#jhmchat Transcript

Healthcare social media transcript of the #jhmchat hashtag.
().
See #jhmchat Influencers/Analytics.

Sign up for FREE Symplur Account and Get
  • Create Transcripts with Custom Dates
  • Get Custom Influencer Lists
  • 3x Hashtag Search Results
Sign Up Now
ProfileTweet
Society of Hospital Medicine @SocietyHospMed
#JHMChat begins NOW! Join the conversation w/ @JHospMedicine @FutureDocs @tony_breu, then claim #CME: https://t.co/fHval4itfN https://t.co/hySjWeZLO1
Vinny Arora MD MAPP @FutureDocs
RT @SHMLive: #JHMChat begins NOW! Join the conversation w/ @JHospMedicine @FutureDocs @tony_breu, then claim #CME: https://t.co/fHval4itfN…
J Hospital Medicine @JHospMedicine
Welcome @tony_breu who is also our @jhospmedicine series editor for @TWDFNR who will be tonight's discussant #JHMChat
J Hospital Medicine @JHospMedicine
Welcome to #JHMChat, I am your moderator @FutureDocs please introduce yourself.
Things We Do For No Reason @TWDFNR
Tony Breu, here from Boston MA. Spend all day with my sick 1-year-old. Docusate was unnecessary! No gown, but lots of hand-washing... I'll be participating tonight from the @TWDFNR account. #JHMchat
Med Peds Hospitalist @medpedshosp
RT @SHMLive: #JHMChat begins NOW! Join the conversation w/ @JHospMedicine @FutureDocs @tony_breu, then claim #CME: https://t.co/fHval4itfN…
Vinny Arora MD MAPP @FutureDocs
RT @JHospMedicine: Welcome to #JHMChat, I am your moderator @FutureDocs please introduce yourself.
Benjamin P. Geisler @ben_geisler
RT @SHMLive: #JHMChat begins NOW! Join the conversation w/ @JHospMedicine @FutureDocs @tony_breu, then claim #CME: https://t.co/fHval4itfN…
Things We Do For No Reason @TWDFNR
@JHospMedicine @tony_breu Alongside the amazing @DocLennyF #JHMChat
J Hospital Medicine @JHospMedicine
RT @TWDFNR: Tony Breu, here from Boston MA. Spend all day with my sick 1-year-old. Docusate was unnecessary! No gown, but lots of hand-wa…
Anika Kumar, MD @freckledpedidoc
Hi Everyone! Anika Kumar, joining from Cleveland. #JHMChat
Dmitriy Kedrin MD @GI_Pearls
RT @JHospMedicine: #JHMChat is TONIGHT at 9pET on @TWDFNR with @tony_breu, moderated by @FutureDocs with live sketches by @gracefarris— Con…
Charlie M. Wray @WrayCharles
RT @JHospMedicine: Welcome @tony_breu who is also our @jhospmedicine series editor for @TWDFNR who will be tonight's discussant #JHMChat
Grace Farris MD @gracefarris
@TWDFNR Oh no! #JHMChat
Avital O'Glasser, MD FACP FHM @aoglasser
#JHMchat avi, hospitalist from @OHSU_dhm (the division has a brand new twitter account!) & @OHSUIMRes still making dinner...so let's see how I can effectively multitask...
