#JHMChat Transcript

Healthcare social media transcript of the #JHMChat hashtag.
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Society of Hospital Medicine @SocietyHospMed
#JHMChat starts NOW! Join the conversation, then claim #CME. Details here: https://t.co/E7QUHZqgFd https://t.co/erWlyQTQod
J Hospital Medicine @JHospMedicine
Welcome to #JHMChat, I am your moderator @FutureDocs please introduce yourself.
J Hospital Medicine @JHospMedicine
tonight on #JHMChat we are pleased to welcome the authors of this paper @AuH2O_md @KDharmarajanMD @hmkyale on post-hospital syndrome - a result of hospitalization induced allostatic overload https://t.co/j2zSEI7sWV? https://t.co/98HXmQoCnb
Harlan Krumholz @hmkyale
RT @SHMLive: #JHMChat starts NOW! Join the conversation, then claim #CME. Details here: https://t.co/E7QUHZqgFd https://t.co/erWlyQTQod
Vinny Arora MD MAPP @FutureDocs
RT @JHospMedicine: tonight on #JHMChat we are pleased to welcome the authors of this paper @AuH2O_md @KDharmarajanMD @hmkyale on post-hos…
Vinny Arora MD MAPP @FutureDocs
RT @SHMLive: #JHMChat starts NOW! Join the conversation, then claim #CME. Details here: https://t.co/E7QUHZqgFd https://t.co/erWlyQTQod
Tony Breu @tony_breu
Tony Breu, here from just-south-of-Boston. #JHMchat
J Hospital Medicine @JHospMedicine
RT @SHMLive: #JHMChat starts NOW! Join the conversation, then claim #CME. Details here: https://t.co/E7QUHZqgFd https://t.co/erWlyQTQod
Grace Farris MD @gracefarris
RT @SHMLive: #JHMChat starts NOW! Join the conversation, then claim #CME. Details here: https://t.co/E7QUHZqgFd https://t.co/erWlyQTQod
Harlan Krumholz @hmkyale
So appreciate the opportunity to join the community and talk about how we can improve hospital care. #JHMChat https://t.co/RACV0UDafB
J Hospital Medicine @JHospMedicine
RT @MGHHMU: Spread the word! #JHMchat is back for a special summer session- Monday July 9th 9pET with a new twist on the Posthospital Syndr…
Avital O'Glasser, MD FACP FHM @aoglasser
joining #JHMchat from Portland OR
J Hospital Medicine @JHospMedicine
RT @hmkyale: So appreciate the opportunity to join the community and talk about how we can improve hospital care. #JHMChat https://t.co/RAC…
Stephanie Burdick @goblueburd
#JHMCHat Stephanie Burdick MD here from Grand Rapids MI.
Nancy H Stewart DO, MS @nvhstewart
Hi all! Nancy here, graduating #pccm fellow upcoming #sleep fellow— excited to join tonight! #jhmchat
Marilyn Mann @MarilynMann
RT @SHMLive: #JHMChat starts NOW! Join the conversation, then claim #CME. Details here: https://t.co/E7QUHZqgFd https://t.co/erWlyQTQod
Deena Goldwater @AuH2O_md
Deena Goldwater. Thank you so much for hosting this chat! #JHMCHat
Donald Edmondson @donaldedmondso2
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/RAC…
Charlie M. Wray @WrayCharles
Charlie Wray, joining from the unseasonably warm SF Bay area #SummerIsOurWinter #JHMChat
John Ryan @JJRyanMD
RT @JHospMedicine: tonight on #JHMChat we are pleased to welcome the authors of this paper @AuH2O_md @KDharmarajanMD @hmkyale on post-hos…
Kumar Dharmarajan @KDharmarajanMD
So important that we make hospitals into the healing environments they are meant to be. Our patients need this #JHMCHat
Sucharita Kher MD @sucharitakher
Hello! #intensivist and pulmonary doc from Boston. Director for med #inpatient services at my hospital. Look forward to discussion. #JHMChat
Society of Hospital Medicine @SocietyHospMed
Claim #CME after tonight's #JHMChat here: https://t.co/SG8h7Rkqwc
J 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 MD @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 m…
J Hospital Medicine @JHospMedicine
RT @SHMLive: 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
J 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 O'Glasser, MD FACP FHM @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??
