#JHMChat Transcript

Healthcare social media transcript of the #JHMChat hashtag.
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See #JHMChat Influencers/Analytics.

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Society of Hospital Medicine @SocietyHospMed
#JHMChat starts NOW! Join the conversation, then claim #CME. Details here: https://t.co/E7QUHZqgFd https://t.co/erWlyQTQod
Journal of Hospital Medicine @JHospMedicine
Welcome to #JHMChat, I am your moderator @FutureDocs please introduce yourself.
Journal of Hospital Medicine @JHospMedicine
tonight on #JHMChat we are pleased to welcome the authors of this paper @AuH2O_md @KDharmarajanMD @hmkyale on post-hospital syndrome - a result of hospitalization induced allostatic overload https://t.co/j2zSEI7sWV? https://t.co/98HXmQoCnb
Harlan Krumholz @hmkyale
RT @SHMLive: #JHMChat starts NOW! Join the conversation, then claim #CME. Details here: https://t.co/E7QUHZqgFd https://t.co/erWlyQTQod
Vinny Arora MD MAPP @FutureDocs
RT @JHospMedicine: tonight on #JHMChat we are pleased to welcome the authors of this paper @AuH2O_md @KDharmarajanMD @hmkyale on post-hos…
Vinny Arora MD MAPP @FutureDocs
RT @SHMLive: #JHMChat starts NOW! Join the conversation, then claim #CME. Details here: https://t.co/E7QUHZqgFd https://t.co/erWlyQTQod
Tony Breu @tony_breu
Tony Breu, here from just-south-of-Boston. #JHMchat
Journal of Hospital Medicine @JHospMedicine
RT @SHMLive: #JHMChat starts NOW! Join the conversation, then claim #CME. Details here: https://t.co/E7QUHZqgFd https://t.co/erWlyQTQod
Harlan Krumholz @hmkyale
So appreciate the opportunity to join the community and talk about how we can improve hospital care. #JHMChat https://t.co/RACV0UDafB
Journal of Hospital Medicine @JHospMedicine
RT @MGHHMU: Spread the word! #JHMchat is back for a special summer session- Monday July 9th 9pET with a new twist on the Posthospital Syndr…
Journal of Hospital Medicine @JHospMedicine
RT @hmkyale: So appreciate the opportunity to join the community and talk about how we can improve hospital care. #JHMChat https://t.co/RAC…
Stephanie Burdick @goblueburd
#JHMCHat Stephanie Burdick MD here from Grand Rapids MI.
Nancy H. Stewart, DO, MS (she/her) @nvhstewart
Hi all! Nancy here, graduating #pccm fellow upcoming #sleep fellow— excited to join tonight! #jhmchat
Marilyn Mann @MarilynMann
RT @SHMLive: #JHMChat starts NOW! Join the conversation, then claim #CME. Details here: https://t.co/E7QUHZqgFd https://t.co/erWlyQTQod
Deena Goldwater @AuH2O_md
Deena Goldwater. Thank you so much for hosting this chat! #JHMCHat
Don Edmondson, PhD, MPH @edmondson_don
Don Edmondson, PhD, Assoc Prof at Columbia Med, researcher in stress and cardiovascular risk. Have a current observational study of post hospital syndrome. #JHMchat
Charlie M. Wray, DO, MS @WrayCharles
Charlie Wray, joining from the unseasonably warm SF Bay area #SummerIsOurWinter #JHMChat
Kumar Dharmarajan @KDharmarajanMD
So important that we make hospitals into the healing environments they are meant to be. Our patients need this #JHMCHat
Society of Hospital Medicine @SocietyHospMed
Claim #CME after tonight's #JHMChat here: https://t.co/SG8h7Rkqwc
Journal of Hospital Medicine @JHospMedicine
T1 The authors highlight several of the "stressors" that clinically contribute to post-hospital syndrome. What are the main ones you see in your practice? #JHMChat https://t.co/O152pPFOqQ
Tony Breu @tony_breu
Sleep disruption is near the top. @FutureDocs #JHMchat https://t.co/B9Fi50y8zd
Elizabeth Gundersen @Top_Gundersen
@JHospMedicine @FutureDocs Hi All, Liz Gundersen joining in #JHMChat from always warm south Florida! https://t.co/SBmftrPE5M
Jeff @geologyjeff
#jhmchat A patient that has been suffering from PHS at Yale!!!!
Nancy H. Stewart, DO, MS (she/her) @nvhstewart
A1: from a specialty standpoint, there is a lot of #patient #confusion on discharge involving follow up, meds, hospital course #jhmchat https://t.co/U5YWnJxAZI
Journal of Hospital Medicine @JHospMedicine
RT @WrayCharles: Charlie Wray, joining from the unseasonably warm SF Bay area #SummerIsOurWinter #JHMChat
Stephanie Burdick @goblueburd
#JHMCHat The first thing patients ask me when I meet them is if they can have a have a real diet. My residents had a 97 yo on a restricted diet and he couldn't order ice cream! It was a teaching moment.....
Harlan Krumholz @hmkyale
Don’t we all see the same thing? Sleep deprivation. Noise. Poor nutrition. Inactivity. Chaos. Disruption. Embarrassment. Discomfort. This is the daily experience of patients. Aside from their illness. #JHMChat https://t.co/bEppplUgIQ
Kumar Dharmarajan @KDharmarajanMD
@JHospMedicine Uncertainty all too common in the hospital. Who is my doctor? Why are my providers always changing? When is my test? When can I eat? What is my prognosis? When will I be able to leave? #JHMChat
Society of Hospital Medicine @SocietyHospMed
T1 for tonight's #JHMChat is live! Join the conversation happening NOW https://t.co/xzWmAduKNS
Harlan Krumholz @hmkyale
Loss of control. That is a huge stress for patients. We don’t even let them wear their own clothes. They aren’t even involved in the most trivial decisions of the day. #JHMchat https://t.co/JO7OR24Y1t
Journal of Hospital Medicine @JHospMedicine
RT @KDharmarajanMD: @JHospMedicine Uncertainty all too common in the hospital. Who is my doctor? Why are my providers always changing? When…
Charlie M. Wray, DO, MS @WrayCharles
T1: In my experience, the physical and emotional isolation that is forced upon our patients appear to have quite an impact. Could prob measure via functional status changes, but largely difficult to measure/quantify #JHMChat
Journal of Hospital Medicine @JHospMedicine
RT @hmkyale: Don’t we all see the same thing? Sleep deprivation. Noise. Poor nutrition. Inactivity. Chaos. Disruption. Embarrassment. Disco…
Journal of Hospital Medicine @JHospMedicine
RT @nvhs0401: A1: from a specialty standpoint, there is a lot of #patient #confusion on discharge involving follow up, meds, hospital cours…
Chris Petrilli, MD, SFHM @PetrilliMD
@goblueburd #JHMChat there was a wonderful @SHMLive @twdfnr presentation on that ... #NoMoreFluidorSodiumRestriction
Inspire @InspireIsHealth
RT @hmkyale: So appreciate the opportunity to join the community and talk about how we can improve hospital care. #JHMChat https://t.co/RAC…
Elizabeth Gundersen @Top_Gundersen
@KDharmarajanMD @JHospMedicine Yes! And even: Why am I here? #JHMChat
Vinny Arora MD MAPP @FutureDocs
RT @hmkyale: So appreciate the opportunity to join the community and talk about how we can improve hospital care. #JHMChat https://t.co/RAC…
Harlan Krumholz @hmkyale
The schedule…when will my doctor come? Will I miss her or him? What is happening today? Days are full of anxiety in anticipation of what might be next. This is the experience of most patients. #JHMChat https://t.co/EF69Gigv2M
Journal of Hospital Medicine @JHospMedicine
T2 up in a moment on #JHMChat.
