#JHMChat Transcript
Healthcare social media transcript of the #JHMChat hashtag.
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| Profile | Tweet |
|---|---|
 | 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: #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-hospital syndrome - a result of hospitalization induced allostatic overload https://t.co/j2zSEI7sWV? https://t.co/98HXmQoCnb |
| Vinny Arora MD MAPP @FutureDocs RT @SHMLive: #JHMChat starts NOW! Join the conversation, then claim #CME. Details here: #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: #JHMChat starts NOW! Join the conversation, then claim #CME. Details here: https://t.co/E7QUHZqgFd https://t.co/erWlyQTQod |
 | Grace Farris @gracefarris RT @SHMLive: #JHMChat starts NOW! Join the conversation, then claim #CME. Details here: #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 Syndrome https://t.co/ZHDAN3heqN |
 | Avital Y. O'Glasser, MD FACP SFHM (she/her) @aoglasser joining #JHMchat from Portland OR |
| 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/RACV0UDafB |
 | Stephanie Burdick @goblueburd #JHMCHat Stephanie Burdick MD here from Grand Rapids MI. |
 | Nancy H Stewart DO, MS @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: #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 |
| Marilyn Mann @MarilynMann RT @hmkyale: So appreciate the opportunity to join the community and talk about how we can improve hospital care. #JHMChat https://t.co/RACV0UDafB |
 | 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 |
| Grace Farris @gracefarris Grace Farris joining from NYC #JHMchat https://t.co/Fz7E65hC9D |
| Marilyn Mann @MarilynMann RT @KDharmarajanMD: So important that we make hospitals into the healing environments they are meant to be. Our patients need this #JHMCHat |
| Marilyn Mann @MarilynMann RT @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 |
| Journal of Hospital Medicine @JHospMedicine RT @SHMLive: Claim #CME after tonight's #JHMChat here: Claim #CME after tonight's #JHMChat here: https://t.co/SG8h7Rkqwc |
| 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 @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 |
| Avital Y. O'Glasser, MD FACP SFHM (she/her) @aoglasser @goblueburd #JHMchat yes! you've got to understand the nuances of each diet order. I hand out the menus to my residents/med students. What is the difference between full and clear liquids?? |
| Journal of Hospital Medicine @JHospMedicine RT @SHMLive: T1 for tonight's #JHMChat is live! Join the conversation happening NOW https://t.co/xzWmAduKNS |
| 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 is my test? When can I eat? What is my prognosis? When will I be able to leave? #JHMChat |
| 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. Discomfort. This is the daily experience of patients. Aside from their illness. #JHMChat https://t.co/bEppplUgIQ |
| Avital Y. O'Glasser, MD FACP SFHM (she/her) @aoglasser @hmkyale #JHMchat all this |
| Journal of Hospital Medicine @JHospMedicine RT @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..... |
| Journal of Hospital Medicine @JHospMedicine RT @nvhs0401: A1: 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 |
 | Chris Petrilli @PetrilliMD @goblueburd #JHMChat there was a wonderful @SHMLive @twdfnr presentation on that ... #NoMoreFluidorSodiumRestriction |
 | Inspire @teaminspire RT @hmkyale: So appreciate the opportunity to join the community and talk about how we can improve hospital care. #JHMChat https://t.co/RACV0UDafB |
| Avital Y. O'Glasser, MD FACP SFHM (she/her) @aoglasser RT @WrayCharles: T1: 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 |
| Vinny Arora MD MAPP @FutureDocs RT @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 |
| 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/RACV0UDafB |
| Journal of Hospital Medicine @JHospMedicine T2 up in a moment on #JHMChat. |
| 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 |
| Vinny Arora MD MAPP @FutureDocs RT @gracefarris: Grace Farris joining from NYC #JHMchat https://t.co/Fz7E65hC9D |
| Nancy H Stewart DO, MS @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 |
| Avital Y. O'Glasser, MD FACP SFHM (she/her) @aoglasser #JHMchat I think the roommate "situation" is a huge contributor. The swanky floors have almost all single rooms, but medicine still seems to have the highest 100% of doubles |
 | Carolyn Thomas @HeartSisters RT @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 @Top_Gundersen: @KDharmarajanMD @JHospMedicine Yes! And even: @KDharmarajanMD @JHospMedicine Yes! And even: Why am I here? #JHMChat |
| Avital Y. O'Glasser, MD FACP SFHM (she/her) @aoglasser @gracefarris @FutureDocs #JHMchat here come the graphics!! |
 | Mary MACK @MaryOCMack Hello, Mary here-- just joined late and lurking #JHMChat |
 | 𝓝𝓪𝓽𝓻𝓲𝓬𝓮𝓡 😷🇨🇦❤️ 🥀 @NatriceR RT @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 |
| Harlan Krumholz @hmkyale RT @donaldedmondso2: 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 |
| Carolyn Thomas @HeartSisters RT @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 |
| 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 |
| 𝓝𝓪𝓽𝓻𝓲𝓬𝓮𝓡 😷🇨🇦❤️ 🥀 @NatriceR RT @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 |
| Avital Y. O'Glasser, MD FACP SFHM (she/her) @aoglasser @hmkyale #JHMChat having family members in the hospital in past, "inpatient" time for patients is completely different than we perceive on the other side of the equation... |
| 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 |
| Avital Y. O'Glasser, MD FACP SFHM (she/her) @aoglasser @tony_breu #JHMchat https://t.co/Wxm7ItU1W9 |
| 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 hospital syndrome #jhmchat https://t.co/uFp4wWvj9L |
| 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 ED contribute to excess stress in the ED and later. 15% develop PTSD-like symptoms after major CVD events. #JHMchat |
| Carolyn Thomas @HeartSisters RT @donaldedmondso2: 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 @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 |
| Avital Y. O'Glasser, MD FACP SFHM (she/her) @aoglasser @hmkyale #JHMchat so true! It's not just the overnight delirium or the middle of the night new admission in the bed on the other side of the curtain |
| 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 |
| Carolyn Thomas @HeartSisters 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 trauma to the hospital roommate. #JHMChat https://t.co/C3ra91tnvT |
| 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 🇺🇸 @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 go home? 3. Am I going to die? #JHMChat |