Jennifer Madeline @jennifermcaputo
Jen Caputo, joining from Tampa, FL #JHMChat
J Hospital Medicine @JHospMedicine
@TWDFNR Welcome! Glad you made it @tony_breu and some lessons even when tending to a sick kid. Hope they are on the mend. #jhmchat
Sonya TG @STangGirdwood
@JHospMedicine @FutureDocs Sonya, #PedsHM fellow from Cincy! #JHMChat
Grace Farris MD @gracefarris
Joining from NYC #JHMChat
J Hospital Medicine @JHospMedicine
RT @TWDFNR: @JHospMedicine @tony_breu Alongside the amazing @DocLennyF #JHMChat
Charlie M. Wray @WrayCharles
Charlie Wray, broadcasting from the SF Bay area. Really looking forward to tonights #JHMChat
Med Peds Hospitalist @medpedshosp
@TWDFNR @JHospMedicine @tony_breu @DocLennyF Dynamic duo!#JHMChat
J Hospital Medicine @JHospMedicine
@STangGirdwood @FutureDocs Welcome to #JHMChat #PedsHM
Grace Farris MD @gracefarris
#WomeninMedicine #JHMchat
Benjamin P. Geisler @ben_geisler
Ben Geisler from Boston #jhmchat
Things We Do For No Reason @TWDFNR
@JHospMedicine @tony_breu Absolutely. 5-hour naps help! #JHMChat
J Hospital Medicine @JHospMedicine
RT @medpedshosp: @TWDFNR @JHospMedicine @tony_breu @DocLennyF Dynamic duo!#JHMChat
Brian McGillen, MD @bmcgillen26
Brian McGillen joining from Hershey, PA. Hello! #JHMChat
Med Peds Hospitalist @medpedshosp
#JHMChat
Salah S. Qutaishat @salahq
Hello all #JHMChat
John @jmomdphd
John, #PedsHM fellow from FL #jhmchat
Michelle Brooks, MD, FACP, FHM @michellebr00ks
Michelle Brooks from VCU Health in Richmond, VA. We got rid of contact precautions in 2008 or 2010 (?) for MRSA/VRE. And I stopped using docusate as of February 2019. #JHMChat
Jen Readlynn, MD @jenreadlynn
Jen Readlynn from Rochester, NY #JHMChat
Things We Do For No Reason @TWDFNR
@michellebr00ks A pro! #JHMChat
Charlie M. Wray @WrayCharles
RT @gracefarris: #WomeninMedicine #JHMchat https://t.co/n6lOzFKZXM
Rachel Johnson @DoubleDawgMD
#JHMChat PGY-2 from Atlanta. Just put the very new baby to bed; excited for tonight's chat!
Vinny Arora MD MAPP @FutureDocs
@TWDFNR @JHospMedicine @tony_breu It is #nationalnappingday today #JHMChat since you asked my #sleep tidbit did you
Med Peds Hospitalist @medpedshosp
@aoglasser @OHSU_DHM @OHSUIMRes Oh, you definitely can! #JHMChat
J Hospital Medicine @JHospMedicine
T1 In @TWDFNR series, Docusate is not an evidence-based way of treating constipation. Why do we do it? #JHMChat https://t.co/MHbJ8PGz4e
Delia Takagi @dltkgi
@JHospMedicine @FutureDocs Geriatrician here. Interesting topics tonight. #JHMChat
Charlie M. Wray @WrayCharles
@michellebr00ks This reminds me of how people remember just where they were when some huge historical event occurred...but for a hospitalist #jhmchat
Sonya TG @STangGirdwood
@aoglasser @OHSU_DHM @OHSUIMRes You can do it! I’m working out and trying to outline a candidate statement for a grant! #JHMChat
Jennifer K. Chen, MD FAAP @DrJenChen4kids
@JHospMedicine @FutureDocs Jen, #PedsHM fellow in (rainy!) San Diego #JHMChat
J Hospital Medicine @JHospMedicine
@dltkgi @FutureDocs Welcome to all specialties on tonight’s #JHMChat @TWDFNR edition! Look forward to discussion T1 coming up
Michelle Brooks, MD, FACP, FHM @michellebr00ks
@JHospMedicine @TWDFNR A1 - Habit and protocol? It's still in our standard bowel regimen pop-up when I prescribe inpatient opiates. #JHMChat
J Hospital Medicine @JHospMedicine
RT @DrJenChen4kids: T-20 min until #JHMchat on #TWDFNR... don’t forget you can get CME too! https://t.co/9Fp1wS9KPk
Kristen Young @kristenyoung
@JHospMedicine @FutureDocs Hi, Kristen, current medicine chief resident (@UAPhxIM), one of the co-authors for Discontinuing Contact Precautions TWDFNR... excited to see these two articles discussed! #JHMchat
Avital O'Glasser, MD FACP FHM @aoglasser
@JHospMedicine @TWDFNR A1 #JHMchat just going to jump to the fact that it's on practically every EHR smartset...
J Hospital Medicine @JHospMedicine
RT @JHospMedicine: @dltkgi @FutureDocs Welcome to all specialties on tonight’s #JHMChat @TWDFNR edition! Look forward to discussion T1 comi…
Adam Rodman @AdamRodmanMD
#jhmchat -- Adam, an internist from Boston! Sorry I'm a little late, I have diaper duty!
Avital O'Glasser, MD FACP FHM @aoglasser
@STangGirdwood @OHSU_DHM @OHSUIMRes #jhmchat that is even more cerebral and brain power intense!
