is a recognized subspecialty of medicine that needs to be taught to all & #palliativecare recognized by all sub… |
| Eileen Barrett MD MPH (she/her) @EileenBarrettNM @CacoMj @JHospMedicine @LTummalapalli @DOMSinaiNYC @Atul_Gawande Well said. Not sure where in this chat this goes, but I hope everyone here knows about https://t.co/IJDJy9lUOs #jhmchat |
| Sri Lekha Tummalapalli, MD, MBA @LTummalapalli We had such great pall care training during residency @MountSinaiNYC led by Dr. Stephen Berns and others on Ask-Tell-Ask and NURSE statements - such useful skills in multiple domains! @Stberns #jhmchat |
 | Rural Home Care BruceGrey @RuralHomeCareBG RT @DianeEMeier: I wish hospitalists knew that #palliative care is an added layer of support for the most complex and high need patients an… |
| Journal of Hospital Medicine @JHospMedicine RT @EileenBarrettNM: @CacoMj @JHospMedicine @LTummalapalli @DOMSinaiNYC @Atul_Gawande Well said. Not sure where in this chat this goes, but… |
| Kelly Cawcutt MD MS @KellyCawcuttMD RT @WrayCharles: This is great, I'm gonna steal this one... #JHMChat https://t.co/Wwqu3sWkp3 |
| Diane E. Meier @DianeEMeier @CAPCpalliative collaborated with the @SHMLive to develop a hospitalist toolkit right now available to CAPC members, see if your hospital is already a member right here: https://t.co/bKx7bHJo1t #JHMChat |
 | Lisa Davis Budzinski @lisadbudzinski @mloxton I’m lurking with you ✨ #jhmchat |
| Robert J. Mahoney, MD @mahoneyr @Top_Gundersen @gretchendiemer @JHospMedicine Fair enough. It is very hard for any consultant to arrive unexpectedly and then feel the need to justify their presence. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @DianeEMeier: @CAPCpalliative collaborated with the @SHMLive to develop a hospitalist toolkit right now available to CAPC members, see i… |
| Sonia Malhotra,MD,MS @SoniaMKhunkhun @AmyMelnick1 @CoalitionHPC @CAPCpalliative @AAHPM @HPNAinfo #teamwork will help us change the status quo esp in regions like the south where #palliativecare #hpm not as readily accepted #jhmchat |
 | jeromel @jeromelmd RT @gretchendiemer: @EileenBarrettNM @JHospMedicine I say "aggressive" as often as I can when talking about palliative care! "Aggressive s… |
| Journal of Hospital Medicine @JHospMedicine Great toolkit here for #hospitalist to improve their skills in #PalliativeCare care. via tonight's #JHMChat https://t.co/dw1eAY1Ev2 |
| Elizabeth Gundersen @Top_Gundersen @gretchendiemer @EileenBarrettNM @JHospMedicine Yes! We don't want to call curative care "aggressive" and palliative care or symptom management "no longer aggressive." We also don't like the phrase "withdrawing care." We always care - aggressively! #JHMChat |
| Diane E. Meier @DianeEMeier RT @LTummalapalli: We had such great pall care training during residency @MountSinaiNYC led by Dr. Stephen Berns and others on Ask-Tell-Ask… |
| Pallimed @Pallimed RT @magthenomad: T3: ALL hospitalists and, lets be honest... ALL clinicians should have basic skills in communication, delivering serious n… |
| Pallimed @Pallimed RT @SoniaMKhunkhun: T3:learn how to describe #HPM #PalliativeCare to patients and trainees.helps set stage upstream for serious illness car… |
| Pallimed @Pallimed RT @edgarvlermamd: Barriers and facilitators to conservative management of CKD in the elderly #Nephpearls #JHMChat 👉🏼 https://t.co/7Z8SnZj… |
| Robert J. Mahoney, MD @mahoneyr @JHospMedicine @refailsafe @DianeEMeier @CAPCpalliative Thanks @JHospMedicine, @refailsafe, and @DianeEMeier for another great #JHMChat! |
| Diane E. Meier @DianeEMeier RT @Top_Gundersen: @gretchendiemer @EileenBarrettNM @JHospMedicine Yes! We don't want to call curative care "aggressive" and palliative ca… |
| Robin Fail @refailsafe For risk-bearing organizations, it is certainly in everyone's best interest to prioritize communication, symptom management, and care coordination. Making the case to leadership should only get easier in a value-based world. And the patients will thank you, too! #JHMchat |
| Pallimed @Pallimed RT @DianeEMeier: @CAPCpalliative collaborated with the @SHMLive to develop a hospitalist toolkit right now available to CAPC members, see i… |
| Pallimed @Pallimed RT @mahoneyr: @JHospMedicine T4 It's surprising how lonely it feels as a provider telling a patient and his/her family that there are no ot… |
| Eileen Barrett MD MPH (she/her) @EileenBarrettNM @JHospMedicine Great chat! Parting thought (besides thanks!): could integrate #palliativecare more through being guest presenters at #hospitalist #journalclub - can build relationships, knowledge, & demonstrate special skillset #jhmchat |