| 𝓝𝓪𝓽𝓻𝓲𝓬𝓮𝓡 😷🇨🇦❤️ 🥀 @NatriceR 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 trauma to the hospital roommate. #JHMChat https://t.co/C3ra91tnvT |
 | Margaret Fleming @mlsfleming2 RT @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 |
| Vinny Arora MD MAPP @FutureDocs RT @donaldedmondso2: Insufficient sleep is known to exacerbate long-term effects of acute stress. #JHMChat |
| Nancy H Stewart DO, MS @nvhstewart RT @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 |
| Avital Y. O'Glasser, MD FACP SFHM (she/her) @aoglasser @hmkyale #JHMchat (and similar personal experience as parent of baby in NICU almost 5 years when a pod-mate coded) |
| 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. Discomfort. This is the daily experience of patients. Aside from their illness. #JHMChat https://t.co/bEppplUgIQ |
| Chris Petrilli @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 |
| Carolyn Thomas @HeartSisters 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 experience of being a patient. And consider that they just needed to tough out the ‘inconvenience’?#JHMChat |
| 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 |
| Journal of Hospital Medicine @JHospMedicine RT @WrayCharles: T1: 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 |
| Kumar Dharmarajan @KDharmarajanMD @Top_Gundersen @WrayCharles Agreed. The dehumanization starts as soon as we get banded and issued a hospital gown. #JHMChat |
| 𝓝𝓪𝓽𝓻𝓲𝓬𝓮𝓡 😷🇨🇦❤️ 🥀 @NatriceR 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 experience of being a patient. And consider that they just needed to tough out the ‘inconvenience’?#JHMChat |
| Journal of Hospital Medicine @JHospMedicine 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 experience of being a patient. And consider that they just needed to tough out the ‘inconvenience’?#JHMChat |
| Carolyn Thomas @HeartSisters RT @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 |
| Journal of Hospital Medicine @JHospMedicine RT @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 |
| 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 anticipation of what might be next. This is the experience of most patients. #JHMChat https://t.co/EF69Gigv2M |
| Grace Farris @gracefarris Agree w bad diet orders, npo for bogus reasons, minimal oob #JHMchat #GraphicMedicine https://t.co/GuzwcaMG8m |
| Avital Y. O'Glasser, MD FACP SFHM (she/her) @aoglasser @FutureDocs oooooo #JHMchat |
| 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. #JHMChat |
| 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 @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 family go through it and we are civilians observing. #JHMChat https://t.co/5Hs1l8G4x9 |
 | ReepRN @reepRN T1: Nurse here. I see the limitations of daily routine in name of safety: patients can’t walk around or bathe or toilet for fear of “falls.” Strips independence and motivation #JHMChat |
 | 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 trauma to the hospital roommate. #JHMChat https://t.co/C3ra91tnvT |
| Nancy H Stewart DO, MS @nvhstewart RT @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 |
| Journal of Hospital Medicine @JHospMedicine RT @gracefarris: Agree w bad diet orders, npo for bogus reasons, minimal oob #JHMchat #GraphicMedicine https://t.co/GuzwcaMG8m |
| 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 -- which ones are most significant for your patients? #JHMChat https://t.co/jUmDKbVv5h |
| Avital Y. O'Glasser, MD FACP SFHM (she/her) @aoglasser @FutureDocs though also interesting to apply this to ICU patients...single rooms but how much spill over from the emotional charge of the entire unit? (plus family may not be able to spend night, no bathroom, more differences than ward single room) #JHMchat |
| Nancy H Stewart DO, MS @nvhstewart @PetrilliMD @WrayCharles @nyulangone This is wonderful!! #jhmchat |
| Carolyn Thomas @HeartSisters RT @KDharmarajanMD: @Top_Gundersen @WrayCharles Agreed. The dehumanization starts as soon as we get banded and issued a hospital gown. #JHMChat |
| Marilyn Mann @MarilynMann RT @donaldedmondso2: 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 |
| Vinny Arora MD MAPP @FutureDocs RT @reepRN: T1: Nurse here. I see the limitations of daily routine in name of safety: T1: Nurse here. I see the limitations of daily routine in name of safety: patients can’t walk around or bathe or toilet for fear of “falls.” Strips independence and motivation #JHMChat |
| 𝓝𝓪𝓽𝓻𝓲𝓬𝓮𝓡 😷🇨🇦❤️ 🥀 @NatriceR RT @KDharmarajanMD: @Top_Gundersen @WrayCharles Agreed. The dehumanization starts as soon as we get banded and issued a hospital gown. #JHMChat |
 | Dr. Aletta #wearamask @dr_aletta RT @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 |
| 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-hospital syndrome - a result of hospitalization induced allostatic overload https://t.co/j2zSEI7sWV? https://t.co/98HXmQoCnb |
 | Andrew Auerbach @ADAuerbachMD RT @JHospMedicine: T2 up in a moment on #JHMChat. |
| Avital Y. O'Glasser, MD FACP SFHM (she/her) @aoglasser I love that this #JHMchat already has a patient and an RN voice #medtwitter https://t.co/LQFhrRRog6 |
 | Lisa Davis Budzinski @lisadbudzinski RT @SHMLive: #JHMChat starts NOW! Join the conversation, then claim #CME. Details here: #JHMChat starts NOW! Join the conversation, then claim #CME. Details here: https://t.co/E7QUHZqgFd https://t.co/erWlyQTQod |
| 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 |
 | New England Nurse @coffeeNCalibers RT @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..... |
| 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 |
| Carolyn Thomas @HeartSisters RT @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 |
 | 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 family go through it and we are civilians observing. #JHMChat https://t.co/5Hs1l8G4x9 |
| New England Nurse @coffeeNCalibers RT @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 |
| 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 |
| Lisa Davis Budzinski @lisadbudzinski RT @SHMLive: #JHMChat begins in 1 hour! Read the article "Is #Posthospital #Syndrome a Result of #Hospitalization-Induced Allostatic Overload?" before the discussion begins: https://t.co/sq2nZOqx5p |
| ReepRN @reepRN RT @aoglasser: I love that this #JHMchat already has a patient and an RN voice #medtwitter https://t.co/LQFhrRRog6 |
| Chris Petrilli @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! |