Chris Petrilli @PetrilliMD
@JHospMedicine @TWDFNR #JHMChat Nostalgia and to make us feel like we are doing something that doesn't sound as aggressive as miraLAX
Jennifer Madeline @jennifermcaputo
@JHospMedicine @TWDFNR A1 At my institution I think it’s tradition. When we implemented EPIC EMR docusate was built in as a default in the admission order set. So each year new interns learn to utilize it. Hard to break cultural habits #JHMChat
John @jmomdphd
A1: It’s also listed on many references (peds included) as a treatment for constipation #JHMChat
Things We Do For No Reason @TWDFNR
@JHospMedicine Great question to start us off. Let's add a quick poll. In your estimation, which of the following is the greatest contributor to the continued use of docusate? #JHMchat
J Hospital Medicine @JHospMedicine
Early adopters are in the house on #JHMchat welcome!
Med Peds Hospitalist @medpedshosp
@JHospMedicine @TWDFNR T1- the main thing in my perspective is that it has been considered as a “non-toxic” mild laxative. Kind of just the custom of using it. #JHMChat
Med Peds Hospitalist @medpedshosp
RT @JHospMedicine: T1 In @TWDFNR series, Docusate is not an evidence-based way of treating constipation. Why do we do it? #JHMChat https:/…
Grace Farris MD @gracefarris
Live your best life! #JHMchat
Avital O'Glasser, MD FACP FHM @aoglasser
@TWDFNR @JHospMedicine #JHMchat culture...it's not just something that grows in a petri dish...
Med Peds Hospitalist @medpedshosp
RT @JHospMedicine: @dltkgi @FutureDocs Welcome to all specialties on tonight’s #JHMChat @TWDFNR edition! Look forward to discussion T1 comi…
Jennifer Madeline @jennifermcaputo
@WrayCharles @michellebr00ks Where were you when docusate was phased out? I like it #JHMChat
Grace Farris MD @gracefarris
RT @WrayCharles: @michellebr00ks This reminds me of how people remember just where they were when some huge historical event occurred...but…
Things We Do For No Reason @TWDFNR
RT @kristenyoung: @JHospMedicine @FutureDocs Hi, Kristen, current medicine chief resident (@UAPhxIM), one of the co-authors for Discontinui…
Vinny Arora MD MAPP @FutureDocs
@EricLSoriano @JHospMedicine Welcome to #JHMChat just use our hashtag to get noticed:)
Sonya TG @STangGirdwood
@aoglasser @OHSU_DHM @OHSUIMRes Clearly, at least one if not all 3 activities will suffer. At least I tried #JHMchat
Jen Readlynn, MD @jenreadlynn
A1: Agree with others. It seems to be a habit for people. We joke about it at conferences with our palliative care colleagues yet keep on prescribing. Also, I don't write for it but my APPs/residents do. But I don't discontinue it either. #JHMChat
Vinny Arora MD MAPP @FutureDocs
RT @JHospMedicine: T1 In @TWDFNR series, Docusate is not an evidence-based way of treating constipation. Why do we do it? #JHMChat https:/…
Salah S. Qutaishat @salahq
We got rid of contact precautions 3 years ago, no CHG bathing! The emotional attachment to old practices are the “wall” #jhmchat
Charlie M. Wray @WrayCharles
@JHospMedicine @TWDFNR #HeirloomMedicine at its best #jhmchat
Med Peds Hospitalist @medpedshosp
Indeed. Habit. And also as it has been incorporated in the formulary - used along w senna. #JHMChat
Society of Hospital Medicine @SocietyHospMed
T1 is live! Join the #JHMChat conversation w/ @JHospMedicine @FutureDocs @tony_breu @TWDFNR, then claim #CME!
Vinny Arora MD MAPP @FutureDocs
RT @TWDFNR: @JHospMedicine Great question to start us off. Let's add a quick poll. In your estimation, which of the following is the gre…
Vinny Arora MD MAPP @FutureDocs
RT @SHMLive: T1 is live! Join the #JHMChat conversation w/ @JHospMedicine @FutureDocs @tony_breu @TWDFNR, then claim #CME! https://t.co/pkX…
Society of Hospital Medicine @SocietyHospMed
RT @TWDFNR: @JHospMedicine Great question to start us off. Let's add a quick poll. In your estimation, which of the following is the gre…
Things We Do For No Reason @TWDFNR
RT @JHospMedicine: T1 In @TWDFNR series, Docusate is not an evidence-based way of treating constipation. Why do we do it? #JHMChat https:/…
J Hospital Medicine @JHospMedicine
RT @SHMLive: T1 is live! Join the #JHMChat conversation w/ @JHospMedicine @FutureDocs @tony_breu @TWDFNR, then claim #CME! https://t.co/pkX…
Anika Kumar, MD @freckledpedidoc
@jmomdphd Yes but it generally isn’t 1st line in Pediatrics because there isn’t much data to support it, except in biliary atresia patients (but even that literature isn’t very good). #JHMChat
Jennifer K. Chen, MD FAAP @DrJenChen4kids
@JHospMedicine @TWDFNR #JHMchat T1: I don’t use docusate much - Miralax/PEG is first line, then maybe enema and/or senna. If the kid’s constipation is bad enough to get admitted just for that, they’re probably getting a NGT cleanout anyway
Chris Petrilli @PetrilliMD
@JHospMedicine "It's gotta go because it won't help them go" - #jhmchat fight song/chant / title of powerpoint for Pharmacy and Therapeutics committee to remove it from formulary
Rachel Johnson @DoubleDawgMD
#JHMChat A1: inertia is hard to overcome. Students follow residents who follow attendings who are often not up to date.