Vinny Arora MD MAPP @FutureDocs
RT @gracefarris: Grace Farris joining from NYC #JHMchat https://t.co/Fz7E65hC9D
Nancy H. Stewart, DO, MS (she/her) @nvhstewart
I had an #ICU pt recently that was admitted for hypertensive urgency and he refused to change I to a gown #jhmchat (I can’t blame him) https://t.co/O7KXKrAeCZ
Don Edmondson, PhD, MPH @edmondson_don
T1. We consistently find that emergency department crowding, patient stress, poor clinician-patient communication in ED contribute to excess stress in the ED and later. 15% develop PTSD-like symptoms after major CVD events. #JHMchat
Journal of Hospital Medicine @JHospMedicine
RT @Top_Gundersen: @KDharmarajanMD @JHospMedicine Yes! And even: Why am I here? #JHMChat
Avital Y. O'Glasser, MD FACP SFHM DFPM (she/her) @aoglasser
@gracefarris @FutureDocs #JHMchat here come the graphics!!
Mary MACK @MaryOCMack
Hello, Mary here-- just joined late and lurking #JHMChat
Vinny Arora MD MAPP @FutureDocs
RT @aoglasser: @gracefarris @FutureDocs #JHMchat here come the graphics!!
Tony Breu @tony_breu
@aoglasser I still see patients in 4-person rooms... #JHMchat
Vinny Arora MD MAPP @FutureDocs
you know i agree with you! we are working to fix this not only in adults but also in kids- be curious is kids have post hospital syndrome #jhmchat https://t.co/uFp4wWvj9L
Harlan Krumholz @hmkyale
T1. Sharing a room with an ill roommate in the hospital… or even one who may die… we do not even acknowledge the emotional trauma to the hospital roommate. #JHMChat https://t.co/C3ra91tnvT
Charlie M. Wray, DO, MS @WrayCharles
Agree that uncertainty is a leading cause. I was once taught pts. want to know 3 things: 1. When can I eat? 2. When can I go home? 3. Am I going to die? #JHMChat
Journal of Hospital Medicine @JHospMedicine
RT @FutureDocs: you know i agree with you! we are working to fix this not only in adults but also in kids- be curious is kids have post hos…
Charlie M. Wray, DO, MS @WrayCharles
@tony_breu @aoglasser you must work in a VA... :)
Don Edmondson, PhD, MPH @edmondson_don
Insufficient sleep is known to exacerbate long-term effects of acute stress. #JHMChat
Journal of Hospital Medicine @JHospMedicine
RT @donaldedmondso2: T1. We consistently find that emergency department crowding, patient stress, poor clinician-patient communication in E…
Harlan Krumholz @hmkyale
T1. How is it that we came to accept the stress of the hospitalization as normative. How did we come to so ignore the experience of being a patient. And consider that they just needed to tough out the ‘inconvenience’?#JHMChat
Elizabeth Gundersen @Top_Gundersen
@WrayCharles Hospitalization can be dehumanizing. It can feel like "conveyor belt" medicine where patients feel they are not treated like individuals with their own unique goals and values. #JHMChat
Tom Varghese Jr. MD, MS, MBA, FACS, MAMSE 🇺🇸 @TomVargheseJr
RT @WrayCharles: Agree that uncertainty is a leading cause. I was once taught pts. want to know 3 things: 1. When can I eat? 2. When can I…
Margaret Fleming @mlsfleming2
RT @hmkyale: Don’t we all see the same thing? Sleep deprivation. Noise. Poor nutrition. Inactivity. Chaos. Disruption. Embarrassment. Disco…
Vinny Arora MD MAPP @FutureDocs
RT @donaldedmondso2: Insufficient sleep is known to exacerbate long-term effects of acute stress. #JHMChat
Vinny Arora MD MAPP @FutureDocs
RT @sucharitakher: T1: the stress of needing to understand medical jargon. We need to speak in a language our patients understand. #JHMChat
Vinny Arora MD MAPP @FutureDocs
this seems like a testable hypothesis- we moved to single rooms recently in a new hospital. #jhmchat https://t.co/VM3yooFZRC
Marilyn Mann @MarilynMann
RT @hmkyale: Don’t we all see the same thing? Sleep deprivation. Noise. Poor nutrition. Inactivity. Chaos. Disruption. Embarrassment. Disco…
Chris Petrilli, MD, SFHM @PetrilliMD
@WrayCharles #JHMChat @nyulangone does a great job with #interdisciplinaryrounds and #ptsafetyhuddle ... every day at 1:45pm patients are told by MD/RN/SW/PT/ETC 4 things 1) Why are you here 2) Why are you still here 3) What needs to happen for you to go home 4) when will you go home
Harlan Krumholz @hmkyale
What happened is that we became socialized to ignore what patients really experience. We only see it if we or our friends and family go through it and we are civilians observing. #JHMChat https://t.co/5Hs1l8G4x9
Kumar Dharmarajan @KDharmarajanMD
@Top_Gundersen @WrayCharles Agreed. The dehumanization starts as soon as we get banded and issued a hospital gown. #JHMChat
Journal of Hospital Medicine @JHospMedicine
RT @Top_Gundersen: @WrayCharles Hospitalization can be dehumanizing. It can feel like "conveyor belt" medicine where patients feel they ar…
Margaret Fleming @mlsfleming2
RT @hmkyale: The schedule…when will my doctor come? Will I miss her or him? What is happening today? Days are full of anxiety in anticipati…
Journal of Hospital Medicine @JHospMedicine
RT @KDharmarajanMD: @Top_Gundersen @WrayCharles Agreed. The dehumanization starts as soon as we get banded and issued a hospital gown. #JHM
Journal of Hospital Medicine @JHospMedicine
T2 Likewise, the authors also explore the main health consequences of stress or allostatic load in hospitalized patients -- which ones are most significant for your patients? #JHMChat https://t.co/jUmDKbVv5h
Chris Petrilli, MD, SFHM @PetrilliMD
@hmkyale #JHMChat that's why I really don't like when people flippantly say "this isnt a hotel" ... maybe it should be more like a hotel than we think...
Journal of Hospital Medicine @JHospMedicine
RT @hmkyale: What happened is that we became socialized to ignore what patients really experience. We only see it if we or our friends and…
Don Edmondson, PhD, MPH @edmondson_don
@FutureDocs We find that perceiving a nearby patient as likely to die is associated with increased PTSD symptoms after discharge.