 | Tariq Ahmad MD MPH @yaleHFdoc 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 experience of being a patient. And consider that they just needed to tough out the ‘inconvenience’?#JHMChat |
| Grace Farris @gracefarris 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 like a hotel than we think... |
| Carolyn Thomas @HeartSisters RT @donaldedmondso2: 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 |
| Nancy H Stewart DO, MS @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 patients. Maybe it is a lot more. Many people suffer health consequences of the toxicity of the hospitalization. That is the new idea. #JHMchat |
| Chris Petrilli @PetrilliMD RT @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 |
| 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 *abortion is health care* @sood_lonika Sorry to chime in late... hospitalistfrom Green Bay here!! #JHMChat |
| Avital Y. O'Glasser, MD FACP SFHM (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 |
| Charlie M. Wray, DO, MS @WrayCharles @tony_breu @hmkyale I love this aspect of the VA #JHMChat |
| Carolyn Thomas @HeartSisters RT @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 |
| Lonika *abortion is health care* @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 |
| Avital Y. O'Glasser, MD FACP SFHM (she/her) @aoglasser @MaryOCMack thank you for saying this! The page to "come deal with the anxious patient" drive me nuts. Let's explore WHY they're anxious #JHMChat |
 | Eileen Barrett MD MPH (she/her) @EileenBarrettNM @gracefarris @JHospMedicine Not only is the food inappropriately restrictive and bad tasting, it’s also generally not culturally appropriate. When is the last time you’ve seen a curry dish in the hospital? Or Halal meat? #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @EileenBarrettNM: @gracefarris @JHospMedicine Not only is the food inappropriately restrictive and bad tasting, it’s also generally not culturally appropriate. When is the last time you’ve seen a curry dish in the hospital? Or Halal meat? #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 |
| Avital Y. O'Glasser, MD FACP SFHM (she/her) @aoglasser @EileenBarrettNM @gracefarris @JHospMedicine there's curry (or curry-ish) on the OHSU menu :) but YES, agree food is not comfort/expected/usual food in most places #JHMchat |
| ReepRN @reepRN I work in a hospital in a retiree bedroom community. #Delirium is a huge health consequence of hospitalization. I wish patients could go home and have critical care there! #JHMChat https://t.co/kkB6ICNUnv |
| Vinny Arora MD MAPP @FutureDocs RT @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 |
| Chris Petrilli @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 |
| Journal of Hospital Medicine @JHospMedicine RT @reepRN: I work in a hospital in a retiree bedroom community. #Delirium is a huge health consequence of hospitalization. I wish patients could go home and have critical care there! #JHMChat https://t.co/kkB6ICNUnv |
| 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 |
| Avital Y. O'Glasser, MD FACP SFHM (she/her) @aoglasser @EileenBarrettNM @gracefarris @JHospMedicine AND, even the best hospital food gets old when you have to chose from the same selections for weeks on end (ex prolonged admission for endocarditis, osteo, etc.) #JHMchat |
| 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 |
| Carolyn Thomas @HeartSisters What Dr. Nancy said.... e.g. "Why physicians must stop saying 'We are all patients'" https://t.co/Unb6xKgFg4 @nvhs0401 #jhmchat https://t.co/fhv69C10Sh |
| Harlan Krumholz @hmkyale RT @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 |
| Nancy H Stewart DO, MS @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 |
| Grace Farris @gracefarris @aoglasser @EileenBarrettNM @JHospMedicine I generally feel like everyone should be on a regular diet (and probably we should do away w aspiration modifications until there is any evidence to suggest that they help) #thickenedliquidschallenge #JHMchat |
| Avital Y. O'Glasser, MD FACP SFHM (she/her) @aoglasser #JHMChat T2--I thought the fight or flight analogy holds very well in this situation. constant bombardment by unexpected alarming stimuli (and plenty of actual alarms), puts us all on high alert |
| 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. Likely needs to be a package of interventions. #JHMChat https://t.co/lpypZHh82D |
| Carolyn Thomas @HeartSisters RT @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 |
| Elizabeth Gundersen @Top_Gundersen @reepRN The "Hospital at Home" concept mentioned in the article is so interesting from that perspective! #JHMchat |
| Journal of Hospital Medicine @JHospMedicine RT @aoglasser: #JHMChat T2--I thought the fight or flight analogy holds very well in this situation. constant bombardment by unexpected alarming stimuli (and plenty of actual alarms), puts us all on high alert |
| Avital Y. O'Glasser, MD FACP SFHM (she/her) @aoglasser @nvhs0401 yup #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 #jhmchat https://t.co/yExvh9Ohhf |
| 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. Likely needs to be a package of interventions. #JHMChat https://t.co/lpypZHh82D |
| ReepRN @reepRN RT @Top_Gundersen: @reepRN The "Hospital at Home" concept mentioned in the article is so interesting from that perspective! #JHMchat |
| 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, healing experience for patients overall - and maybe mitigate post-hospital syndrome. #JHMChat https://t.co/uw4MKj5gQj |
| Avital Y. O'Glasser, MD FACP SFHM (she/her) @aoglasser @gracefarris @EileenBarrettNM @JHospMedicine yes! the #thickenedliquidchallenge gets mentioned #JHMchat our inpatient geriatrician recommends milk shakes and smoothies--things that are SUPPOSED to be thick |
| Nancy H Stewart DO, MS @nvhstewart @sood_lonika @JHospMedicine Yes. All of these!!! #jhmchat |
| ReepRN @reepRN RT @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 |
| Eileen Barrett MD MPH (she/her) @EileenBarrettNM @JHospMedicine Hospitalist from Albuquerque here. Where to start? Inadequate access to interpreter services, immobility, uncomfortable beds, endless noise, polypharmacy, no sunlight, sharing a room with a stranger. #JHMChat |
| ReepRN @reepRN RT @gracefarris: @aoglasser @EileenBarrettNM @JHospMedicine I generally feel like everyone should be on a regular diet (and probably we should do away w aspiration modifications until there is any evidence to suggest that they help) #thickenedliquidschallenge #JHMchat |
| Vinny Arora MD MAPP @FutureDocs @Top_Gundersen @reepRN stay tuned for T4! #jhmchat |
| Eileen Barrett MD MPH (she/her) @EileenBarrettNM @KDharmarajanMD @JHospMedicine Yes! And what did all those tests show? #JHMChat |