| Sonia Malhotra,MD,MS @SoniaMKhunkhun RT @refailsafe: For risk-bearing organizations, it is certainly in everyone's best interest to prioritize communication, symptom management… |
| Pallimed @Pallimed RT @gretchendiemer: @JHospMedicine Setting the stage "I'm going to ask my experts in symptom management to come help us. Before they get he… |
 | Doctivist 🏳️🌈 @jbcowartmd RT @JHospMedicine: Great toolkit here for #hospitalist to improve their skills in #PalliativeCare care. via tonight's #JHMChat https://t.co… |
| Diane E. Meier @DianeEMeier thank you everyone- this was really fun. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine #JHMChat wouldn't be something without each of you! Thanks to all those who joined us and hope tonight's discussion was informative. Loved having our #hpm colleagues w/us as well. We should do this more often... |
 | Temple Ratcliffe @templeratcliffe RT @WrayCharles: This is great, I'm gonna steal this one... #JHMChat https://t.co/Wwqu3sWkp3 |
| Grace Farris MD @gracefarris Thanks @WrayCharles for another great #JHMChat ! |
| Allison Silvers @SilversAllison Palliative care skills can ensure patients feel heard & understood #HCAHPS #JHMChat |
| Grace Farris MD @gracefarris RT @mahoneyr: @JHospMedicine @refailsafe @DianeEMeier @CAPCpalliative Thanks @JHospMedicine, @refailsafe, and @DianeEMeier for another grea… |
 | Jason A. Webb, M.D., DFAPA FAAHPM @JasAWebb RT @DianeEMeier: setting the stage involves saying to a patient, I am calling in a colleague to help us figure out how best to meet your +y… |
| Journal of Hospital Medicine @JHospMedicine One final shout out to our partners @SHMLive @CostsofCare @ABIMFoundation 4 bringing you #JHMChat tonight - another #CME edition! --> https://t.co/0R3URG3dK5 |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: #JHMChat wouldn't be something without each of you! Thanks to all those who joined us and hope tonight's discussion was… |
| Journal of Hospital Medicine @JHospMedicine One final shout out to our partners @SHMLive @CostsofCare @ABIMFoundation 4 bringing you #JHMChat tonight - another #CME edition! --> https://t.co/0R3URG3dK5 https://t.co/0R3URG3dK5 |
| Maggie Rogers @magthenomad @JHospMedicine Foreshadowing for the future of palliative and hospital medicine collaborations!! #JHMChat #HPM |
 | Michelle Fleshner @MFleshner301 RT @gracefarris: Q1, A1 this is sometimes how I feel #jhmchat #GraphicMedicine #medtwitter #MedTwitterRocks #PalliativeCare https://t.co/… |
| Charlie M. Wray, DO, MS @WrayCharles @gracefarris It was my pleasure. And I still remain in awe of your quick artistic abilities. I'm a huge fan #JHMChat |
 | Mary Dunne @MimiDunneMD RT @DianeEMeier: by the way #hospitalists- you have influence- tell your CMO and other administrators that there is desperate need for mor… |
 | Senior discovery @SeniorTypes RT @DianeEMeier: Nobody knows better than #hospitalists which patients are suffering; which patients don't understand what to expect; which… |
| Sonia Malhotra,MD,MS @SoniaMKhunkhun Thank you to #hospitalist colleagues for a great #jhmchat from this #PalliativeCare #hpm doc!Why I ♥️being in General IM group at our SOM! |
| Journal of Hospital Medicine @JHospMedicine RT @refailsafe: For risk-bearing organizations, it is certainly in everyone's best interest to prioritize communication, symptom management… |
| Mary Dunne @MimiDunneMD RT @DianeEMeier: see recent meta-analysis in last week's JAMA IM on economics of hospital #palliative care https://t.co/HJtUItdZvR #JHMChat |
| Elizabeth Gundersen @Top_Gundersen @mahoneyr @gretchendiemer @JHospMedicine Yes, ideally the patient would be informed, but I know that can be complicated and I'm happy to help any way I can. I ask the patient up front if s/he was expecting me and go from there. We're all on the same team trying to help patients. #jhmchat |
| Michelle Fleshner @MFleshner301 RT @WrayCharles: As hospitalist, we're constantly put in this position. Anecdotally, I've NEVER regretted calling a #PalliativeCare consult… |
 | William Rivero @williamrivero RT @edgarvlermamd: Palliative approach to dialysis care #Nephpearls #JHMChat 👉🏼 https://t.co/Ggz6UkHuUJ https://t.co/v33TFryFqs |
| Eileen Barrett MD MPH (she/her) @EileenBarrettNM @DianeEMeier @JHospMedicine Honestly, I also wish everyone knew it’s a extra layer of support for the #hospitalist team, too. #JHMChat |
| Laura Lawler, MD @DocLauraLawler @WrayCharles @gracefarris Yes! I was only following along for part, but I was super impressed by your real-time #GraphicMedicine responses! Also, ♥️ #MedTwitterRocks. Haven’t seen that hashtag before but it’s so perfect. #JHMChat |
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