David T. Liebers @dtliebers
RT @hmkyale: T1. Sharing a room with an ill roommate in the hospital… or even one who may die… we do not even acknowledge the emotional tra…
Nancy H. Stewart, DO, MS (she/her) @nvhstewart
RT @PetrilliMD: @WrayCharles #JHMChat @nyulangone does a great job with #interdisciplinaryrounds and #ptsafetyhuddle ... every day at 1:45p…
Harlan Krumholz @hmkyale
Does it need testing? Who wants to room with someone who is acutely ill? Ill enough to be hospitalized? Privacy matters. #JHMChat https://t.co/CYsrjWGFTZ
Society of Hospital Medicine @SocietyHospMed
RT @JHospMedicine: T2 Likewise, the authors also explore the main health consequences of stress or allostatic load in hospitalized patients…
Nancy H. Stewart, DO, MS (she/her) @nvhstewart
@PetrilliMD @WrayCharles @nyulangone This is wonderful!! #jhmchat
Marilyn Mann @MarilynMann
RT @donaldedmondso2: T1. We consistently find that emergency department crowding, patient stress, poor clinician-patient communication in E…
Dr. Aletta #StandWithUkraine🌻 @dr_aletta
RT @hmkyale: Don’t we all see the same thing? Sleep deprivation. Noise. Poor nutrition. Inactivity. Chaos. Disruption. Embarrassment. Disco…
Elizabeth Gundersen @Top_Gundersen
RT @JHospMedicine: tonight on #JHMChat we are pleased to welcome the authors of this paper @AuH2O_md @KDharmarajanMD @hmkyale on post-hos…
Mary MACK @MaryOCMack
As a patient in the hospital I had a lot of anxiety. I overheard someone complaining about having to deal w/ anxious patients. #JHMChat
Don Edmondson, PhD, MPH @edmondson_don
T2 In two separate cohorts, we have found that acute stress symptoms at discharge are associated with increased 30 day readmission risk (Edmondson et al, 2014) and (Sumner et al, 2017). #JHMchat
Khurram Nasir @khurramn1
RT @hmkyale: What happened is that we became socialized to ignore what patients really experience. We only see it if we or our friends and…
New England Nurse @coffeeNCalibers
RT @hmkyale: Don’t we all see the same thing? Sleep deprivation. Noise. Poor nutrition. Inactivity. Chaos. Disruption. Embarrassment. Disco…
Tony Breu @tony_breu
@hmkyale While I agree that most want private rooms, I have observed on many occasions my patients (all veterans) "watching out" for their roommates and enjoying the conversations/connections. #JHMchat
Harlan Krumholz @hmkyale
T2. Our point is that we have been indifferent to the consequences of the stress, thinking it is just inconvenient for patients. Maybe it is a lot more. Many people suffer health consequences of the toxicity of the hospitalization. That is the new idea. #JHMchat
Margaret Fleming @mlsfleming2
RT @FutureDocs: this seems like a testable hypothesis- we moved to single rooms recently in a new hospital. #jhmchat https://t.co/VM3yooFZRC
Vinny Arora MD MAPP @FutureDocs
@PetrilliMD @hmkyale true... in fact maybe you saw our hotel that works like a hospital video once upon a time? #jhmchat https://t.co/sbdl71aznQ cc @CostsofCare @neel_shah
Chris Petrilli, MD, SFHM @PetrilliMD
@reepRN #JHMChat Agree and thank you! It's always great to have nurses on here...the ones who spend most (read: all) of their day with patients... @hvpaa would love to have caring and passionate RNs like you join!
@
RT @PetrilliMD: @hmkyale #JHMChat that's why I really don't like when people flippantly say "this isnt a hotel" ... maybe it should be more…
Nancy H. Stewart, DO, MS (she/her) @nvhstewart
Yes. We as providers should all have to experience the #dehumanization a #patientexperience during a #hospitalization to contextualize what our #patients go through- speaking from experience #jhmchat https://t.co/B5izP4MRef
Tariq Ahmad MD MPH @yaleHFdoc
RT @hmkyale: T2. Our point is that we have been indifferent to the consequences of the stress, thinking it is just inconvenient for patient…
Chris Petrilli, MD, SFHM @PetrilliMD
RT @FutureDocs: @PetrilliMD @hmkyale true... in fact maybe you saw our hotel that works like a hospital video once upon a time? #jhmchat ht…
Harlan Krumholz @hmkyale
T2. The idea of consequences came as I realized we were not making fast enough progress in readmissions; and I began thinking that maybe the hospitalization is creating vulnerability to illness after discharge; why else do people suffer from so many problems afterwards. #JHMchat
Vinny Arora MD MAPP @FutureDocs
RT @aoglasser: I love that this #JHMchat already has a patient and an RN voice #medtwitter https://t.co/LQFhrRRog6
Lonika Sood @sood_lonika
Sorry to chime in late... hospitalistfrom Green Bay here!! #JHMChat
Avital Y. O'Glasser, MD FACP SFHM DFPM (she/her) @aoglasser
@tony_breu @hmkyale good point. pre-rounding in the quad VA rooms as a resident always helped me gain insightful "subjectives" as the roommates would rat each other out :) "you had a good night? like hell you did.." #JHMchat
Don Edmondson, PhD, MPH @edmondson_don
@hmkyale And we are now seeing evidence that there are consequences.
Charlie M. Wray, DO, MS @WrayCharles
@tony_breu @hmkyale I love this aspect of the VA #JHMChat
Lonika Sood @sood_lonika
@JHospMedicine T2: delirium, malnutrition, depression, deconsitioning #JHMCHat
Vinny Arora MD MAPP @FutureDocs
@hmkyale true. although not prospective- just a natural experiment to look at post hospital syndrome before and after moving to private rooms #jhmchat
Harlan Krumholz @hmkyale
T2. Many people were saying that people were being readmitted for illnesses unrelated to the initial admission; and were saying it was something different; but what if it were related to the stress of the initial hospitalization. That transient vulnerability was related. #JHMChat
Elizabeth Gundersen @Top_Gundersen
@tony_breu @hmkyale Not to get off track but I agree...I've always been struck by that instant camaraderie in VA hospitals. #jhmchat
Chris Petrilli, MD, SFHM @PetrilliMD
@FutureDocs @hmkyale @CostsofCare @neel_shah #JHMChat Watching it now...already loving it #PaoloIsTheBest
Elizabeth Gundersen @Top_Gundersen
@aoglasser @tony_breu @hmkyale Haha, love it! #jhmchat
Deena Goldwater @AuH2O_md
Agreed. Also, the health consequences after discharge can be obvious (i.e. like mortality and readmission) but also more subtle (i.e. depression, prolonged sleep disruption, progressive physical deconditioning, falls). Need heightened awareness to these issues post-d/c #JHMChat https://t.co/V25KC9KRxe
Harlan Krumholz @hmkyale
Single rooms may be necessary but not sufficient to create a healing, strengthening environment in hospitals. But a start. Likely needs to be a package of interventions. #JHMChat https://t.co/lpypZHh82D
Nancy H. Stewart, DO, MS (she/her) @nvhstewart
I had a #medstudent wake me @5am and ask how my night was— I wanted to say “fine, but it wasn’t over yet!” #patientexperience #jhmchat https://t.co/yExvh9Ohhf
Charlie M. Wray, DO, MS @WrayCharles
RT @hmkyale: Single rooms may be necessary but not sufficient to create a healing, strengthening environment in hospitals. But a start. Lik…
Elizabeth Gundersen @Top_Gundersen
@reepRN The "Hospital at Home" concept mentioned in the article is so interesting from that perspective! #JHMchat
Harlan Krumholz @hmkyale
Interestingly the interventions to prevent delirium are very much like what would be necessary to create a humane, caring, healing experience for patients overall - and maybe mitigate post-hospital syndrome. #JHMChat https://t.co/uw4MKj5gQj
Journal of Hospital Medicine @JHospMedicine
RT @nvhs0401: I had a #medstudent wake me @5am and ask how my night was— I wanted to say “fine, but it wasn’t over yet!” #patientexperience
Tony Breu @tony_breu
@gracefarris @aoglasser @EileenBarrettNM @JHospMedicine I could not agree more. #JHMchat
Journal of Hospital Medicine @JHospMedicine
RT @hmkyale: Single rooms may be necessary but not sufficient to create a healing, strengthening environment in hospitals. But a start. Lik…