| Stephanie Burdick @goblueburd RT @gracefarris: @aoglasser @EileenBarrettNM @JHospMedicine I generally feel like everyone should be on a regular diet (and probably we should do away w aspiration modifications until there is any evidence to suggest that they help) #thickenedliquidschallenge #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 @PetrilliMD RT @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 |
| Society of Hospital Medicine @SocietyHospMed RT @gracefarris: Agree w bad diet orders, npo for bogus reasons, minimal oob #JHMchat #GraphicMedicine https://t.co/GuzwcaMG8m |
| 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 |
| Avital Y. O'Glasser, MD FACP SFHM (she/her) @aoglasser @goblueburd @gracefarris @EileenBarrettNM @JHospMedicine so true. and how long are patients made npo while we wait for the speech/swallow eval? #JHMchat |
| Vinny Arora MD MAPP @FutureDocs RT @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 |
| Avital Y. O'Glasser, MD FACP SFHM (she/her) @aoglasser @FutureDocs @gracefarris @EileenBarrettNM @JHospMedicine @geripal @jeannemfarnan #JHMchat https://t.co/S9o5FEyUw0 |
| 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 |
| Vinny Arora MD MAPP @FutureDocs RT @aoglasser: @FutureDocs @gracefarris @EileenBarrettNM @JHospMedicine @geripal @jeannemfarnan #JHMchat https://t.co/S9o5FEyUw0 |
| Nancy H Stewart DO, MS @nvhstewart RT @gracefarris: @aoglasser @EileenBarrettNM @JHospMedicine I generally feel like everyone should be on a regular diet (and probably we should do away w aspiration modifications until there is any evidence to suggest that they help) #thickenedliquidschallenge #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 |
| Eileen Barrett MD MPH (she/her) @EileenBarrettNM @JHospMedicine T2. Yes! And powerlessness, loneliness. #JHMchat |
| Avital Y. O'Glasser, MD FACP SFHM (she/her) @aoglasser @goblueburd @WrayCharles @gracefarris @EileenBarrettNM @JHospMedicine bingo! I lift salt restrictions and other restrictions. Test drive the "real world" in the hospital #JHMchat |
| Chris Petrilli @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 to secondary prevention meds/behaviors (Wasson et al, 2018; Kronish et al, 2016) #JHMchat |
| ReepRN @reepRN @hmkyale I highly recommend this book by Victoria Sweet. Touches on many of these ideas. Balancing patient dignity and self-determination with safety and cure. #JHMChat https://t.co/xyDCP1FOcF |
| Andrew Auerbach @ADAuerbachMD RT @FutureDocs: @Top_Gundersen @reepRN stay tuned for T4! #jhmchat |
| Nancy H Stewart DO, MS @nvhstewart @Top_Gundersen It was the day after I delivered #baby 2 and #sleep was #critical 😩 #jhmchat |
| Chris Petrilli @PetrilliMD RT @reepRN: @hmkyale I highly recommend this book by Victoria Sweet. Touches on many of these ideas. Balancing patient dignity and self-determination with safety and cure. #JHMChat https://t.co/xyDCP1FOcF |
| Avital Y. O'Glasser, MD FACP SFHM (she/her) @aoglasser #JHMchat I think the "sensory deprivation chamber" delirium analogy needs to be expanded beyond older patients |
 | 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 |
| Avital Y. O'Glasser, MD FACP SFHM (she/her) @aoglasser @gracefarris @goblueburd @EileenBarrettNM @JHospMedicine #JHMchat wasn't this the winning abstract at SHM this year? https://t.co/1Za4LnfB5M |
| 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 @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 |
| Journal of Hospital Medicine @JHospMedicine RT @aoglasser: @gracefarris @goblueburd @EileenBarrettNM @JHospMedicine #JHMchat wasn't this the winning abstract at SHM this year? https://t.co/1Za4LnfB5M |
| Eileen Barrett MD MPH (she/her) @EileenBarrettNM @hmkyale @JHospMedicine I worked at a rural hospital on the Navajo reservation where patients often requested shared rooms due to loneliness. I’ve never seen that since moving to a city. Regardless, I’d love to see art, windows, lights & light switches in places that make sense #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 @KDharmarajanMD on new theory of post-hospital syndrome -cc @AlexSmithMD @GeriPalBlog @gracefarris @MattisonMelissa @tony_breu @geri_doc https://t.co/j2zSEI7sWV https://t.co/5qXR2eGHGx |
 | 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 patients. Maybe it is a lot more. Many people suffer health consequences of the toxicity of the hospitalization. That is the new idea. #JHMchat |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: T3 #JHMChat Given these hypotheses, what interventions can help prevent post-hospital syndrome? https://t.co/mFNoSXkSCe |
| 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 |
 | Beth Suereth @BethSuereth RT @donaldedmondso2: 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 |
| Rebecca Jaffe, MD @RJmdphilly RT @hmkyale: What about looking at children’s hospitals - we wrote a paper..Balloon Animals, Guitars, and Fewer Blood Draws: 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 |
| Avital Y. O'Glasser, MD FACP SFHM (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 |
 | Kitsey @KitseyCanaan1 RT @reepRN: I work in a hospital in a retiree bedroom community. #Delirium is a huge health consequence of hospitalization. I wish patients could go home and have critical care there! #JHMChat https://t.co/kkB6ICNUnv |
| 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 |
| Carolyn Thomas @HeartSisters RT @hmkyale: What about looking at children’s hospitals - we wrote a paper..Balloon Animals, Guitars, and Fewer Blood Draws: 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 |
| ReepRN @reepRN RT @hmkyale: What about looking at children’s hospitals - we wrote a paper..Balloon Animals, Guitars, and Fewer Blood Draws: 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 |
| Eileen Barrett MD MPH (she/her) @EileenBarrettNM @aoglasser @JHospMedicine @gracefarris @goblueburd I *love* this and refer to it every week on the wards! #JHMCHat |
| Vinny Arora MD MAPP @FutureDocs RT @aoglasser: @gracefarris @goblueburd @EileenBarrettNM @JHospMedicine #JHMchat wasn't this the winning abstract at SHM this year? https://t.co/1Za4LnfB5M |
| 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 fear/perceived vulnerability in the ED on long-term psychological stress/PTSD (Chang et al, 2017) #JHMchat |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: T3 #JHMChat Given these hypotheses, what interventions can help prevent post-hospital syndrome? https://t.co/mFNoSXkSCe |
| ReepRN @reepRN RT @aoglasser: #JHMchat I think the "sensory deprivation chamber" delirium analogy needs to be expanded beyond older patients |