Grace Farris MD @gracefarris
Yes! We *just* go it out of our Ortho and OB ones #JHMChat thanx to a motivated EMR savvy pharm
Chris Petrilli @PetrilliMD
RT @SHMLive: T1 is live! Join the #JHMChat conversation w/ @JHospMedicine @FutureDocs @tony_breu @TWDFNR, then claim #CME! https://t.co/pkX…
Jennifer Madeline @jennifermcaputo
RT @TWDFNR: @JHospMedicine Great question to start us off. Let's add a quick poll. In your estimation, which of the following is the gre…
Adam Rodman @AdamRodmanMD
#jhmchat T1 docusate SOUNDS like an ideal treatment -- cheap, well-tolerated. It just doesn't work
Avital O'Glasser, MD FACP FHM @aoglasser
#jhmchat btw for anyone keeping score at home, it’s steelhead (not salmon...if you have to ask, you need to come visit the pacific NW) https://t.co/aiGqkxidzJ
Michelle Brooks, MD, FACP, FHM @michellebr00ks
A1 - #JHMChat - looks like surgeons and medicine use docusate with equivalent frequency. It's like the one thing we agree on.
Charlie M. Wray @WrayCharles
@jennifermcaputo @michellebr00ks This should be our goal for every @TWDFNR article @tony_breu & @DocLennyF #JHMChat
Avital O'Glasser, MD FACP FHM @aoglasser
@gracefarris #JHMchat that's the ticket!!
Charlie M. Wray @WrayCharles
RT @jennifermcaputo: @WrayCharles @michellebr00ks Where were you when docusate was phased out? I like it #JHMChat
J Hospital Medicine @JHospMedicine
RT @gracefarris: Yes! We *just* go it out of our Ortho and OB ones #JHMChat thanx to a motivated EMR savvy pharm https://t.co/ra3hZcgMxh
J Hospital Medicine @JHospMedicine
RT @DoubleDawgMD: #JHMChat A1: inertia is hard to overcome. Students follow residents who follow attendings who are often not up to date.
Kshitij Thakur @drkshitijthakur
@JHospMedicine @FutureDocs Kshitij Thakur from University of Kentucky #JHMchat
Avital O'Glasser, MD FACP FHM @aoglasser
@AdamRodmanMD #jhmchat modification...doesn't work for constipation. may work for cerumen :)
Med Peds Hospitalist @medpedshosp
@PetrilliMD @JHospMedicine @TWDFNR Nostalgia! Poetic laxation :) #JHMChat
Society of Hospital Medicine @SocietyHospMed
Don't forget to claim #CME after tonight's #JHMChat: https://t.co/zJYslL00dW
J Hospital Medicine @JHospMedicine
RT @DrJenChen4kids: @JHospMedicine @TWDFNR #JHMchat T1: I don’t use docusate much - Miralax/PEG is first line, then maybe enema and/or senn…
luke buchanan @LukeBuchananana
RT @JHospMedicine: T1 In @TWDFNR series, Docusate is not an evidence-based way of treating constipation. Why do we do it? #JHMChat https:/…
J Hospital Medicine @JHospMedicine
RT @WrayCharles: @JHospMedicine @TWDFNR #HeirloomMedicine at its best #jhmchat
John @jmomdphd
@freckledpedidoc Agree; and I don’t use it as first line either #JHMChat
J Hospital Medicine @JHospMedicine
RT @jennifermcaputo: @WrayCharles @michellebr00ks Where were you when docusate was phased out? I like it #JHMChat
J Hospital Medicine @JHospMedicine
RT @TWDFNR: @JHospMedicine Great question to start us off. Let's add a quick poll. In your estimation, which of the following is the gre…
Avital O'Glasser, MD FACP FHM @aoglasser
@WrayCharles @jennifermcaputo @michellebr00ks @TWDFNR @tony_breu @DocLennyF #jhmchat I love "remember when"s still remember my first case of takotsubo's as MS4 when attending (@DavidWienerMD) was shocked to see it in the states!