Journal of Hospital Medicine @JHospMedicine
RT @hmkyale: Interestingly the interventions to prevent delirium are very much like what would be necessary to create a humane, caring, hea…
Lonika Sood @sood_lonika
@nvhs0401 Patient standard time asynchronous with hospital standard time
Nancy H. Stewart, DO, MS (she/her) @nvhstewart
@sood_lonika @JHospMedicine Yes. All of these!!! #jhmchat
@
RT @hmkyale: Interestingly the interventions to prevent delirium are very much like what would be necessary to create a humane, caring, hea…
Vinny Arora MD MAPP @FutureDocs
@Top_Gundersen @reepRN stay tuned for T4! #jhmchat
Charlie M. Wray, DO, MS @WrayCharles
@gracefarris @aoglasser @EileenBarrettNM @JHospMedicine I'm a huge proponent of this! The only way you're getting a diabetic diet order out of me is if you're in full on DKA/HHS #JHMChat
Chris Petrilli, MD, SFHM @PetrilliMD
RT @hmkyale: Interestingly the interventions to prevent delirium are very much like what would be necessary to create a humane, caring, hea…
Vinny Arora MD MAPP @FutureDocs
@aoglasser @gracefarris @EileenBarrettNM @JHospMedicine im getting flashbacks from the #thickenedliquidchallenge - i made my entire gens team do it in solidarity with our patients #jhmchat @geripal cc @jeannemfarnan
Don Edmondson, PhD, MPH @edmondson_don
Ironically, patients who are most stressed by the medical event/hospitalization are also least likely to be adherent to secondary prevention meds/behaviors (Wasson et al, 2018; Kronish et al, 2016) #JHMchat
Elizabeth Gundersen @Top_Gundersen
@nvhs0401 Ouch! Private rooms by themselves will not protect you from those types of interruptions, bright lights, blood draws, vital sign checks, etc. #jhmchat
Chris Petrilli, MD, SFHM @PetrilliMD
@WrayCharles @gracefarris @aoglasser @EileenBarrettNM @JHospMedicine #JHMChat Especially when hospitals offer meals that patients can select from menu...the only diet order that makes sense is "No Reds" or "clears" prior to colonoscopy prep - the patient should be able to decide everything else #WhyAreOutpatientPrepsDoneInpatientSoOften
Rebecca Jaffe, MD @RJmdphilly
@donaldedmondso2 #readlater #JHMchat
Journal of Hospital Medicine @JHospMedicine
RT @donaldedmondso2: Ironically, patients who are most stressed by the medical event/hospitalization are also least likely to be adherent t…
Andrew Auerbach @ADAuerbachMD
RT @FutureDocs: @Top_Gundersen @reepRN stay tuned for T4! #jhmchat
Nancy H. Stewart, DO, MS (she/her) @nvhstewart
@Top_Gundersen It was the day after I delivered #baby 2 and #sleep was #critical 😩 #jhmchat
Darren Goldwater @DarrenGoldwater
After years of research and writing, my sister @AuH2O_md co-authored a report detailing the issues of post-hospital syndrome. Check out #JHMChat now to hear her and others discuss the topic. #ProudBrother https://t.co/lJgpi7B9H2
Harlan Krumholz @hmkyale
What about looking at children’s hospitals - we wrote a paper..Balloon Animals, Guitars, and Fewer Blood Draws: Applying Strategies From Pediatrics to the Treatment of Hospitalized Adults https://t.co/xUEdV9Bk4F #JHMchat
Journal of Hospital Medicine @JHospMedicine
T3 #JHMChat Given these hypotheses, what interventions can help prevent post-hospital syndrome? https://t.co/mFNoSXkSCe
Vinny Arora MD MAPP @FutureDocs
@Top_Gundersen @nvhs0401 exactly why more on how to improve sleep environments in hospital needed #jhmchat !
Nancy H. Stewart, DO, MS (she/her) @nvhstewart
RT @FutureDocs: @Top_Gundersen @nvhs0401 exactly why more on how to improve sleep environments in hospital needed #jhmchat !
Rebecca Jaffe, MD @RJmdphilly
@nvhs0401 @Top_Gundersen Wonder how many of us the only personal experience of the hospital is L&D? Likely a minor dose of what our patients experience (but had enough) #JHMchat
Darren Goldwater @DarrenGoldwater
RT @JHospMedicine: Spread the word! #JHMchat is back for a special summer session- Monday July 9th 9pET with @hmkyale @AuH2O_md @KDharmaraj
Lonika Sood @sood_lonika
@nvhs0401 @Top_Gundersen I was impressed with the l&d floor staff- let me rest, helped me with baby... can’t say our medsurg Patients get the same rest
Rebecca Jaffe, MD @RJmdphilly
@nvhs0401 @Top_Gundersen Bad enough...
Jon Lim, MD 🏳️‍🌈 @JonLimMD
@JHospMedicine Some patients face truly existential challenges— am I going to live? Am I going to die? What does life and living mean to me? Some patients reckon with their mortality and transience. #JHMChat
Enlightening Results 💡 @GraceCordovano
RT @hmkyale: T2. Our point is that we have been indifferent to the consequences of the stress, thinking it is just inconvenient for patient…
Stephanie Burdick @goblueburd
#JHMCHat Also hospital blankets and pillows are horrible. No wonder no one can sleep. I bring my own for a single call night.
Don Edmondson, PhD, MPH @edmondson_don
On a positive note, good clinician-patient communication in the ED appears to mitigate the impact of high stress/death fear/perceived vulnerability in the ED on long-term psychological stress/PTSD (Chang et al, 2017) #JHMchat
Avital Y. O'Glasser, MD FACP SFHM DFPM (she/her) @aoglasser
@RJmdphilly @nvhs0401 @Top_Gundersen very true, trying to channel the sympathy to empathy (honestly, I think I learned a ton as a physician as a NICU parent, even with the cross-specialties) #JHMChat
Harlan Krumholz @hmkyale
Your sister rocks. She did a great job bringing together ideas from basic and clinical science. And introduced me to her mentor, Bruce McEwan, the pioneer of allostatic stress. Thanks @AuH2O_md. #JHMchat https://t.co/MRvnBHByvA
Vinny Arora MD MAPP @FutureDocs
RT @aoglasser: @gracefarris @goblueburd @EileenBarrettNM @JHospMedicine #JHMchat wasn't this the winning abstract at SHM this year? https:/…
Charlie M. Wray, DO, MS @WrayCharles
RT @donaldedmondso2: On a positive note, good clinician-patient communication in the ED appears to mitigate the impact of high stress/death…
Vinny Arora MD MAPP @FutureDocs
RT @JHospMedicine: T3 #JHMChat Given these hypotheses, what interventions can help prevent post-hospital syndrome? https://t.co/mFNoSXkSCe
JC Stanford @JCDarnestown
RT @hmkyale: Interestingly the interventions to prevent delirium are very much like what would be necessary to create a humane, caring, hea…
Rebecca Jaffe, MD @RJmdphilly
@hmkyale Love this Have often mentioned this “disparity” It is obvious we don’t care about other adults the way we do kids. Worth examining... #JHMchat
Chris Petrilli, MD, SFHM @PetrilliMD
@RJmdphilly @nvhs0401 @Top_Gundersen #JHMChat I told the med student taking care of my wife to please let her sleep and I'd go along with whatever she said on rounds ... still didn't work :) #4amMDstudWakeUpCall
Beth Suereth @BethSuereth
RT @donaldedmondso2: On a positive note, good clinician-patient communication in the ED appears to mitigate the impact of high stress/death…
Darren Goldwater @DarrenGoldwater
RT @hmkyale: Your sister rocks. She did a great job bringing together ideas from basic and clinical science. And introduced me to her mento…
nursemo @CostelloMonica
@hmkyale Patients do not understand the admission process, who sees them, how specialists are involved. Throw residents into the mix and they are even more confused. And we wonder why they are non-compliant and bounce back?
@
@RJmdphilly @nvhs0401 @Top_Gundersen Agree! Was too nervous/scared to ask L&D nurse to change TV channel from Fox News 🙄 #JHMchat
Kumar Dharmarajan @KDharmarajanMD
T3: Let's take the traditional free-standing hospital out of the mix with hospital at home. Familiar bed and food. Easy accessibility to family. Eliminates nosocominal infections and traditional care transitions. #JHMchat
Darren Goldwater @DarrenGoldwater
@hmkyale @AuH2O_md She sure does. That’s awesome.