| Grace Farris @gracefarris @aoglasser @goblueburd @EileenBarrettNM @JHospMedicine When I learned that our Ortho now allows a Gatorade on the day of surgery bc they find it helps mobilize their THR and TKR pts POD 1 I was like “whyyyyy are people still NPO for stress tests?” 🤯 #JHMchat |
 | JC Stanford @JCDarnestown RT @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 |
| 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 @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 fear/perceived vulnerability in the ED on long-term psychological stress/PTSD (Chang et al, 2017) #JHMchat |
| 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 mentor, Bruce McEwan, the pioneer of allostatic stress. Thanks @AuH2O_md. #JHMchat https://t.co/MRvnBHByvA |
| Grace Farris @gracefarris @RJmdphilly @nvhs0401 @Top_Gundersen Agree! Was too nervous/scared to ask L&D nurse to change TV channel from Fox News 🙄 #JHMchat |
| Avital Y. O'Glasser, MD FACP SFHM (she/her) @aoglasser @gracefarris @goblueburd @EileenBarrettNM @JHospMedicine #JHMchat clear liquids until 2 hours before!!! best/worse (?) kept secret and there's data for positive effect of glycemic load before some surgeries I think #periopmedicine |
| 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 |
| Rebecca Jaffe, MD @RJmdphilly RT @gracefarris: @aoglasser @goblueburd @EileenBarrettNM @JHospMedicine When I learned that our Ortho now allows a Gatorade on the day of surgery bc they find it helps mobilize their THR and TKR pts POD 1 I was like “whyyyyy are people still NPO for stress tests?” 🤯 #JHMchat |
| Avital Y. O'Glasser, MD FACP SFHM (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 |
| Vinny Arora MD MAPP @FutureDocs RT @WrayCharles: T1: 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 |
| Deena Goldwater @AuH2O_md Yes! Also significantly decreases immobility, isolation, and anxiety. #JHMchat https://t.co/3ghSXCCkqN |
| Vinny Arora MD MAPP @FutureDocs RT @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 |
| Vinny Arora MD MAPP @FutureDocs RT @KDharmarajanMD: T3: 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 |
 | Theresa Boyle @theresaboyle RT @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 |
| Carolyn Thomas @HeartSisters RT @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 |
| Charlie M. Wray, DO, MS @WrayCharles RT @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 |
| Nancy H Stewart DO, MS @nvhstewart @aoglasser @gracefarris @goblueburd @EileenBarrettNM @JHospMedicine If only some of the specialists followed this too! #jhmchat |
| Avital Y. O'Glasser, MD FACP SFHM (she/her) @aoglasser #JHMchat vivid memory of "very agitated", "we can't deal with him" patient who was hitting call button every 30 minutes for oxycodone despite the next time written on white boat--didn't have glasses and couldn't see the clock or the time due |
| 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 @PetrilliMD @aoglasser @gracefarris @RJmdphilly @nvhs0401 @Top_Gundersen #JHMChat (Upon startling patient awake) ... "How are you today??" (smh) |
| Nancy H Stewart DO, MS @nvhstewart RT @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 |
| Eileen Barrett MD MPH (she/her) @EileenBarrettNM @JHospMedicine A3. Communication training for all healthcare workers, improved access to interpreter services and spiritual care, early mobilization, culturally appropriate food, windows, art, opt out (not opt in) quiet time at night after day 3 for floor level care -just a start! #JHMChat |
| Grace Farris @gracefarris @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 (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 |
| 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 |
| Vinny Arora MD MAPP @FutureDocs RT @donaldedmondso2: 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 |
| Chris Petrilli @PetrilliMD @nvhs0401 @aoglasser @gracefarris @goblueburd @EileenBarrettNM @JHospMedicine #JHMChat "Keep them NPO just in case" - #ItalianGrandmothersWouldBeFuriousIfTheyKnew |
| Nancy H Stewart DO, MS @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 Hospitals Should Treat Adults as Children" in WSJ. Sorry it's behind paywall. https://t.co/TMuLfbakeQ #JHMChat |
| 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 |
| Avital Y. O'Glasser, MD FACP SFHM (she/her) @aoglasser @EileenBarrettNM @JHospMedicine #JHMchat our inpatient geriatric post "do not disturb during normal sleep hour" signs on the doors of patients :) it's awesome |
| 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 for mobilization, socialization and education should be added around these. #JHMchat |
| ReepRN @reepRN @gracefarris @aoglasser @goblueburd @EileenBarrettNM @JHospMedicine #JHMChat our hospital just extended Enhanced Recovery After Surgery protocol to CT surgery and now Thoracic. Decreased LOS, decreased opioid use, no aspiration with Gatorade 2-4 hours before surgery. NPO after MN is going to fade away into history! https://t.co/ffiVGoyvps |
| 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 |
| Carolyn Thomas @HeartSisters RT @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 |
| Nancy H Stewart DO, MS @nvhstewart RT @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 |
| 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 |
 | Teresa Chan | 陳敏怡 @TChanMD RT @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 |
| 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 |
 | kathy kastner @KathyKastner RT @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 |
| 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 medical team and its not at the crack of dawn. part of @acgme pursuing excellence grant |
| ReepRN @reepRN RT @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 |
| Grace Farris @gracefarris I like “fade away” idea 🤞#JHMchat https://t.co/S33wSZ0nfe |
| 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 |
| Avital Y. O'Glasser, MD FACP SFHM (she/her) @aoglasser @RJmdphilly I'm going to use this to justify my "discover rounds" on weekends :) #JHMchat |
| Don Edmondson, PhD, MPH @edmondson_don RT @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 |
| Nancy H Stewart DO, MS @nvhstewart RT @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 |
| ReepRN @reepRN RT @donaldedmondso2: Interestingly, anxious family members are worse for patients than being in the hospital alone (Homma et al, 2016) #JHMchat |
| Don Edmondson, PhD, MPH @edmondson_don RT @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 |