Med Peds Hospitalist @medpedshosp
RT @freckledpedidoc: @jmomdphd Yes but it generally isn’t 1st line in Pediatrics because there isn’t much data to support it, except in bil…
Delia Takagi @dltkgi
A1. Habit. Plus, easily available at pharmacy for outpatient use. #JHMChat
Grace Farris MD @gracefarris
@SHMLive @JHospMedicine @FutureDocs @tony_breu @TWDFNR Culture! The mush and the push #JHMChat https://t.co/KbH7RUcJ4g
Benji Mathews @benjikmathews
@JHospMedicine @TWDFNR Once an treatment becomes popular it is difficult to disimpact #jhmchat #docusate #TWDFNR
Sonya TG @STangGirdwood
@JHospMedicine @TWDFNR I don’t think I’ve been the primary prescriber of docusate for #pedsHM patient but have continued it for patients wi/chronic constipation, esp complex care patient, where it was prescribed by GI doc. I feel like a lot of parents prefer over Miralax and senna (cramping). #JHMChat
Grace Farris MD @gracefarris
RT @PetrilliMD: @JHospMedicine "It's gotta go because it won't help them go" - #jhmchat fight song/chant / title of powerpoint for Pharmacy…
Jennifer Madeline @jennifermcaputo
@DrJenChen4kids @JHospMedicine @TWDFNR I’ll agree I don’t see nearly as much docusate use from my med-Peds colleagues #JHMChat
Avital O'Glasser, MD FACP FHM @aoglasser
@benjikmathews @JHospMedicine @TWDFNR #jhmchat the new tweet to top tonight folks!
Vinny Arora MD MAPP @FutureDocs
RT @TWDFNR: @JHospMedicine @tony_breu Alongside the amazing @DocLennyF #JHMChat
Vinny Arora MD MAPP @FutureDocs
RT @DoubleDawgMD: #JHMChat A1: inertia is hard to overcome. Students follow residents who follow attendings who are often not up to date.
Chris Petrilli @PetrilliMD
RT @gracefarris: @SHMLive @JHospMedicine @FutureDocs @tony_breu @TWDFNR Culture! The mush and the push #JHMChat https://t.co/KbH7RUcJ4g
Benjamin P. Geisler @ben_geisler
how did you do it @michellebr00ks? #jhmchat
Charlie M. Wray @WrayCharles
@gracefarris We're still working on getting our ortho colleagues to flush the docusate #jhmchat
Renee Dversdal @DRsonosRD
@JHospMedicine @TWDFNR Belated intro (hi from Oregon, I’m a hospitalist finishing up notes in preop clinic!) & A1: agree re: smart sets & culture, but sometimes because patients think it works & need education as well! #JHMchat
Vinny Arora MD MAPP @FutureDocs
RT @michellebr00ks: Michelle Brooks from VCU Health in Richmond, VA. We got rid of contact precautions in 2008 or 2010 (?) for MRSA/VRE.…
Med Peds Hospitalist @medpedshosp
Polyethylenglycol with senna is very effective in both adult and children #JHMChat
Benjamin P. Geisler @ben_geisler
time for a #SIESTA #jhmchat
Vinny Arora MD MAPP @FutureDocs
RT @ben_geisler: time for a #SIESTA #jhmchat https://t.co/rvNvyDLWTM
Chris Petrilli @PetrilliMD
@benjikmathews @JHospMedicine @TWDFNR #jhmchat I see what you did there, Benji...and I love it!
Kristen Young @kristenyoung
@JHospMedicine @TWDFNR T1: Docusate and doc-senna are on the admissions order set, it's easier just to click the doc-senna and move on. More clicks to get to the senna and miralax. #jhmchat
Grace Farris MD @gracefarris
RT @WrayCharles: @gracefarris We're still working on getting our ortho colleagues to flush the docusate #jhmchat
Sonya TG @STangGirdwood
@JHospMedicine @TWDFNR With the “scare” that Miralax causes psychiatric issues in kids (not true), parents often ask for other constipation meds that are easy to administer. I personally go with lactulose if they refuse Miralax. #JHMchat
Avital O'Glasser, MD FACP FHM @aoglasser
#jhmchat I let out a suppressed eye-roll every time i do a med rec with docusate on it these days... I know med recs are supposed to be accurate including PRNs/OTC, but I really really really don't want to add that one...