@sucharitakher
T3: talking to a patient with limited English proficiency in a language they understand! Daily and as often as needed. One of the resident pearls I start with on day 1 of Ward service! #JHMChat #TipsForNewDocs
Avital Y. O'Glasser, MD FACP SFHM DFPM (she/her) @aoglasser
@gracefarris @RJmdphilly @nvhs0401 @Top_Gundersen WHAT!?! #JHMchat
Vinny Arora MD MAPP @FutureDocs
check it out - this is what we have been saying! cc @NicolaOrlov @comerpedschiefs @Al26Norenberg @ajantapatel @freckledpedidoc @vdimaggio @siddante #tweetiatricians everywhere #JHMChat https://t.co/xKsHanFuvN
Elizabeth Gundersen @Top_Gundersen
@EileenBarrettNM @hmkyale @JHospMedicine This makes me think of design thinking in healthcare - designing places and processes with the "end user" - the patient - in mind. For example: https://t.co/DKFpOPOGin #jhmchat
Deena Goldwater @AuH2O_md
Yes! Also significantly decreases immobility, isolation, and anxiety. #JHMchat https://t.co/3ghSXCCkqN
Nancy H. Stewart, DO, MS (she/her) @nvhstewart
@aoglasser @gracefarris @goblueburd @EileenBarrettNM @JHospMedicine If only some of the specialists followed this too! #jhmchat
Don Edmondson, PhD, MPH @edmondson_don
T3 We know there are hospital environment hanged that can help, and geriatric EDs are a good example. Appropriate lighting, quiet, clear communication, reasonable staff/bed/patient ratios. #JHMchat
Stephanie Burdick @goblueburd
#JHMchat Also we need to come up with something more dignified than a gown that let's your bum hang out the back.
Chris Petrilli, MD, SFHM @PetrilliMD
@aoglasser @gracefarris @RJmdphilly @nvhs0401 @Top_Gundersen #JHMChat (Upon startling patient awake) ... "How are you today??" (smh)
Nancy H. Stewart, DO, MS (she/her) @nvhstewart
RT @Top_Gundersen: @EileenBarrettNM @hmkyale @JHospMedicine This makes me think of design thinking in healthcare - designing places and pro…
@
@KDharmarajanMD It’s been hard for me to convince pts to enroll in @MountSinaiNYC hosp at home. Still a foreign idea #JHMchat
Kumar Dharmarajan @KDharmarajanMD
@FutureDocs @NicolaOrlov @comerpedschiefs @Al26Norenberg @ajantapatel @freckledpedidoc @vdimaggio @siddante "Why Hospitals Should Treat Adults as Children" in WSJ. Sorry it's behind paywall. https://t.co/TMuLfbakeQ #JHMChat
Harlan Krumholz @hmkyale
T3. Here are some thoughts that I put together with Allen Detsky for @JAMA_current: Reducing the Trauma of Hospitalization; started with ‘promote personalization.' https://t.co/qpVhFwAd6X #JHMchat
Avital Y. O'Glasser, MD FACP SFHM DFPM (she/her) @aoglasser
@PetrilliMD @gracefarris @RJmdphilly @nvhs0401 @Top_Gundersen #JHMchat or the subjective on rounds "well the patient denied (sorry @adamcifu) it when i prerounded." I think anyone can have a "subjective" reversal if it's first obtained before sunrise
Stephanie Burdick @goblueburd
@PetrilliMD @aoglasser @gracefarris @RJmdphilly @nvhs0401 @Top_Gundersen Now that I'm an attending I dont round until 830 so I dont have to wake people up😁
Vinny Arora MD MAPP @FutureDocs
this is an idea that many have been working on but i have not seen widespread dissemination... former chief patient experience officer at cleveland clinic was doing this..need to spread prototypes. #ptexp #jhmchat https://t.co/93NeL4s8rU
Harlan Krumholz @hmkyale
RT @gracefarris: Agree w bad diet orders, npo for bogus reasons, minimal oob #JHMchat #GraphicMedicine https://t.co/GuzwcaMG8m
Chris Petrilli, MD, SFHM @PetrilliMD
@nvhs0401 @aoglasser @gracefarris @goblueburd @EileenBarrettNM @JHospMedicine #JHMChat "Keep them NPO just in case" - #ItalianGrandmothersWouldBeFuriousIfTheyKnew
Nancy H. Stewart, DO, MS (she/her) @nvhstewart
@aoglasser @PetrilliMD @gracefarris @RJmdphilly @Top_Gundersen @adamcifu @adamcifu has a wonderful list of these!! Love his teaching lists!! #jhmchat
Kumar Dharmarajan @KDharmarajanMD
@gracefarris @MountSinaiNYC Our experience has been that "pre-enrollment" helps. Talk to patients about these programs and address their questions before they become acutely ill. #JHMChat
Vinny Arora MD MAPP @FutureDocs
RT @KDharmarajanMD: @FutureDocs @NicolaOrlov @comerpedschiefs @Al26Norenberg @ajantapatel @freckledpedidoc @vdimaggio @siddante "Why Hospit…
Stephanie Burdick @goblueburd
@aoglasser @PetrilliMD @gracefarris @RJmdphilly @nvhs0401 @Top_Gundersen @adamcifu So true. Anything said before coffee is delivered at the VA is suspect.
Rebecca Jaffe, MD @RJmdphilly
A3 - coordinating teams/rounds. Tasks should be bundled so that interruptions to “daily life” are minimized. Then options for mobilization, socialization and education should be added around these. #JHMchat
Harlan Krumholz @hmkyale
For promote personalization I have often asked patients to bring in pictures of family to put on their walls. It helps everyone see them as the total person that she or he is. Creates a more positive vibe. #JHMchat
Journal of Hospital Medicine @JHospMedicine
RT @RJmdphilly: A3 - coordinating teams/rounds. Tasks should be bundled so that interruptions to “daily life” are minimized. Then options f…
Jon Lim, MD 🏳️‍🌈 @JonLimMD
@JHospMedicine T3 Could supporting staff with technology to reduce administrative burdens with the hopes that additional time for nurses and physicians will be spent at the bed side reduce the psychic stressors for patients? #JHMChat
Peg Graham @kbbtr
@hmkyale Please HEAR family caregivers. Older adults aging w mobility-related disabilities = distinct population, NHATStudy equipment data
Don Edmondson, PhD, MPH @edmondson_don
Interestingly, anxious family members are worse for patients than being in the hospital alone (Homma et al, 2016) #JHMchat
Harlan Krumholz @hmkyale
Do you know that at my hospital the quiet time is 10pm-4am. I was shocked when I saw 4am. I wonder who thought that was wake up time. That is stressful. #JHMchat https://t.co/hWpa0vqSUF
Vinny Arora MD MAPP @FutureDocs
T3 #Jhmchat folks at @MaineMed are piloting an IPACE unit where the patients and families have "appointments" with the medical team and its not at the crack of dawn. part of @acgme pursuing excellence grant
Harlan Krumholz @hmkyale
RT @FutureDocs: T3 #Jhmchat folks at @MaineMed are piloting an IPACE unit where the patients and families have "appointments" with the medi…
@
RT @Top_Gundersen: @EileenBarrettNM @hmkyale @JHospMedicine This makes me think of design thinking in healthcare - designing places and pro…
Elizabeth Gundersen @Top_Gundersen
@RJmdphilly Love it! Can't forget that socialization aspect. So critical especially for our patients who may be socially isolated to begin with. #jhmchat
Gervasio Lamas MD @GLamasMD
RT @KDharmarajanMD: So important that we make hospitals into the healing environments they are meant to be. Our patients need this #JHMCHat
Vinny Arora MD MAPP @FutureDocs
T3 we have used nudges in the electronic health record to reduce objective and subjective sleep disruptions (& improve hcahps scores) @UChicagoMed https://t.co/Kc77Nwwx6Q #jhmchat
Chris Petrilli, MD, SFHM @PetrilliMD
@FutureDocs @MaineMed @acgme #JHMChat it would be great if they decided on "daily labs" (cringe) at that time rather than the night before... #PercentMonosAndMCHCBefore7amAreCritical
Harlan Krumholz @hmkyale
How about giving patients a calendar every day that is updated - and they are told about updates. I have people waiting for procedures and it is an interminable wait often - with little information about timing. And meals missed. So stressful. Surely there are solutions. #jhmchat https://t.co/DlCNLc2z9e
Nancy H. Stewart, DO, MS (she/her) @nvhstewart
@aoglasser @RJmdphilly “Discover rounds”?! That sounds exciting!! #jhmchat
Henry Cruz @RealCruzHenry
RT @hmkyale: T1. How is it that we came to accept the stress of the hospitalization as normative. How did we come to so ignore the experien…
Peg Graham @kbbtr
@hmkyale Right equipment? Enable self-care capacity thru design? Avoid adverse conseq of unmet need arising from caregiver gaps. LISTEN
Stephanie Burdick @goblueburd
#JHMCHat Also why do we try to measure urine output in the middle of the night in stable patients? Leave them alone! No one pees overnight while sleeping!