J Hospital Medicine @JHospMedicine
RT @SHMLive: T1 for tonight's #JHMChat is live! Join the conversation happening NOW https://t.co/xzWmAduKNS
J Hospital Medicine @JHospMedicine
RT @KDharmarajanMD: @JHospMedicine Uncertainty all too common in the hospital. Who is my doctor? Why are my providers always changing? When…
Charlie M. Wray @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
J Hospital Medicine @JHospMedicine
RT @hmkyale: Don’t we all see the same thing? Sleep deprivation. Noise. Poor nutrition. Inactivity. Chaos. Disruption. Embarrassment. Disco…
J 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…
Avital O'Glasser, MD FACP FHM @aoglasser
@hmkyale #JHMchat all this
J Hospital Medicine @JHospMedicine
RT @nvhs0401: A1: from a specialty standpoint, there is a lot of #patient #confusion on discharge involving follow up, meds, hospital cours…
Chris Petrilli @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/RAC…
Avital O'Glasser, MD FACP FHM @aoglasser
RT @WrayCharles: T1: In my experience, the physical and emotional isolation that is forced upon our patients appear to have quite an impact…
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 m…
Elizabeth Gundersen @Top_Gundersen
@KDharmarajanMD @JHospMedicine Yes! And even: Why am I here? #JHMChat
Vinny Arora MD MAPP @FutureDocs
RT @hmkyale: So appreciate the opportunity to join the community and talk about how we can improve hospital care. #JHMChat https://t.co/RAC…
Harlan Krumholz @hmkyale
The schedule…when will my doctor come? Will I miss her or him? What is happening today? Days are full of anxiety in anticipation of what might be next. This is the experience of most patients. #JHMChat https://t.co/EF69Gigv2M
J Hospital Medicine @JHospMedicine
T2 up in a moment on #JHMChat.
Vinny Arora MD MAPP @FutureDocs
RT @gracefarris: Grace Farris joining from NYC #JHMchat https://t.co/Fz7E65hC9D
Nancy H Stewart DO, MS @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
Avital O'Glasser, MD FACP FHM @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
Donald Edmondson @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 @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…
J Hospital Medicine @JHospMedicine
RT @Top_Gundersen: @KDharmarajanMD @JHospMedicine Yes! And even: Why am I here? #JHMChat
Avital O'Glasser, MD FACP FHM @aoglasser
@gracefarris @FutureDocs #JHMchat here come the graphics!!
Harlan Krumholz @hmkyale
RT @donaldedmondso2: T1. We consistently find that emergency department crowding, patient stress, poor clinician-patient communication in E…
Mary MACK @MaryOCMack
Hello, Mary here-- just joined late and lurking #JHMChat
Natrice Rese 🇨🇦 @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…
Carolyn Thomas @HeartSisters
RT @KDharmarajanMD: @JHospMedicine Uncertainty all too common in the hospital. Who is my doctor? Why are my providers always changing? When…
Vinny Arora MD MAPP @FutureDocs
RT @aoglasser: @gracefarris @FutureDocs #JHMchat here come the graphics!!
Natrice Rese 🇨🇦 @NatriceR
RT @KDharmarajanMD: @JHospMedicine Uncertainty all too common in the hospital. Who is my doctor? Why are my providers always changing? When…
Tony Breu @tony_breu
@aoglasser I still see patients in 4-person rooms... #JHMchat
Avital O'Glasser, MD FACP FHM @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 O'Glasser, MD FACP FHM @aoglasser
@tony_breu #JHMchat https://t.co/Wxm7ItU1W9
Charlie M. Wray @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
Sucharita Kher MD @sucharitakher
T1: the stress of needing to understand medical jargon. We need to speak in a language our patients understand. #JHMChat
J Hospital Medicine @JHospMedicine
RT @FutureDocs: you know i agree with you! we are working to fix this not only in adults but also in kids- be curious is kids have post hos…
Donald Edmondson @donaldedmondso2
Insufficient sleep is known to exacerbate long-term effects of acute stress. #JHMChat
J Hospital Medicine @JHospMedicine
RT @donaldedmondso2: T1. We consistently find that emergency department crowding, patient stress, poor clinician-patient communication in E…
Carolyn Thomas @HeartSisters
RT @donaldedmondso2: T1. We consistently find that emergency department crowding, patient stress, poor clinician-patient communication in E…
J 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 anticipati…
Carolyn Thomas @HeartSisters
RT @sucharitakher: T1: the stress of needing to understand medical jargon. We need to speak in a language our patients understand. #JHMChat
Avital O'Glasser, MD FACP FHM @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 tra…
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 @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…
Natrice Rese 🇨🇦 @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 tra…
Margaret Fleming @mlsfleming2
RT @hmkyale: Don’t we all see the same thing? Sleep deprivation. Noise. Poor nutrition. Inactivity. Chaos. Disruption. Embarrassment. Disco…
Vinny Arora MD MAPP @FutureDocs
RT @donaldedmondso2: Insufficient sleep is known to exacerbate long-term effects of acute stress. #JHMChat
Vinny Arora MD MAPP @FutureDocs
RT @sucharitakher: T1: the stress of needing to understand medical jargon. We need to speak in a language our patients understand. #JHMChat
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 ar…
Avital O'Glasser, MD FACP FHM @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. Disco…
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 experien…
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
J Hospital Medicine @JHospMedicine
RT @WrayCharles: T1: In my experience, the physical and emotional isolation that is forced upon our patients appear to have quite an impact…
Kumar Dharmarajan @KDharmarajanMD
@Top_Gundersen @WrayCharles Agreed. The dehumanization starts as soon as we get banded and issued a hospital gown. #JHMChat
Natrice Rese 🇨🇦 @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 experien…
J 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 experien…
Carolyn Thomas @HeartSisters
RT @hmkyale: Don’t we all see the same thing? Sleep deprivation. Noise. Poor nutrition. Inactivity. Chaos. Disruption. Embarrassment. Disco…
J Hospital Medicine @JHospMedicine
RT @Top_Gundersen: @WrayCharles Hospitalization can be dehumanizing. It can feel like "conveyor belt" medicine where patients feel they ar…
Margaret Fleming @mlsfleming2
RT @hmkyale: The schedule…when will my doctor come? Will I miss her or him? What is happening today? Days are full of anxiety in anticipati…
Grace Farris MD @gracefarris
Agree w bad diet orders, npo for bogus reasons, minimal oob #JHMchat #GraphicMedicine https://t.co/GuzwcaMG8m
Avital O'Glasser, MD FACP FHM @aoglasser
@FutureDocs oooooo #JHMchat
J Hospital Medicine @JHospMedicine
RT @KDharmarajanMD: @Top_Gundersen @WrayCharles Agreed. The dehumanization starts as soon as we get banded and issued a hospital gown. #JHM
J 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...