Benjamin P. Geisler @ben_geisler
A1 100% ot tweeps responded culture #jhmchat
Med Peds Hospitalist @medpedshosp
Indeed! The ENT surgeons use liquid docusate to dissolve cerumen. #JHMChat
Michelle Brooks, MD, FACP, FHM @michellebr00ks
A1 - when I brought this topic up at Grand Rounds 2 weeks ago, the ICU attendings listed pharmacists as the culprits. But I talked to the pharmacists, and they're on board. EHR needs to change. #JHMChat
Things We Do For No Reason @TWDFNR
@JHospMedicine Culture is winning in a landslide. So, who did we all learn this from? And how can we change the culture? #jhmchat https://t.co/GWiYNSABUh
Med Peds Hospitalist @medpedshosp
RT @SHMLive: Don't forget to claim #CME after tonight's #JHMChat: https://t.co/zJYslL00dW
Anika Kumar, MD @freckledpedidoc
A1. In Peds we use PEG as 1st line and then senna/enemas (depending on etiology of constipation). I have seen docusate used for biliary atresia patients in liver failure, but in those patients 1st line is still lactulose. #JHMChat
Adam K. @Duece430
Adam, from NYP-BMH in Brooklyn here #jhmchat
Charlie M. Wray @WrayCharles
The pun game is strong in tonights #JHMChat
John @jmomdphd
@STangGirdwood @JHospMedicine @TWDFNR I’m also a PEG followed by lactulose kind of guy #JHMChat
Rebecca Jaffe @RJmdphilly
#jhmchat rebecca here from philly s/p bedtime handoff to husband.
Vinny Arora MD MAPP @FutureDocs
RT @WrayCharles: The pun game is strong in tonights #JHMChat https://t.co/FbLCe3dYra
Vinny Arora MD MAPP @FutureDocs
RT @TWDFNR: @JHospMedicine Culture is winning in a landslide. So, who did we all learn this from? And how can we change the culture? #jhmc
Vinny Arora MD MAPP @FutureDocs
RT @michellebr00ks: A1 - when I brought this topic up at Grand Rounds 2 weeks ago, the ICU attendings listed pharmacists as the culprits.…
Med Peds Hospitalist @medpedshosp
Indeed. Is “benign” - doesn’t do anything. #JHMChat
Chris Petrilli @PetrilliMD
@TWDFNR @JHospMedicine #jhmchat #1980sPSA :) https://t.co/g6AtjYOel2
Michelle Brooks, MD, FACP, FHM @michellebr00ks
A2 - Can we just leave it off the hospital formulary? Making it a non-formulary medication would make it harder to order. #jhmchat
Sonya TG @STangGirdwood
@JHospMedicine @TWDFNR I know the @TWDFNR article was specific to the adult/geriatric population. Anyone know what studies, if any, have been done in peds? #JHMchat
Charlie M. Wray @WrayCharles
@TWDFNR @JHospMedicine Do we change culture or do we change formularies...? #jhmchat
Michelle Brooks, MD, FACP, FHM @michellebr00ks
RT @benjikmathews: @JHospMedicine @TWDFNR Once an treatment becomes popular it is difficult to disimpact #jhmchat #docusate #TWDFNR
Jennifer Madeline @jennifermcaputo
@kristenyoung @JHospMedicine @TWDFNR We also have a shortage of senna, but have senna-docusate available #JHMChat
J Hospital Medicine @JHospMedicine
RT @benjikmathews: @JHospMedicine @TWDFNR Once an treatment becomes popular it is difficult to disimpact #jhmchat #docusate #TWDFNR
Grace Farris MD @gracefarris
RT @WrayCharles: The pun game is strong in tonights #JHMChat https://t.co/FbLCe3dYra
Things We Do For No Reason @TWDFNR
@JHospMedicine And, (assuming it was our residents who taught us), did anyone ever say, "show me the evidence?". I certainly didn't. #jhmchat
J Hospital Medicine @JHospMedicine
T2 up in a moment...#JHMChat
Avital O'Glasser, MD FACP FHM @aoglasser
@WrayCharles @TWDFNR @JHospMedicine #jhmchat both!!