Henry Cruz @RealCruzHenry
RT @AuH2O_md: Agreed. Also, the health consequences after discharge can be obvious (i.e. like mortality and readmission) but also more subt…
@EileenBarrettNM
@KDharmarajanMD @FutureDocs @NicolaOrlov @comerpedschiefs @Al26Norenberg @ajantapatel @freckledpedidoc @vdimaggio @siddante Totally agree! Why don’t we offer EMLA before lab draws/IV sticks, puppies, and kindness to all? #JHMChat
Henry Cruz @RealCruzHenry
RT @hmkyale: What about looking at children’s hospitals - we wrote a paper..Balloon Animals, Guitars, and Fewer Blood Draws: Applying Strat…
Lonika Sood @sood_lonika
@hmkyale Reduces delirium
Charlie M. Wray, DO, MS @WrayCharles
I love it when my patients do this! Gives me, so much insight into who they were/are and helps me reframe the patient -- as I think we often define them as who they are in the hospital, not who they are as individuals prior to hospitalization #JHMChat https://t.co/AIY2s8bCf9
Chris Petrilli, MD, SFHM @PetrilliMD
@hmkyale #JHMChat 4am is when most of my patients are asking for sleeping pills with all the distractions!
Harlan Krumholz @hmkyale
How about having patients wear a smartwatch and have sleep be a vital sign? Not to use to overmedicate - but to track for rest. #JHMchat https://t.co/IOgl8zOXg7
Mary MACK @MaryOCMack
The tendency to allow alarms to go on and on is difficult to handle as a patient. #JHMCHat
Vinny Arora MD MAPP @FutureDocs
@hmkyale they put a monitor that updates with the patients "itinerary" for the day so it includes consult visits etc #jhmchat
Lonika Sood @sood_lonika
@aoglasser @EileenBarrettNM @JHospMedicine A3: early discharge, clear expectations, teamwork, early mobilization #jhmchat
Elizabeth Gundersen @Top_Gundersen
@donaldedmondso2 As a hospice doc I can believe it - sometimes part of anxiety management is working with families to calm their anxiety so that there are not 15 concerned family members crowding the patient. We mustn't forget to include caregivers in our interventions! #jhmchat
Journal of Hospital Medicine @JHospMedicine
RT @Top_Gundersen: @EileenBarrettNM @hmkyale @JHospMedicine This makes me think of design thinking in healthcare - designing places and pro…
Nancy H. Stewart, DO, MS (she/her) @nvhstewart
@PetrilliMD @FutureDocs @MaineMed @acgme I think @FutureDocs and @WrayCharles did some work on #dailylabs #jhmchat
Margaret Fleming @mlsfleming2
RT @KDharmarajanMD: T3: Let's take the traditional free-standing hospital out of the mix with hospital at home. Familiar bed and food. Easy…
Megan Hosey @DrMeganHoseyPhD
RT @hmkyale: Interestingly the interventions to prevent delirium are very much like what would be necessary to create a humane, caring, hea…
Journal of Hospital Medicine @JHospMedicine
T4 #JHMChat How can we best measure “stress” in hospitalized patients so that we can improve it? https://t.co/yrGZQSY382
Chris Petrilli, MD, SFHM @PetrilliMD
#jhmchat dominos pizza has had a "TRACKER" since 2008 - if only we can catch up to a pizza shop with technology so patients can see in real time what is happening ... #WhatTimeIsMyProcedure...#ThereIsNoWayToKnowThatInformation
Nancy H. Stewart, DO, MS (she/her) @nvhstewart
Oh 100x like this!!! It’s a bit different in #icu where everyone has a foley 🙄🙈 #jhmchat https://t.co/hPq7knEm96
Peg Graham @kbbtr
@hmkyale SO not all abt MEDICAL care of older adults aging w mobility-related disabilities. Very often lack of caregiver, equipment. LISTEN
Jess Macha @jess_macha
RT @hmkyale: For promote personalization I have often asked patients to bring in pictures of family to put on their walls. It helps everyon…
Charlie M. Wray, DO, MS @WrayCharles
@FutureDocs @MaineMed @acgme Interesting! I've heard of #pediatrics doing this...#JHMChat
Chris Petrilli, MD, SFHM @PetrilliMD
@nvhs0401 @FutureDocs @MaineMed @acgme @WrayCharles #JHMChat @FutureDocs and @WrayCharles did some work on everything :)
nobism @nobismhealth
RT @nvhs0401: Yes. We as providers should all have to experience the #dehumanization a #patientexperience during a #hospitalization to cont…
nobism @nobismhealth
RT @nvhs0401: I had a #medstudent wake me @5am and ask how my night was— I wanted to say “fine, but it wasn’t over yet!” #patientexperience
Rebecca Jaffe, MD @RJmdphilly
T4 scatter these around the hospital and heat map patient distress.#JHMchat https://t.co/qMnE8j3BrI
Chris Petrilli, MD, SFHM @PetrilliMD
@Apple #JHMChat How did this get in here?
Margaret Fleming @mlsfleming2
@KDharmarajanMD @FutureDocs @NicolaOrlov @comerpedschiefs @Al26Norenberg @ajantapatel @freckledpedidoc @vdimaggio @siddante When my first baby was born, I had my own room to stay overnight = light off, door closed. Nurse came in once, with her hand over flashlite to let me sleep. Now??????
Harlan Krumholz @hmkyale
How many times, in a stable patients, does disturbing them at night for measurements yield critically important information? I gotta believe it is so rare. We can monitor so much unobtrusively if it is necessary. #JHMchat https://t.co/QfwsXHNWB6
Lonika Sood @sood_lonika
@JHospMedicine T4:talk to patients and families, PCP, staff; read Missions, loss of income #jhmchat
Kumar Dharmarajan @KDharmarajanMD
@JHospMedicine Not to be flippant-- We can start by asking patients how they feel. #JHMChat
Harlan Krumholz @hmkyale
RT @RJmdphilly: T4 scatter these around the hospital and heat map patient distress.#JHMchat https://t.co/qMnE8j3BrI
Journal of Hospital Medicine @JHospMedicine
RT @KDharmarajanMD: @JHospMedicine Not to be flippant-- We can start by asking patients how they feel. #JHMChat
Elizabeth Gundersen @Top_Gundersen
@WrayCharles I love asking to see pics for just that reason, especially when I'm with residents. The frail person we see may have been playing tag with his grandson two weeks prior. #jhmchat
Nancy H. Stewart, DO, MS (she/her) @nvhstewart
This is a great idea and I bet provides for some wonderful on the spot teaching/learning experiences!! #jhmchat https://t.co/Qht4Yw0VYe
Stephanie Burdick @goblueburd
@nvhs0401 At least the nurse isnt waking them up to measure UOP!