J 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…
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 tra…
Nancy H Stewart DO, MS @nvhstewart
RT @PetrilliMD: @WrayCharles #JHMChat @nyulangone does a great job with #interdisciplinaryrounds and #ptsafetyhuddle ... every day at 1:45p…
J 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…
Avital O'Glasser, MD FACP FHM @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. #JHM
Marilyn Mann @MarilynMann
RT @donaldedmondso2: T1. We consistently find that emergency department crowding, patient stress, poor clinician-patient communication in E…
Vinny Arora MD MAPP @FutureDocs
RT @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 fea…
Natrice Rese 🇨🇦 @NatriceR
RT @KDharmarajanMD: @Top_Gundersen @WrayCharles Agreed. The dehumanization starts as soon as we get banded and issued a hospital gown. #JHM
Elvira G Aletta, PhD @dr_aletta
RT @hmkyale: Don’t we all see the same thing? Sleep deprivation. Noise. Poor nutrition. Inactivity. Chaos. Disruption. Embarrassment. Disco…
Elizabeth Gundersen @Top_Gundersen
RT @JHospMedicine: tonight on #JHMChat we are pleased to welcome the authors of this paper @AuH2O_md @KDharmarajanMD @hmkyale on post-hos…
Andrew Auerbach @ADAuerbachMD
RT @JHospMedicine: T2 up in a moment on #JHMChat.
Avital O'Glasser, MD FACP FHM @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: 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…
Donald Edmondson @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
Carolyn Thomas @HeartSisters
RT @JHospMedicine: T2 Likewise, the authors also explore the main health consequences of stress or allostatic load in hospitalized patients…
Khurram Nasir @khurramn1
RT @hmkyale: What happened is that we became socialized to ignore what patients really experience. We only see it if we or our friends and…
New England Nurse @coffeeNCalibers
RT @hmkyale: Don’t we all see the same thing? Sleep deprivation. Noise. Poor nutrition. Inactivity. Chaos. Disruption. Embarrassment. Disco…
Tony Breu @tony_breu
@hmkyale While I agree that most want private rooms, I have observed on many occasions my patients (all veterans) "watching out" for their roommates and enjoying the conversations/connections. #JHMchat
Harlan Krumholz @hmkyale
T2. Our point is that we have been indifferent to the consequences of the stress, thinking it is just inconvenient for patients. Maybe it is a lot more. Many people suffer health consequences of the toxicity of the hospitalization. That is the new idea. #JHMchat
Margaret Fleming @mlsfleming2
RT @FutureDocs: this seems like a testable hypothesis- we moved to single rooms recently in a new hospital. #jhmchat https://t.co/VM3yooFZRC
Vinny Arora MD MAPP @FutureDocs
@PetrilliMD @hmkyale true... in fact maybe you saw our hotel that works like a hospital video once upon a time? #jhmchat https://t.co/sbdl71aznQ cc @CostsofCare @neel_shah
Lisa Davis Budzinski @lisadbudzinski
RT @SHMLive: #JHMChat begins in 1 hour! Read the article "Is #Posthospital #Syndrome a Result of #Hospitalization-Induced Allostatic Overlo…
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 experien…
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…
Grace Farris MD @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…
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 patient…
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 ht…
Harlan Krumholz @hmkyale
T2. The idea of consequences came as I realized we were not making fast enough progress in readmissions; and I began thinking that maybe the hospitalization is creating vulnerability to illness after discharge; why else do people suffer from so many problems afterwards. #JHMchat
Vinny Arora MD MAPP @FutureDocs
RT @aoglasser: I love that this #JHMchat already has a patient and an RN voice #medtwitter https://t.co/LQFhrRRog6
Lonika Sood, MD, MHPE @sood_lonika
Sorry to chime in late... hospitalistfrom Green Bay here!! #JHMChat
Avital O'Glasser, MD FACP FHM @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 @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…
Lonika Sood, MD, MHPE @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 O'Glasser, MD FACP FHM @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 @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
J Hospital Medicine @JHospMedicine
RT @EileenBarrettNM: @gracefarris @JHospMedicine Not only is the food inappropriately restrictive and bad tasting, it’s also generally not…
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 O'Glasser, MD FACP FHM @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 sayin…
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
J 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…
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 O'Glasser, MD FACP FHM @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 subt…