| Andrew Auerbach @ADAuerbachMD RT @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 |
 | 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 |
| Grace Farris @gracefarris RT @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 |
| Carolyn Thomas @HeartSisters RT @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 |
| Avital Y. O'Glasser, MD FACP SFHM (she/her) @aoglasser @hmkyale I just wrote a med student letter of rec focusing on the conversations the student had with patient based on photos on wall, plus student would take pics of the view to share with pt (quadriplegic, couldn't look out window) #backtobedside #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 @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 @nvhstewart @aoglasser @RJmdphilly “Discover rounds”?! That sounds exciting!! #jhmchat |
 | Henry Cruz @RealCruzHenry RT @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 |
| 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 experience of being a patient. And consider that they just needed to tough out the ‘inconvenience’?#JHMChat |
| Avital Y. O'Glasser, MD FACP SFHM (she/her) @aoglasser @reepRN @gracefarris @goblueburd @EileenBarrettNM @JHospMedicine can't wait for npo to fade away (I mostly work in hospitalist-led preop clinic) #JHMchat |
| 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 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 |
| Eileen Barrett MD MPH (she/her) @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: 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 |
| 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 @PetrilliMD @hmkyale #JHMChat 4am is when most of my patients are asking for sleeping pills with all the distractions! |
| Margaret Fleming @mlsfleming2 RT @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 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 |
| ReepRN @reepRN RT @aoglasser: @reepRN @gracefarris @goblueburd @EileenBarrettNM @JHospMedicine can't wait for npo to fade away (I mostly work in hospitalist-led preop clinic) #JHMchat |
| 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 |
| Avital Y. O'Glasser, MD FACP SFHM (she/her) @aoglasser @nvhs0401 @RJmdphilly #JHMchat I see the patient for the first time at the same time as the resident/intern. No prerounding, maybe some chart stalking first. We all go together, I see the bedside interaction, we ask the same questions together |
| Grace Farris @gracefarris RT @aoglasser: @reepRN @gracefarris @goblueburd @EileenBarrettNM @JHospMedicine can't wait for npo to fade away (I mostly work in hospitalist-led preop clinic) #JHMchat |
| Lonika *abortion is health care* @sood_lonika @aoglasser @EileenBarrettNM @JHospMedicine A3: early discharge, clear expectations, teamwork, early mobilization #jhmchat |
| Nancy H Stewart DO, MS @nvhstewart @PetrilliMD @FutureDocs @MaineMed @acgme I think @FutureDocs and @WrayCharles did some work on #dailylabs #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 processes with the "end user" - the patient - in mind. For example: https://t.co/DKFpOPOGin #jhmchat |
| Margaret Fleming @mlsfleming2 RT @KDharmarajanMD: T3: 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 |
 | Megan Hosey @DrMeganHoseyPhD RT @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 T4 #JHMChat How can we best measure “stress” in hospitalized patients so that we can improve it? https://t.co/yrGZQSY382 |
| Journal of Hospital Medicine @JHospMedicine RT @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 |
| Chris Petrilli @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 |
| Carolyn Thomas @HeartSisters RT @JHospMedicine: T4 #JHMChat How can we best measure “stress” in hospitalized patients so that we can improve it? https://t.co/yrGZQSY382 |
| Nancy H Stewart DO, MS @nvhstewart Oh 100x like this!!! It’s a bit different in #icu where everyone has a foley 🙄🙈 #jhmchat https://t.co/hPq7knEm96 |
 | 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 everyone see them as the total person that she or he is. Creates a more positive vibe. #JHMchat |
| Avital Y. O'Glasser, MD FACP SFHM (she/her) @aoglasser @goblueburd exactly! concern for anuria or oliguria overnight just means the patient wasn't woken up by nocturia... #JHMchat |
| 𝓝𝓪𝓽𝓻𝓲𝓬𝓮𝓡 😷🇨🇦❤️ 🥀 @NatriceR RT @JHospMedicine: T4 #JHMChat How can we best measure “stress” in hospitalized patients so that we can improve it? https://t.co/yrGZQSY382 |
| Andrew Auerbach @ADAuerbachMD RT @JHospMedicine: T4 #JHMChat How can we best measure “stress” in hospitalized patients so that we can improve it? https://t.co/yrGZQSY382 |
| Charlie M. Wray, DO, MS @WrayCharles @FutureDocs @MaineMed @acgme Interesting! I've heard of #pediatrics doing this...#JHMChat |
| Avital Y. O'Glasser, MD FACP SFHM (she/her) @aoglasser @goblueburd or the overnight cross cover call and then hour+ of intervention for "overnight hypotension" when the patient was sleeping... SMH #JHMchat |
| Chris Petrilli @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 contextualize what our #patients go through- speaking from experience #jhmchat https://t.co/B5izP4MRef |
| 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 #jhmchat https://t.co/yExvh9Ohhf |
| Rebecca Jaffe, MD @RJmdphilly T4 scatter these around the hospital and heat map patient distress.#JHMchat https://t.co/qMnE8j3BrI |
| Chris Petrilli @PetrilliMD @Apple #JHMChat How did this get in here? |
| 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 *abortion is health care* @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 |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: T4 #JHMChat How can we best measure “stress” in hospitalized patients so that we can improve it? https://t.co/yrGZQSY382 |
| 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 @nvhstewart This is a great idea and I bet provides for some wonderful on the spot teaching/learning experiences!! #jhmchat https://t.co/Qht4Yw0VYe |
 | Joannie Yeh MD (she/her) @BetaMomma RT @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 |
| Nancy H Stewart DO, MS @nvhstewart @PetrilliMD @FutureDocs @MaineMed @acgme @WrayCharles #goals #jhmchat |
| Avital Y. O'Glasser, MD FACP SFHM (she/her) @aoglasser @hmkyale #JHMchat there may be some times...but can't be 100% at risk I think of the patient with untreated OSA/OHS on post-op narcs with post-op respiratory failure discovered on midnight vitals...but that begs question of the most appropriate monitoring for high risk patients |
| 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 gotta believe it is so rare. We can monitor so much unobtrusively if it is necessary. #JHMchat https://t.co/QfwsXHNWB6 |