Med Peds Hospitalist @medpedshosp
It is a though process - have to “clean” all order sets. #JHMChat
J Hospital Medicine @JHospMedicine
RT @TWDFNR: @JHospMedicine And, (assuming it was our residents who taught us), did anyone ever say, "show me the evidence?". I certainly d…
Adam Rodman @AdamRodmanMD
Does docusate prescribing in the inpatient setting actually harm anybody? It might if it prevents you from prescribing an effective anti-constipation agent.#jhmchat
Chris Petrilli @PetrilliMD
@WrayCharles @TWDFNR @JHospMedicine #JHMChat formularies first then culture, it's much easier to get people to not order something if they can't
Grace Farris MD @gracefarris
T1 we’ve known for such a long time 🧐 #jhmchat https://t.co/sRgIb4steA
Sonya TG @STangGirdwood
@AdamRodmanMD @jmomdphd @JHospMedicine @TWDFNR Mag sulfate is definitely something I should get more comfortable prescribing without GI recommendations. Thanks for the reminder! #JHMChat
J Hospital Medicine @JHospMedicine
@WrayCharles @TWDFNR Stay tuned ....for T2 #JHMChat
Rebecca Jaffe @RJmdphilly
#JHMChat I'm still on A1 - I have heard pharmacists say "docusate works more as a stool softener if taken daily for someone at risk for constipation" - is there a difference in evidence for prevention vs treatment?
Rachel Johnson @DoubleDawgMD
RT @AdamRodmanMD: Does docusate prescribing in the inpatient setting actually harm anybody? It might if it prevents you from prescribing an…
Things We Do For No Reason @TWDFNR
If you can change the formulary, that is the most durable. But, that's not possible for everyone, immediately. #JHMChat
J Hospital Medicine @JHospMedicine
RT @gracefarris: T1 we’ve known for such a long time 🧐 #jhmchat https://t.co/sRgIb4steA
Sonya TG @STangGirdwood
RT @gracefarris: T1 we’ve known for such a long time 🧐 #jhmchat https://t.co/sRgIb4steA
Jen Readlynn, MD @jenreadlynn
@WrayCharles @TWDFNR @JHospMedicine #jhmchat both! It's probably easier to first change the formulary.
J Hospital Medicine @JHospMedicine
RT @WrayCharles: The pun game is strong in tonights #JHMChat https://t.co/FbLCe3dYra
Med Peds Hospitalist @medpedshosp
@TWDFNR @JHospMedicine By enhancing the knowledge and disseminating this new information. Promoting massive education in a redundant way #JHMChat
Avital O'Glasser, MD FACP FHM @aoglasser
#JHMchat btw, don't underestimate the power of docusate to creative new #medtwitter relationships one of the first real "conversations" between @BostonChiefs and @OHSUIMRes about 2 years ago https://t.co/38C1uCKOJ0
Jennifer Madeline @jennifermcaputo
@michellebr00ks That would be ideal! #jhmchat
Benjamin P. Geisler @ben_geisler
maybe this is the REAL problem - not all of us are involved enough in nudging EHR "smart"/ordersets in right right direction? #jhmchat
Vinny Arora MD MAPP @FutureDocs
RT @TWDFNR: If you can change the formulary, that is the most durable. But, that's not possible for everyone, immediately. #JHMChat https:…
Charlie M. Wray @WrayCharles
@RJmdphilly great question. I've heard the same...Anyone know? #jhmchat
Vinny Arora MD MAPP @FutureDocs
RT @gracefarris: T1 we’ve known for such a long time 🧐 #jhmchat https://t.co/sRgIb4steA
Med Peds Hospitalist @medpedshosp
RT @TWDFNR: @JHospMedicine And, (assuming it was our residents who taught us), did anyone ever say, "show me the evidence?". I certainly d…
Michelle Brooks, MD, FACP, FHM @michellebr00ks
This is what made me stop ordering it. If it prevents patients from getting correct treatment, it's a dangerous drug. #JHMChat
Med Peds Hospitalist @medpedshosp
RT @PetrilliMD: @WrayCharles @TWDFNR @JHospMedicine #JHMChat formularies first then culture, it's much easier to get people to not order so…
Chris Petrilli @PetrilliMD
@TWDFNR #jhmchat It should be pretty easy - who can say no with a powerpoint title like my previous tweet? #HaveThemCallMe
Avital O'Glasser, MD FACP FHM @aoglasser
RT @michellebr00ks: This is what made me stop ordering it. If it prevents patients from getting correct treatment, it's a dangerous drug.…
Sonya TG @STangGirdwood
@freckledpedidoc @AdamRodmanMD @jmomdphd @JHospMedicine @TWDFNR Mag Sulfate on ice? Sounds fancy! I’ll have one please! #JHMChat