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 MD @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 O'Glasser, MD FACP FHM @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 @WrayCharles
RT @hmkyale: Single rooms may be necessary but not sufficient to create a healing, strengthening environment in hospitals. But a start. Lik…
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 subt…
Elizabeth Gundersen @Top_Gundersen
@reepRN The "Hospital at Home" concept mentioned in the article is so interesting from that perspective! #JHMchat
J Hospital Medicine @JHospMedicine
RT @aoglasser: #JHMChat T2--I thought the fight or flight analogy holds very well in this situation. constant bombardment by unexpected al…
Avital O'Glasser, MD FACP FHM @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
J Hospital Medicine @JHospMedicine
RT @nvhs0401: I had a #medstudent wake me @5am and ask how my night was— I wanted to say “fine, but it wasn’t over yet!” #patientexperience
Tony Breu @tony_breu
@gracefarris @aoglasser @EileenBarrettNM @JHospMedicine I could not agree more. #JHMchat
J Hospital Medicine @JHospMedicine
RT @hmkyale: Single rooms may be necessary but not sufficient to create a healing, strengthening environment in hospitals. But a start. Lik…
reepRN @reepRN
RT @Top_Gundersen: @reepRN The "Hospital at Home" concept mentioned in the article is so interesting from that perspective! #JHMchat
J Hospital Medicine @JHospMedicine
RT @hmkyale: Interestingly the interventions to prevent delirium are very much like what would be necessary to create a humane, caring, hea…
Avital O'Glasser, MD FACP FHM @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, hea…
Eileen Barrett MD MPH @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
Sucharita Kher MD @sucharitakher
PTSD after critical illness is a well known consequence #JHMChat
reepRN @reepRN
RT @gracefarris: @aoglasser @EileenBarrettNM @JHospMedicine I generally feel like everyone should be on a regular diet (and probably we sho…
Vinny Arora MD MAPP @FutureDocs
@Top_Gundersen @reepRN stay tuned for T4! #jhmchat
Eileen Barrett MD MPH @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 sho…
Charlie M. Wray @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, hea…
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 O'Glasser, MD FACP FHM @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, hea…
Avital O'Glasser, MD FACP FHM @aoglasser
@FutureDocs @gracefarris @EileenBarrettNM @JHospMedicine @geripal @jeannemfarnan #JHMchat https://t.co/S9o5FEyUw0
Donald Edmondson @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
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 sho…
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 @EileenBarrettNM
@JHospMedicine T2. Yes! And powerlessness, loneliness. #JHMchat
Avital O'Glasser, MD FACP FHM @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 @RJmdphilly
@donaldedmondso2 #readlater #JHMchat
J Hospital Medicine @JHospMedicine
RT @donaldedmondso2: Ironically, patients who are most stressed by the medical event/hospitalization are also least likely to be adherent t…
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-det…
Avital O'Glasser, MD FACP FHM @aoglasser
#JHMchat I think the "sensory deprivation chamber" delirium analogy needs to be expanded beyond older patients
Darren AuH2O @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
Isoris Nivar @INivar89
RT @donaldedmondso2: Insufficient sleep is known to exacerbate long-term effects of acute stress. #JHMChat
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
J Hospital Medicine @JHospMedicine
T3 #JHMChat Given these hypotheses, what interventions can help prevent post-hospital syndrome? https://t.co/mFNoSXkSCe
Avital O'Glasser, MD FACP FHM @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 !
J Hospital Medicine @JHospMedicine
RT @aoglasser: @gracefarris @goblueburd @EileenBarrettNM @JHospMedicine #JHMchat wasn't this the winning abstract at SHM this year? https:/…
Rebecca Jaffe @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
Eileen Barrett MD MPH @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 AuH2O @DarrenGoldwater
RT @JHospMedicine: Spread the word! #JHMchat is back for a special summer session- Monday July 9th 9pET with @hmkyale @AuH2O_md @KDharmaraj
Jonathan Lim @JonLimMD
@JHospMedicine Some patients face truly existential challenges— am I going to live? Am I going to die? What does life and living mean to me? Some patients reckon with their mortality and transience. #JHMChat
Enlightening Results @GraceCordovano
RT @hmkyale: T2. Our point is that we have been indifferent to the consequences of the stress, thinking it is just inconvenient for patient…
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.