Elizabeth Gundersen @Top_Gundersen
RT @hmkyale: For promote personalization I have often asked patients to bring in pictures of family to put on their walls. It helps everyon…
Nancy H. Stewart, DO, MS (she/her) @nvhstewart
@PetrilliMD @FutureDocs @MaineMed @acgme @WrayCharles #goals #jhmchat
Don Edmondson, PhD, MPH @edmondson_don
We developed the Emergency Department Perceptions scale (Cornelius, in press). 7 items, asks tough questions (fear of dying, vulnerability, perceived impact of the event, fear, etc). Predictive of 1 month PTSD and readmission, as is the Acute Stress Disorder Scale. #jhmchat
Charlie M. Wray, DO, MS @WrayCharles
@PetrilliMD It hurts my soul that we can track a pizza better than when someone is going to have a colonoscopy performed...#JHMChat
Margaret Fleming @mlsfleming2
RT @hmkyale: How many times, in a stable patients, does disturbing them at night for measurements yield critically important information? I…
Society of Hospital Medicine @SocietyHospMed
Don't forget to claim #CME immediately following tonight's #JHMChat! https://t.co/3nYBUsfF83
Chris Petrilli, MD, SFHM @PetrilliMD
@nvhs0401 #JHMChat I love this...AND it allows interns/residents the sleep that everyone deserves
Vinny Arora MD MAPP @FutureDocs
RT @KDharmarajanMD: @JHospMedicine Not to be flippant-- We can start by asking patients how they feel. #JHMChat
Harlan Krumholz @hmkyale
Seems we need a cultural shift in our approach to hospitalized patients before technology can really help us. We need to care about what they experience. And realize the harm we may be doing by the toxicity of hospitalization. #JHMchat
Vinny Arora MD MAPP @FutureDocs
RT @JHospMedicine: T4 #JHMChat How can we best measure “stress” in hospitalized patients so that we can improve it? https://t.co/yrGZQSY382
Don Edmondson, PhD, MPH @edmondson_don
For lower level stress, repeated single item “how stressed do you feel” is probably pretty good. #jhmchat
Elizabeth Gundersen @Top_Gundersen
@KDharmarajanMD @JHospMedicine Yes! We can also ask patients how they are feeling about being in the hospital, what they are worried about, what their goals are...and simply, what can we do to help? #jhmchat
Lynne Maxwell MD, FAAP @ubudoc
RT @KDharmarajanMD: @FutureDocs @NicolaOrlov @comerpedschiefs @Al26Norenberg @ajantapatel @freckledpedidoc @vdimaggio @siddante "Why Hospit…
Rebecca Jaffe, MD @RJmdphilly
@hmkyale Again, tapping into the peds mindset a little. not to infantilize our patients, but caring about their wellbeeing in the immediate moment would be a great start. #jhmchat
Chris Petrilli, MD, SFHM @PetrilliMD
RT @WrayCharles: @PetrilliMD It hurts my soul that we can track a pizza better than when someone is going to have a colonoscopy performed..…
Sanjay Saint @sanjaysaint
@JHospMedicine @AuH2O_md @KDharmarajanMD @hmkyale This work is intriguing & important. It has major applicability to @VAAnnArbor & #Veterans. Use & misuse of devices contributory? #JHMchat
Chris Petrilli, MD, SFHM @PetrilliMD
@goblueburd @WrayCharles #jhmchat but it’s Michigan pizza ;-)
TheTransferPortal @pdh214
@hmkyale How about getting a *large cake for being hospitalized at Yale NH hospital for 50 days. except the patient is gluten free. Dumb and dumber
Harlan Krumholz @hmkyale
But many patients have been trained to have low expectations - yet are suffering from chaos & disruptions & resulting adverse stress. We need to be able to gauge the degree that we are preparing people for successful recovery; leaving the hospital as strong as possible. #JHMchat https://t.co/Fe5WnZ8lq7
Vinny Arora MD MAPP @FutureDocs
waiting for the poster display for this study at @SHMLive yum.. #jhmchat in all seriousness love this idea. https://t.co/YHMNRLQ9TW
Deena Goldwater @AuH2O_md
@donaldedmondso2 excited to read this paper! Would be interested to know if responses/predicted outcomes differ with admitted patients as compared to ED patients. #JHMChat
Charlie M. Wray, DO, MS @WrayCharles
@EileenBarrettNM @JHospMedicine @gracefarris I smell a K-award...#JHMChat
Andrew Auerbach @ADAuerbachMD
RT @SHMLive: Don't forget to claim #CME immediately following tonight's #JHMChat! https://t.co/3nYBUsfF83
Rebecca Jaffe, MD @RJmdphilly
@Top_Gundersen @KDharmarajanMD @JHospMedicine Important to distinguish between this "measurement" as a research question, vs the simple act of inquiry/curiosity as an act of caring/healing. #jhmchat
Vinny Arora MD MAPP @FutureDocs
@WrayCharles @EileenBarrettNM @JHospMedicine @gracefarris or taste one:) #JHMChat
Journal of Hospital Medicine @JHospMedicine
CT #JHMChat Please add closing thoughts on post-hospital syndrome https://t.co/j2zSEI7sWV?
Journal of Hospital Medicine @JHospMedicine
Dont forget to claim your #CME here after #JHMChat https://t.co/0R3URGkP8F
Journal of Hospital Medicine @JHospMedicine
CT #JHMChat Please add closing thoughts on post-hospital syndrome https://t.co/j2zSEI7sWV? https://t.co/j2zSEI7sWV
Journal of Hospital Medicine @JHospMedicine
RT @RJmdphilly: @Top_Gundersen @KDharmarajanMD @JHospMedicine Important to distinguish between this "measurement" as a research question, v…
Nancy H. Stewart, DO, MS (she/her) @nvhstewart
@hmkyale @FutureDocs and I are doing work on this now!! #sleep inpatient #jhmchat #moretocome
Journal of Hospital Medicine @JHospMedicine
Dont forget to claim your #CME here after #JHMChat https://t.co/0R3URGkP8F https://t.co/0R3URGkP8F
Vinny Arora MD MAPP @FutureDocs
RT @JHospMedicine: CT #JHMChat Please add closing thoughts on post-hospital syndrome https://t.co/j2zSEI7sWV? https://t.co/j2zSEI7sWV
Chris Petrilli, MD, SFHM @PetrilliMD
@FutureDocs @WrayCharles @EileenBarrettNM @JHospMedicine @gracefarris #jhmchat I think you just won twitter tonight :-)
Nancy H. Stewart, DO, MS (she/her) @nvhstewart
RT @PetrilliMD: #jhmchat dominos pizza has had a "TRACKER" since 2008 - if only we can catch up to a pizza shop with technology so patients…
Andrew Auerbach @ADAuerbachMD
RT @JHospMedicine: CT #JHMChat Please add closing thoughts on post-hospital syndrome https://t.co/j2zSEI7sWV? https://t.co/j2zSEI7sWV
Harlan Krumholz @hmkyale
What can we do to start fresh with design thinking on the hospital experience. What if we are doing harm with the current approach. We likely are. It is a nosocomial harm. How do we fight it. On behalf of our patients. #JHMchat
Avital Y. O'Glasser, MD FACP SFHM DFPM (she/her) @aoglasser
RT @hmkyale: What can we do to start fresh with design thinking on the hospital experience. What if we are doing harm with the current appr…
Preeti R. John MD, MPH, FACS, FCCM, CPE, HEC-C @preeti_john
So true. "NPO for possible OR tomorrow". So much uncertainty & lack of predictability in the #hospital environment #JHMchat https://t.co/XBm58Fxc7K
Stephanie Burdick @goblueburd
#JHMCHat Every little bit counts! One less pt on a restricted diet, one less foley, one less unnecessary tele order can make a difference. We have to be vigilant in providing CARE, not monitoring and interventions without evidence!
@ArgentoMD
RT @hmkyale: Interestingly the interventions to prevent delirium are very much like what would be necessary to create a humane, caring, hea…
Vinny Arora MD MAPP @FutureDocs
@PetrilliMD @WrayCharles @EileenBarrettNM @JHospMedicine @gracefarris ill take it:) #jhmchat i am just so glad this chat was a success!
Vinny Arora MD MAPP @FutureDocs
RT @JHospMedicine: Dont forget to claim your #CME here after #JHMChat https://t.co/0R3URGkP8F https://t.co/0R3URGkP8F
Journal of Hospital Medicine @JHospMedicine
@tony_breu Great to have you Tony and congrats! #JHMchat
Vinny Arora MD MAPP @FutureDocs
@hmkyale Love it - we are sending watches home with patients to track sleep and activity post discharge but more for Research than clinical tool #jhmchat cc @nvhs0401
Journal of Hospital Medicine @JHospMedicine
@aoglasser Thx for joining Avital! Great to have our West coast representation! #jhmchat
Journal of Hospital Medicine @JHospMedicine
@goblueburd Welcome to #JHMchat!