| Avital Y. O'Glasser, MD FACP SFHM (she/her) @aoglasser @nvhs0401 thanks for justifying my time saving efforts when I cover two teams on some weekends! #JHMchat |
| Chris Petrilli @PetrilliMD @nvhs0401 #JHMChat I love this...AND it allows interns/residents the sleep that everyone deserves |
| Society of Hospital Medicine @SocietyHospMed Don't forget to claim #CME immediately following tonight's #JHMChat! https://t.co/3nYBUsfF83 |
| Eileen Barrett MD MPH (she/her) @EileenBarrettNM @JHospMedicine @gracefarris I’m being completely serious here. I would love if someone studied the effect on inpatient nutrition if things like Sriracha, Tapatio, curry, cinnamon, basil, oregano, garlic, peppers, onions were available to patients to add to their food on their own . #JHMChat |
| Vinny Arora MD MAPP @FutureDocs RT @KDharmarajanMD: @JHospMedicine Not to be flippant-- We can start by asking patients how they feel. #JHMChat |
| Avital Y. O'Glasser, MD FACP SFHM (she/her) @aoglasser RT @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 |
| 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 |
| Avital Y. O'Glasser, MD FACP SFHM (she/her) @aoglasser @WrayCharles @PetrilliMD can you please pin this tweet to the top of your twitter profile???? #JHMchat |
| Harlan Krumholz @hmkyale RT @WrayCharles: @PetrilliMD It hurts my soul that we can track a pizza better than when someone is going to have a colonoscopy performed...#JHMChat |
| Don Edmondson, PhD, MPH @edmondson_don For lower level stress, repeated single item “how stressed do you feel” is probably pretty good. #jhmchat |
 | Jason Karlawish @jasonkarlawish RT @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 |
| Carolyn Thomas @HeartSisters RT @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 |
| 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 |
| Avital Y. O'Glasser, MD FACP SFHM (she/her) @aoglasser @EileenBarrettNM @JHospMedicine @gracefarris i love this idea! #JHMchat |
 | Nathan Gray MD, FACP @NathanAGray RT @gracefarris: Agree w bad diet orders, npo for bogus reasons, minimal oob #JHMchat #GraphicMedicine https://t.co/GuzwcaMG8m |
 | Leigh Ann Myers @LAMYERSRN 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 anticipation of what might be next. This is the experience of most patients. #JHMChat https://t.co/EF69Gigv2M |
| Carolyn Thomas @HeartSisters 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 can see in real time what is happening ... #WhatTimeIsMyProcedure...#ThereIsNoWayToKnowThatInformation |
| Vinny Arora MD MAPP @FutureDocs RT @WrayCharles: @PetrilliMD It hurts my soul that we can track a pizza better than when someone is going to have a colonoscopy performed...#JHMChat |
| Vinny Arora MD MAPP @FutureDocs RT @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 |
 | Lynne Maxwell MD, FAAP @ubudoc RT @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 |
| 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 @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...#JHMChat |
| Avital Y. O'Glasser, MD FACP SFHM (she/her) @aoglasser @donaldedmondso2 #JHMchat move beyond the "no chest pain/dyspnea", "pain level X", "last bowel movement" in the morning SOAP presentation. gotta humanize the checkin |
| Avital Y. O'Glasser, MD FACP SFHM (she/her) @aoglasser RT @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 @PetrilliMD @goblueburd @WrayCharles #jhmchat but it’s Michigan pizza ;-) |
| 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 |
| Carolyn Thomas @HeartSisters RT @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 |
| 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 RT @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 |
| Journal of Hospital Medicine @JHospMedicine CT #JHMChat Please add closing thoughts on post-hospital syndrome https://t.co/j2zSEI7sWV? https://t.co/j2zSEI7sWV |
| Nancy H Stewart DO, MS @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 @PetrilliMD @FutureDocs @WrayCharles @EileenBarrettNM @JHospMedicine @gracefarris #jhmchat I think you just won twitter tonight :-) |
| Nancy H Stewart DO, MS @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 can see in real time what is happening ... #WhatTimeIsMyProcedure...#ThereIsNoWayToKnowThatInformation |
| Avital Y. O'Glasser, MD FACP SFHM (she/her) @aoglasser #JHMchat closing thought-we're not seeing patients at their usual selves with emotional self-regulation when in the hospital. Anxiety/fight-or-flight activates the primordial, limbic areas of the brain |
| 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 (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 approach. We likely are. It is a nosocomial harm. How do we fight it. On behalf of our patients. #JHMchat |
| Grace Farris @gracefarris RT @aoglasser: #JHMchat closing thought-we're not seeing patients at their usual selves with emotional self-regulation when in the hospital. Anxiety/fight-or-flight activates the primordial, limbic areas of the brain |
 | 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! |
 | Vivian Argento @ArgentoMD RT @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 |
| 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 |
| Avital Y. O'Glasser, MD FACP SFHM (she/her) @aoglasser RT @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! |
| Journal of Hospital Medicine @JHospMedicine @tony_breu Great to have you Tony and congrats! #JHMchat |
| 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! |
| 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 Welcome to one of our authors tonight @AuH2O_md ! #JHMchat https://t.co/RHodXSYwdV |
| Journal of Hospital Medicine @JHospMedicine Definitely look forward to discussing #sleep & post hospital syndrome #JHMchat https://t.co/Dkh0rwEZJ8 |
| 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 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 Excited to have author @KDharmarajanMD join us to discuss post hospital syndrome #JHMChat https://t.co/SaSJHsxwP4 |
| Journal of Hospital Medicine @JHospMedicine @MaryOCMack Better late than never! Welcome to #JHMchat |
| Eileen Barrett MD MPH (she/her) @EileenBarrettNM @JHospMedicine We have so many opportunities to learn from each other and do better for our patients, their families, & our teams — looking forward to seeing these studies & until then trying to pilot them! #JHMChat |
| Vinny Arora MD MAPP @FutureDocs 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 anticipation of what might be next. This is the experience of most patients. #JHMChat https://t.co/EF69Gigv2M |