Donald Edmondson @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
Beth Suereth @BethSuereth
RT @donaldedmondso2: Ironically, patients who are most stressed by the medical event/hospitalization are also least likely to be adherent t…
Rebecca Jaffe @RJmdphilly
RT @hmkyale: What about looking at children’s hospitals - we wrote a paper..Balloon Animals, Guitars, and Fewer Blood Draws: Applying Strat…
Avital O'Glasser, MD FACP FHM @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…
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: Applying Strat…
reepRN @reepRN
RT @hmkyale: What about looking at children’s hospitals - we wrote a paper..Balloon Animals, Guitars, and Fewer Blood Draws: Applying Strat…
Eileen Barrett MD MPH @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:/…
Charlie M. Wray @WrayCharles
RT @donaldedmondso2: On a positive note, good clinician-patient communication in the ED appears to mitigate the impact of high stress/death…
Vinny Arora MD MAPP @FutureDocs
RT @JHospMedicine: T3 #JHMChat Given these hypotheses, what interventions can help prevent post-hospital syndrome? https://t.co/mFNoSXkSCe
reepRN @reepRN
RT @aoglasser: #JHMchat I think the "sensory deprivation chamber" delirium analogy needs to be expanded beyond older patients
Grace Farris MD @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, hea…
Rebecca Jaffe @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…
Darren AuH2O @DarrenGoldwater
RT @hmkyale: Your sister rocks. She did a great job bringing together ideas from basic and clinical science. And introduced me to her mento…
Grace Farris MD @gracefarris
@RJmdphilly @nvhs0401 @Top_Gundersen Agree! Was too nervous/scared to ask L&D nurse to change TV channel from Fox News 🙄 #JHMchat
Avital O'Glasser, MD FACP FHM @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
Sucharita Kher MD @sucharitakher
T3: talking to a patient with limited English proficiency in a language they understand! Daily and as often as needed. One of the resident pearls I start with on day 1 of Ward service! #JHMChat #TipsForNewDocs
Rebecca Jaffe @RJmdphilly
RT @gracefarris: @aoglasser @goblueburd @EileenBarrettNM @JHospMedicine When I learned that our Ortho now allows a Gatorade on the day of s…
Avital O'Glasser, MD FACP FHM @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: In my experience, the physical and emotional isolation that is forced upon our patients appear to have quite an impact…
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 pro…
Vinny Arora MD MAPP @FutureDocs
RT @KDharmarajanMD: T3: Let's take the traditional free-standing hospital out of the mix with hospital at home. Familiar bed and food. Easy…
Theresa Boyle @theresaboyle
RT @Top_Gundersen: @EileenBarrettNM @hmkyale @JHospMedicine This makes me think of design thinking in healthcare - designing places and pro…
Carolyn Thomas @HeartSisters
RT @Top_Gundersen: @EileenBarrettNM @hmkyale @JHospMedicine This makes me think of design thinking in healthcare - designing places and pro…
Charlie M. Wray @WrayCharles
RT @Top_Gundersen: @EileenBarrettNM @hmkyale @JHospMedicine This makes me think of design thinking in healthcare - designing places and pro…
Nancy H Stewart DO, MS @nvhstewart
@aoglasser @gracefarris @goblueburd @EileenBarrettNM @JHospMedicine If only some of the specialists followed this too! #jhmchat
Avital O'Glasser, MD FACP FHM @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
Donald Edmondson @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
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 pro…
Eileen Barrett MD MPH @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 MD @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 O'Glasser, MD FACP FHM @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 ligh…
Sucharita Kher MD @sucharitakher
Have family get the glasses, hearing aid and dentures... cut down delirium #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 Hospit…
Rebecca Jaffe @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 O'Glasser, MD FACP FHM @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
J Hospital Medicine @JHospMedicine
RT @RJmdphilly: A3 - coordinating teams/rounds. Tasks should be bundled so that interruptions to “daily life” are minimized. Then options f…
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
Jonathan Lim @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 everyon…
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 f…
Donald Edmondson @donaldedmondso2
Interestingly, anxious family members are worse for patients than being in the hospital alone (Homma et al, 2016) #JHMchat
Teresa Chan @TChanMD
RT @Top_Gundersen: @EileenBarrettNM @hmkyale @JHospMedicine This makes me think of design thinking in healthcare - designing places and pro…
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 subt…
Vinny Arora MD MAPP @FutureDocs
T3 #Jhmchat folks at @MaineMed are piloting an IPACE unit where the patients and families have "appointments" with the medical team and its not at the crack of dawn. part of @acgme pursuing excellence grant
Harlan Krumholz @hmkyale
RT @FutureDocs: T3 #Jhmchat folks at @MaineMed are piloting an IPACE unit where the patients and families have "appointments" with the medi…
reepRN @reepRN
RT @Top_Gundersen: @EileenBarrettNM @hmkyale @JHospMedicine This makes me think of design thinking in healthcare - designing places and pro…
Grace Farris MD @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 O'Glasser, MD FACP FHM @aoglasser
@RJmdphilly I'm going to use this to justify my "discover rounds" on weekends :) #JHMchat
Donald Edmondson @donaldedmondso2
RT @FutureDocs: T3 #Jhmchat folks at @MaineMed are piloting an IPACE unit where the patients and families have "appointments" with the medi…
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 medi…
reepRN @reepRN
RT @donaldedmondso2: Interestingly, anxious family members are worse for patients than being in the hospital alone (Homma et al, 2016) #JHM
Donald Edmondson @donaldedmondso2
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 u…
Andrew Auerbach @ADAuerbachMD
RT @FutureDocs: T3 #Jhmchat folks at @MaineMed are piloting an IPACE unit where the patients and families have "appointments" with the medi…
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 MD @gracefarris
RT @FutureDocs: T3 #Jhmchat folks at @MaineMed are piloting an IPACE unit where the patients and families have "appointments" with the medi…
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 u…
reepRN @reepRN
RT @sucharitakher: Have family get the glasses, hearing aid and dentures... cut down delirium #JHMChat