Journal of Hospital Medicine @JHospMedicine
Definitely look forward to discussing #sleep & post hospital syndrome #JHMchat https://t.co/Dkh0rwEZJ8
Journal of Hospital Medicine @JHospMedicine
Welcome to one of our authors tonight @AuH2O_md ! #JHMchat https://t.co/RHodXSYwdV
Journal of Hospital Medicine @JHospMedicine
Great to have research experts from other specialties tonight on #JHMchat ! https://t.co/SaDl1CI9YY
Journal of Hospital Medicine @JHospMedicine
It would not be #JHMchat without @gracefarris and her amazing real time graphic art https://t.co/OVyA8IvNSD
Journal of Hospital Medicine @JHospMedicine
@sucharitakher Welcome to you and those from the critical care community to #JHMChat
Journal of Hospital Medicine @JHospMedicine
Excited to have author @KDharmarajanMD join us to discuss post hospital syndrome #JHMChat https://t.co/SaSJHsxwP4
Journal of Hospital Medicine @JHospMedicine
We welcome Patient input tonight from anyone with post hospital syndrome #jhmchat - thank you for joining us @geologyjeff https://t.co/L99SZHvBii
Journal of Hospital Medicine @JHospMedicine
@MaryOCMack Better late than never! Welcome to #JHMchat
Don Edmondson, PhD, MPH @edmondson_don
@AuH2O_md Responses in ED are similar to discharge in n=500 or so. Some get better, others worse. We’re starting a study soon to compare admitted TIA to outpatient TIA evaluation within 24 hours (with randomization by week to all inpatient or all outpatient). #jhmchat
Harlan Krumholz @hmkyale
I believe our disregard for each patient’s rest, nutrition, serenity, health, peace - has dire consequences for their outcomes. In the paper we present the support for the theory. Now can we test solutions? Why not? #JHMchat
Nancy H. Stewart, DO, MS (she/her) @nvhstewart
@JHospMedicine Yes!! I know of work being done in this area now!! #moretocome #jhmchat
Journal of Hospital Medicine @JHospMedicine
RT @hmkyale: I believe our disregard for each patient’s rest, nutrition, serenity, health, peace - has dire consequences for their outcomes…
Harlan Krumholz @hmkyale
RT @JHospMedicine: Excited to have author @KDharmarajanMD join us to discuss post hospital syndrome #JHMChat https://t.co/SaSJHsxwP4
Elizabeth Gundersen @Top_Gundersen
@RJmdphilly @KDharmarajanMD @JHospMedicine Haha, yes - I wasn't intending that as a "measurement;" more the latter as you suggest. #jhmchat
Journal of Hospital Medicine @JHospMedicine
Thank you to our authors @hmkyale @KDharmarajanMD @AuH20_md for an insightful #JHMChat & partners @SHMLive @CostsofCare and @ABIMFoundation for supporting us!
Mary MACK @MaryOCMack
CT: that Hospitals are very stressful for patients is a given. Expect anxiety and work to reduce it, whenever possible. #JHMChat
Adam Cifu @adamcifu
@nvhs0401 @aoglasser @PetrilliMD @gracefarris @RJmdphilly @Top_Gundersen I've been searching... Finally found it.
Michael Katz @MGKatz036
RT @hmkyale: The schedule…when will my doctor come? Will I miss her or him? What is happening today? Days are full of anxiety in anticipati…
Society of Hospital Medicine @SocietyHospMed
RT @JHospMedicine: Thank you to our authors @hmkyale @KDharmarajanMD @AuH20_md for an insightful #JHMChat & partners @SHMLive @CostsofCa
Andrew Auerbach @ADAuerbachMD
@JHospMedicine Editor’s takeaway - The humanistic and professional imperative of post hospital syndrome clear, and research in disentangling contributing factors and designing patient centered and effective hospitals (or avoiding altogether) will provide plenty of work for us all. #JHMchat
Charlie M. Wray, DO, MS @WrayCharles
My guess is that Harlan is way out in front on this one, but keeping with a theme...there's a K/RO1 sitting in this statement #JHMChat https://t.co/wW8pDtaBaz
Journal of Hospital Medicine @JHospMedicine
Thx for an amazing #JHMChat everyone! We officially broke our account with all your tweets RT and mentions! So just in case you see some tweets coming through late! https://t.co/wEMfIGccN8
Preeti R. John MD, MPH, FACS, FCCM, CPE, HEC-C @preeti_john
We often lose touch with the humanistic aspect of medicine. The importance of body language, empathy / touch / listening are not stressed enough during training. Sometimes the focus is on making the numbers/medical records look good #JHMChat https://t.co/dAlUS5rHaa
Journal of Hospital Medicine @JHospMedicine
RT @ADAuerbachMD: @JHospMedicine Editor’s takeaway - The humanistic and professional imperative of post hospital syndrome clear, and resear…
Andrew Auerbach @ADAuerbachMD
My deepest thanks as well!: RT @JHospMedicine: Thank you to our authors @hmkyale @KDharmarajanMD @AuH20_md for an insightful #JHMChat & partners @SHMLive @CostsofCare and @ABIMFoundation for supporting us!
Vinny Arora MD MAPP @FutureDocs
RT @JHospMedicine: Thx for an amazing #JHMChat everyone! We officially broke our account with all your tweets RT and mentions! So just in c…
Harlan Krumholz @hmkyale
We need a groundswell of people to help all of us make the necessary changes to better serve patients. A community that includes patients and researchers and clinicians and administrators - to change our way of thinking - our approach - our systems - and our actions. #JHMchat https://t.co/seDAoHX0c2
Rebecca Jaffe, MD @RJmdphilly
@Top_Gundersen @KDharmarajanMD @JHospMedicine I assumed! I was thinking about T4 I think. My mind went to the qualitative rsch questions, and I was trying to steer myself back towards inquiry as a meaningful intervention for the individual, rather than an attempt to generalize the patient experience... #jhmchat
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@JHospMedicine Thanks for another great #JHMchat @FutureDocs @WrayCharles @JHospMedicine and thanks to the article authors! @hmkyale
Preeti R. John MD, MPH, FACS, FCCM, CPE, HEC-C @preeti_john
RT @hmkyale: We need a groundswell of people to help all of us make the necessary changes to better serve patients. A community that includ…
Andrew Auerbach @ADAuerbachMD
We can rebuild!! RT @JHospMedicine: Thx for an amazing #JHMChat everyone! We officially broke our account with all your tweets RT and mentions! So just in case you see some tweets coming through late! https://t.co/muK3iIw4e7
Nancy H. Stewart, DO, MS (she/her) @nvhstewart
RT @aoglasser: @goblueburd #JHMchat someone is anxious, bombarding nurses with questions, pulling you away from your team room/EHR time?? G…
@StrongHeartNow1
RT @AuH2O_md: Agreed. Also, the health consequences after discharge can be obvious (i.e. like mortality and readmission) but also more subt…
@StrongHeartNow1
RT @hmkyale: T2. Our point is that we have been indifferent to the consequences of the stress, thinking it is just inconvenient for patient…
Alex Small @alexcsmall
RT @hmkyale: What about looking at children’s hospitals - we wrote a paper..Balloon Animals, Guitars, and Fewer Blood Draws: Applying Strat…
Savvy Cooperative | #AskPatients @savvy_coop
How we yearn for the day when suggesting one talks to patients does not need a disclaimer. 🙏🏽 You can’t improve the #patientexperience if you don’t know which experiences need improving. Ask #savvypatients. #JHMchat https://t.co/UZzUnjJNWx
#JHMChat content from Twitter.