| 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 |
| ReepRN @reepRN @KDharmarajanMD @JHospMedicine Also asking spouses outside patient earshot. They can accurately assess what is normal and what is stress. Irritability is a common sign #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 |
| Journal of Hospital Medicine @JHospMedicine RT @EileenBarrettNM: @JHospMedicine We have so many opportunities to learn from each other and do better for our patients, their families, & our teams — looking forward to seeing these studies & until then trying to pilot them! #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @reepRN: @KDharmarajanMD @JHospMedicine Also asking spouses outside patient earshot. They can accurately assess what is normal and what is stress. Irritability is a common sign #JHMchat |
| Nancy H Stewart DO, MS @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. In the paper we present the support for the theory. Now can we test solutions? Why not? #JHMchat |
| Harlan Krumholz @hmkyale RT @JHospMedicine: Excited to have author @KDharmarajanMD join us to discuss post hospital syndrome #JHMChat https://t.co/SaSJHsxwP4 |
| Grace Farris @gracefarris @goblueburd Agree; was feeling a little depressed by this topic but you are right 👊#JHMChat |
| Elizabeth Gundersen @Top_Gundersen @RJmdphilly @KDharmarajanMD @JHospMedicine Haha, yes - I wasn't intending that as a "measurement;" more the latter as you suggest. #jhmchat |
 | Aaron Maestri @aaronmaestri RT @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 |
| Avital Y. O'Glasser, MD FACP SFHM (she/her) @aoglasser @goblueburd #JHMchat someone is anxious, bombarding nurses with questions, pulling you away from your team room/EHR time?? GO TALK TO THEM and elicit their concerns |
 | William Dale, MD, PhD @WilliamDale_MD RT @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 |
| Grace Farris @gracefarris RT @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 |
| 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 |
| Carolyn Thomas @HeartSisters The #JHMChat is based on this study on #PostHospitalSyndrome: can simply being a hospital patient make us even sicker? "More than 1 in 3 patients discharged from the hospital require acute care in the month after hospital discharge" https://t.co/ITmoIj09ZQ |
| Theresa Boyle @theresaboyle RT @FutureDocs: this seems like a testable hypothesis- we moved to single rooms recently in a new hospital. #jhmchat https://t.co/VM3yooFZRC |
| Eileen Barrett MD MPH (she/her) @EileenBarrettNM RT @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! |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: Thank you to our authors @hmkyale @KDharmarajanMD @AuH20_md for an insightful #JHMChat & partners @SHMLive @CostsofCare and @ABIMFoundation for supporting us! |
| 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 |
| Harlan Krumholz @hmkyale RT @HeartSisters: The #JHMChat is based on this study on #PostHospitalSyndrome: The #JHMChat is based on this study on #PostHospitalSyndrome: can simply being a hospital patient make us even sicker? "More than 1 in 3 patients discharged from the hospital require acute care in the month after hospital discharge" https://t.co/ITmoIj09ZQ |
| 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 |
 | Zackary Berger @DrZackaryBerger 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 anticipation of what might be next. This is the experience of most patients. #JHMChat https://t.co/EF69Gigv2M |
| 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 research in disentangling contributing factors and designing patient centered and effective hospitals (or avoiding altogether) will provide plenty of work for us all. #JHMchat |
| 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! |
| Avital Y. O'Glasser, MD FACP SFHM (she/her) @aoglasser #JHMchat I've been an attending long enough to remember exactly what "FASTHUG" means in notes... but can we add a line for "serenity?" on progress notes?? https://t.co/2hEIdMKCXB |
 | sarahkbingler @sarahkbingler 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 trauma to the hospital roommate. #JHMChat https://t.co/C3ra91tnvT |
| 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 case you see some tweets coming through late! https://t.co/wEMfIGccN8 |
 | Ryan P. Daly, MD @DrRyanPDaly RT @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 |
| 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 |
| Vinny Arora MD MAPP @FutureDocs RT @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 |
| Harlan Krumholz @hmkyale RT @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 |
| 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 |
| Avital Y. O'Glasser, MD FACP SFHM (she/her) @aoglasser #scotuspick going on simultaneously, and @JHospMedicine breaks their twitter account over #JHMchat... https://t.co/XWQkLFUzjy |
| Grace Farris @gracefarris @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 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 |
| 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 |
| Grace Farris @gracefarris RT @aoglasser: #scotuspick going on simultaneously, and @JHospMedicine breaks their twitter account over #JHMchat... https://t.co/XWQkLFUzjy |
 | sic @kimvie RT @HeartSisters: The #JHMChat is based on this study on #PostHospitalSyndrome: The #JHMChat is based on this study on #PostHospitalSyndrome: can simply being a hospital patient make us even sicker? "More than 1 in 3 patients discharged from the hospital require acute care in the month after hospital discharge" https://t.co/ITmoIj09ZQ |
| Nancy H Stewart DO, MS @nvhstewart RT @aoglasser: @goblueburd #JHMchat someone is anxious, bombarding nurses with questions, pulling you away from your team room/EHR time?? GO TALK TO THEM and elicit their concerns |
 | Strong Heart Now @StrongHeartNow1 RT @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 |
| Strong Heart Now @StrongHeartNow1 RT @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 |
| Nancy H Stewart DO, MS @nvhstewart RT @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 |
 | Alex Small @alexcsmall RT @hmkyale: What about looking at children’s hospitals - we wrote a paper..Balloon Animals, Guitars, and Fewer Blood Draws: 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 |
| ReepRN @reepRN RT @aoglasser: @goblueburd #JHMchat someone is anxious, bombarding nurses with questions, pulling you away from your team room/EHR time?? GO TALK TO THEM and elicit their concerns |
 | Savvy Co-op | #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 |
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