Avital O'Glasser, MD FACP FHM @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
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 patient…
Nancy H Stewart DO, MS @nvhstewart
@aoglasser @RJmdphilly “Discover rounds”?! That sounds exciting!! #jhmchat
Henry Cruz @RealCruzHenry
RT @hmkyale: T1. How is it that we came to accept the stress of the hospitalization as normative. How did we come to so ignore the experien…
Avital O'Glasser, MD FACP FHM @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 subt…
Eileen Barrett MD MPH @EileenBarrettNM
@KDharmarajanMD @FutureDocs @NicolaOrlov @comerpedschiefs @Al26Norenberg @ajantapatel @freckledpedidoc @vdimaggio @siddante Totally agree! Why don’t we offer EMLA before lab draws/IV sticks, puppies, and kindness to all? #JHMChat
Henry Cruz @RealCruzHenry
RT @hmkyale: What about looking at children’s hospitals - we wrote a paper..Balloon Animals, Guitars, and Fewer Blood Draws: Applying Strat…
Charlie M. Wray @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 subt…
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 hospitali…
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 O'Glasser, MD FACP FHM @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 MD @gracefarris
RT @aoglasser: @reepRN @gracefarris @goblueburd @EileenBarrettNM @JHospMedicine can't wait for npo to fade away (I mostly work in hospitali…
Lonika Sood, MD, MHPE @sood_lonika
@aoglasser @EileenBarrettNM @JHospMedicine A3: early discharge, clear expectations, teamwork, early mobilization #jhmchat
Elizabeth Gundersen @Top_Gundersen
@donaldedmondso2 As a hospice doc I can believe it - sometimes part of anxiety management is working with families to calm their anxiety so that there are not 15 concerned family members crowding the patient. We mustn't forget to include caregivers in our interventions! #jhmchat
J Hospital Medicine @JHospMedicine
RT @Top_Gundersen: @EileenBarrettNM @hmkyale @JHospMedicine This makes me think of design thinking in healthcare - designing places and pro…
Nancy H Stewart DO, MS @nvhstewart
@PetrilliMD @FutureDocs @MaineMed @acgme I think @FutureDocs and @WrayCharles did some work on #dailylabs #jhmchat
Margaret Fleming @mlsfleming2
RT @KDharmarajanMD: T3: Let's take the traditional free-standing hospital out of the mix with hospital at home. Familiar bed and food. Easy…
Megan Hosey @DrMeganHoseyPhD
RT @hmkyale: Interestingly the interventions to prevent delirium are very much like what would be necessary to create a humane, caring, hea…
J Hospital Medicine @JHospMedicine
T4 #JHMChat How can we best measure “stress” in hospitalized patients so that we can improve it? https://t.co/yrGZQSY382
J 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…
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 everyon…
Avital O'Glasser, MD FACP FHM @aoglasser
@goblueburd exactly! concern for anuria or oliguria overnight just means the patient wasn't woken up by nocturia... #JHMchat
Natrice Rese 🇨🇦 @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 @WrayCharles
@FutureDocs @MaineMed @acgme Interesting! I've heard of #pediatrics doing this...#JHMChat
Avital O'Glasser, MD FACP FHM @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 cont…
nobism @nobismhealth
RT @nvhs0401: I had a #medstudent wake me @5am and ask how my night was— I wanted to say “fine, but it wasn’t over yet!” #patientexperience
Rebecca Jaffe @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 Sood, MD, MHPE @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
J 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 FAAP @BetaMomma
RT @FutureDocs: T3 #Jhmchat folks at @MaineMed are piloting an IPACE unit where the patients and families have "appointments" with the medi…
Nancy H Stewart DO, MS @nvhstewart
@PetrilliMD @FutureDocs @MaineMed @acgme @WrayCharles #goals #jhmchat
Avital O'Glasser, MD FACP FHM @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
Donald Edmondson @donaldedmondso2
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 @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 O'Glasser, MD FACP FHM @aoglasser
@nvhs0401 thanks for justifying my time saving efforts when I cover two teams on some weekends! #JHMchat
Margaret Fleming @mlsfleming2
RT @hmkyale: How many times, in a stable patients, does disturbing them at night for measurements yield critically important information? I…
Society of Hospital Medicine @SocietyHospMed
Don't forget to claim #CME immediately following tonight's #JHMChat! https://t.co/3nYBUsfF83
Chris Petrilli @PetrilliMD
@nvhs0401 #JHMChat I love this...AND it allows interns/residents the sleep that everyone deserves
Eileen Barrett MD MPH @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 O'Glasser, MD FACP FHM @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…
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 O'Glasser, MD FACP FHM @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..…
Donald Edmondson @donaldedmondso2
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, hea…
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…
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 O'Glasser, MD FACP FHM @aoglasser
@EileenBarrettNM @JHospMedicine @gracefarris i love this idea! #JHMchat
Nathan Gray @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 anticipati…
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…
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..…
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…
JACKMOM @ubudoc
RT @KDharmarajanMD: @FutureDocs @NicolaOrlov @comerpedschiefs @Al26Norenberg @ajantapatel @freckledpedidoc @vdimaggio @siddante "Why Hospit…
Rebecca Jaffe @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..…
Avital O'Glasser, MD FACP FHM @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
Sucharita Kher MD @sucharitakher
RT @Top_Gundersen: @KDharmarajanMD @JHospMedicine Yes! We can also ask patients how they are feeling about being in the hospital, what they…
Avital O'Glasser, MD FACP FHM @aoglasser
RT @RJmdphilly: @hmkyale Again, tapping into the peds mindset a little. not to infantilize our patients, but caring about their wellbeeing…
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 @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 @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…
Sucharita Kher MD @sucharitakher
T4: before leaving patients’room, ask”have I answered all your questions?” Or “what else can I do for you?” #TipsForNewDocs #Jhmchat
J Hospital Medicine @JHospMedicine
CT #JHMChat Please add closing thoughts on post-hospital syndrome https://t.co/j2zSEI7sWV?
J Hospital Medicine @JHospMedicine
Dont forget to claim your #CME here after #JHMChat https://t.co/0R3URGkP8F
J Hospital Medicine @JHospMedicine
CT #JHMChat Please add closing thoughts on post-hospital syndrome https://t.co/j2zSEI7sWV? https://t.co/j2zSEI7sWV
J Hospital Medicine @JHospMedicine
RT @RJmdphilly: @Top_Gundersen @KDharmarajanMD @JHospMedicine Important to distinguish between this "measurement" as a research question, v…
Nancy H Stewart DO, MS @nvhstewart
@hmkyale @FutureDocs and I are doing work on this now!! #sleep inpatient #jhmchat #moretocome
J 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…
Avital O'Glasser, MD FACP FHM @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 O'Glasser, MD FACP FHM @aoglasser
RT @hmkyale: What can we do to start fresh with design thinking on the hospital experience. What if we are doing harm with the current appr…
Dr. Preeti R John @preeti_john
So true. "NPO for possible OR tomorrow". So much uncertainty & lack of predictability in the #hospital environment #JHMchat https://t.co/XBm58Fxc7K
Grace Farris MD @gracefarris
RT @aoglasser: #JHMchat closing thought-we're not seeing patients at their usual selves with emotional self-regulation when in the hospital…
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, hea…
Vinny Arora MD MAPP @FutureDocs
@PetrilliMD @WrayCharles @EileenBarrettNM @JHospMedicine @gracefarris ill take it:) #jhmchat i am just so glad this chat was a success!
Vinny Arora MD MAPP @FutureDocs
RT @JHospMedicine: Dont forget to claim your #CME here after #JHMChat https://t.co/0R3URGkP8F https://t.co/0R3URGkP8F
Avital O'Glasser, MD FACP FHM @aoglasser
RT @goblueburd: #JHMCHat Every little bit counts! One less pt on a restricted diet, one less foley, one less unnecessary tele order can mak…
J Hospital Medicine @JHospMedicine
@tony_breu Great to have you Tony and congrats! #JHMchat
Vinny Arora MD MAPP @FutureDocs
@hmkyale Love it - we are sending watches home with patients to track sleep and activity post discharge but more for Research than clinical tool #jhmchat cc @nvhs0401
J Hospital Medicine @JHospMedicine
@aoglasser Thx for joining Avital! Great to have our West coast representation! #jhmchat
J Hospital Medicine @JHospMedicine
@goblueburd Welcome to #JHMchat!
J Hospital Medicine @JHospMedicine
Definitely look forward to discussing #sleep & post hospital syndrome #JHMchat https://t.co/Dkh0rwEZJ8
J Hospital Medicine @JHospMedicine
Welcome to one of our authors tonight @AuH2O_md ! #JHMchat https://t.co/RHodXSYwdV
J Hospital Medicine @JHospMedicine
Great to have research experts from other specialties tonight on #JHMchat ! https://t.co/SaDl1CI9YY
J Hospital Medicine @JHospMedicine
It would not be #JHMchat without @gracefarris and her amazing real time graphic art https://t.co/OVyA8IvNSD
J Hospital Medicine @JHospMedicine
@sucharitakher Welcome to you and those from the critical care community to #JHMChat
J Hospital Medicine @JHospMedicine
Excited to have author @KDharmarajanMD join us to discuss post hospital syndrome #JHMChat https://t.co/SaSJHsxwP4
J 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
J Hospital Medicine @JHospMedicine
@MaryOCMack Better late than never! Welcome to #JHMchat
Eileen Barrett MD MPH @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 anticipati…
Donald Edmondson @donaldedmondso2
@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
J Hospital Medicine @JHospMedicine
RT @EileenBarrettNM: @JHospMedicine We have so many opportunities to learn from each other and do better for our patients, their families,…
J Hospital Medicine @JHospMedicine
RT @reepRN: @KDharmarajanMD @JHospMedicine Also asking spouses outside patient earshot. They can accurately assess what is normal and what…
Nancy H Stewart DO, MS @nvhstewart
@JHospMedicine Yes!! I know of work being done in this area now!! #moretocome #jhmchat
J Hospital Medicine @JHospMedicine
RT @hmkyale: I believe our disregard for each patient’s rest, nutrition, serenity, health, peace - has dire consequences for their outcomes…
Harlan Krumholz @hmkyale
RT @JHospMedicine: Excited to have author @KDharmarajanMD join us to discuss post hospital syndrome #JHMChat https://t.co/SaSJHsxwP4
Grace Farris MD @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, Ph.D. @aaronmaestri
RT @hmkyale: I believe our disregard for each patient’s rest, nutrition, serenity, health, peace - has dire consequences for their outcomes…
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…
Avital O'Glasser, MD FACP FHM @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
Grace Farris MD @gracefarris
RT @hmkyale: I believe our disregard for each patient’s rest, nutrition, serenity, health, peace - has dire consequences for their outcomes…
J 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
Michael Katz @MGKatz036
RT @hmkyale: The schedule…when will my doctor come? Will I miss her or him? What is happening today? Days are full of anxiety in anticipati…
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 @EileenBarrettNM
RT @goblueburd: #JHMCHat Every little bit counts! One less pt on a restricted diet, one less foley, one less unnecessary tele order can mak…
Society of Hospital Medicine @SocietyHospMed
RT @JHospMedicine: Thank you to our authors @hmkyale @KDharmarajanMD @AuH20_md for an insightful #JHMChat & partners @SHMLive @CostsofCa
Andrew Auerbach @ADAuerbachMD
@JHospMedicine Editor’s takeaway - The humanistic and professional imperative of post hospital syndrome clear, and research in disentangling contributing factors and designing patient centered and effective hospitals (or avoiding altogether) will provide plenty of work for us all. #JHMchat
Harlan Krumholz @hmkyale
RT @HeartSisters: The #JHMChat is based on this study on #PostHospitalSyndrome: can simply being a hospital patient make us even sicker? "M…
Charlie M. Wray @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
J 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, MD, PhD @ZackBergerMDPhD
RT @hmkyale: The schedule…when will my doctor come? Will I miss her or him? What is happening today? Days are full of anxiety in anticipati…
Dr. Preeti R John @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
J Hospital Medicine @JHospMedicine
RT @ADAuerbachMD: @JHospMedicine Editor’s takeaway - The humanistic and professional imperative of post hospital syndrome clear, and resear…
Andrew Auerbach @ADAuerbachMD
My deepest thanks as well!: RT @JHospMedicine: Thank you to our authors @hmkyale @KDharmarajanMD @AuH20_md for an insightful #JHMChat & partners @SHMLive @CostsofCare and @ABIMFoundation for supporting us!
Avital O'Glasser, MD FACP FHM @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 tra…
Vinny Arora MD MAPP @FutureDocs
RT @JHospMedicine: Thx for an amazing #JHMChat everyone! We officially broke our account with all your tweets RT and mentions! So just in c…
Ryan Daly, MD @DrRyanPDaly
RT @hmkyale: I believe our disregard for each patient’s rest, nutrition, serenity, health, peace - has dire consequences for their outcomes…
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 resear…
Harlan Krumholz @hmkyale
RT @ADAuerbachMD: @JHospMedicine Editor’s takeaway - The humanistic and professional imperative of post hospital syndrome clear, and resear…
Rebecca Jaffe @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 O'Glasser, MD FACP FHM @aoglasser
#scotuspick going on simultaneously, and @JHospMedicine breaks their twitter account over #JHMchat... https://t.co/XWQkLFUzjy
Grace Farris MD @gracefarris
@JHospMedicine Thanks for another great #JHMchat @FutureDocs @WrayCharles @JHospMedicine and thanks to the article authors! @hmkyale
Dr. Preeti R John @preeti_john
RT @hmkyale: We need a groundswell of people to help all of us make the necessary changes to better serve patients. A community that includ…
Andrew Auerbach @ADAuerbachMD
We can rebuild!! RT @JHospMedicine: Thx for an amazing #JHMChat everyone! We officially broke our account with all your tweets RT and mentions! So just in case you see some tweets coming through late! https://t.co/muK3iIw4e7
Grace Farris MD @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: can simply being a hospital patient make us even sicker? "M…
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?? G…
Susan Strong @stronglifenow
RT @AuH2O_md: Agreed. Also, the health consequences after discharge can be obvious (i.e. like mortality and readmission) but also more subt…
Susan Strong @stronglifenow
RT @hmkyale: T2. Our point is that we have been indifferent to the consequences of the stress, thinking it is just inconvenient for patient…
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 a…
Alex Small @alexcsmall
RT @hmkyale: What about looking at children’s hospitals - we wrote a paper..Balloon Animals, Guitars, and Fewer Blood Draws: Applying Strat…
reepRN @reepRN
RT @aoglasser: @goblueburd #JHMchat someone is anxious, bombarding nurses with questions, pulling you away from your team room/EHR time?? G…
Theresa Boyle @theresaboyle
RT @sucharitakher: T1: the stress of needing to understand medical jargon. We need to speak in a language our patients understand. #JHMChat
Savvy Coop💡 @savvy_coop
How we yearn for the day when suggesting one talks to patients does not need a disclaimer. 🙏🏽 You can’t improve the #patientexperience if you don’t know which experiences need improving. Ask #savvypatients. #JHMchat https://t.co/UZzUnjJNWx
#JHMChat content from Twitter.