Vinny Arora MD MAPP @FutureDocs
@RJmdphilly As is your moderator #JHMchat
Anika Kumar, MD @freckledpedidoc
@STangGirdwood @JHospMedicine @TWDFNR I don’t believe docusate is well-studied in Peds. #JHMChat
Med Peds Hospitalist @medpedshosp
@PetrilliMD @WrayCharles @TWDFNR @JHospMedicine That is why formularies must be reviewed and updated routinely.#JHMChat
Charlie M. Wray @WrayCharles
@TWDFNR Sounds like these formularies need an enema (sorry, couldn't resist) #jhmchat
Grace Farris MD @gracefarris
@AdamRodmanMD #JHMChat I think there is a suggestion that it increases LOS, pt discomfort dt constipation (from the pall care hospice study) so yes
Avital O'Glasser, MD FACP FHM @aoglasser
@michellebr00ks #jhmchat yup, no effectiveness, prevents optimal treatment one of the arguments/themes laid out in "medical reversal" @adamcifu @VPrasadMDMPH
Michelle Brooks, MD, FACP, FHM @michellebr00ks
@RJmdphilly I think some of the studies in the chart were for prophylaxis. #JHMChat
Med Peds Hospitalist @medpedshosp
RT @gracefarris: T1 we’ve known for such a long time 🧐 #jhmchat https://t.co/sRgIb4steA
Rebecca Jaffe @RJmdphilly
@FutureDocs We'll see if it takes. #JHMchat
Things We Do For No Reason @TWDFNR
@WrayCharles @RJmdphilly The study we're discussing looked at both treatment and prophylaxis. No benefit for either. #JHMChat https://t.co/RiJz6jxbpb
Kristen Young @kristenyoung
@AdamRodmanMD @JHospMedicine @TWDFNR #JHMchat definitely true - since someone created those admission order sets... This is just my observed practice. It has taken a long time (18years?!) to spread the word, and evidence, that docusate is unhelpful.
Sonya TG @STangGirdwood
@freckledpedidoc @JHospMedicine @TWDFNR Like most medications...#WhyImAPedsClinicalPharmacologist #JHMChat
Med Peds Hospitalist @medpedshosp
RT @aoglasser: #JHMchat btw, don't underestimate the power of docusate to creative new #medtwitter relationships one of the first real "con…
Vinny Arora MD MAPP @FutureDocs
@RJmdphilly huddling downstairs hoping for the best #jhmchat
Benjamin P. Geisler @ben_geisler
that'd solve our problem! #nuclearoption #jhmchat
Grace Farris MD @gracefarris
@RJmdphilly #JHMChat the article suggest that it does not soften more than placebo
Things We Do For No Reason @TWDFNR
This is the exact point made by the authors. But other, more serious, harms have occurred. https://t.co/wQeyEDxwzJ #JHMChat
Med Peds Hospitalist @medpedshosp
This is when we can see the power of engagement - we can make a difference #JHMChat
Rebecca Jaffe @RJmdphilly
@laxswamy @WrayCharles Because hospital diet? #jhmchat
Vinny Arora MD MAPP @FutureDocs
RT @ben_geisler: that'd solve our problem! #nuclearoption #jhmchat https://t.co/h5XJLbdnRs
Omi @Omi_082
RT @TWDFNR: @JHospMedicine Great question to start us off. Let's add a quick poll. In your estimation, which of the following is the gre…
J Hospital Medicine @JHospMedicine
T2 One of the recommendations from @TWDFNR is to remove docusate from your hospital formulary. Is this feasible? What are other ways we can de-implement this practice? #JHMChat https://t.co/52h3yRWZxH
Avital O'Glasser, MD FACP FHM @aoglasser
@laxswamy @WrayCharles @RJmdphilly #jhmchat https://t.co/YtGmCl9IAd
Eric Soriano, MD @EricLSoriano
@JHospMedicine @TWDFNR #jhmchat We don't usually see docusate alone, but our formulary does have the very fancy sounding senna-plus which is senna-docusate so it slips in to the bowel regimen all the time!
Parth Trivedi @TrivediParthD
RT @gracefarris: T1 we’ve known for such a long time 🧐 #jhmchat https://t.co/sRgIb4steA
Sonya TG @STangGirdwood
@AdamRodmanMD @freckledpedidoc @jmomdphd @JHospMedicine @TWDFNR Our residents do antibiotics tasting - clindamycin is definitely yucky! I also did an AED tasting as an intern, and definitely got giggly afterwards. Should do a constipation med tasting! #JHMChat
Chris Petrilli @PetrilliMD
@WrayCharles @TWDFNR #JHMChat just ask your Pharmacy team how much they spend on docusate every year...I predict it is surprisingly higher than you would think! https://t.co/Lwj9nxOCbQ
Med Peds Hospitalist @medpedshosp
RT @WrayCharles: @TWDFNR Sounds like these formularies need an enema (sorry, couldn't resist) #jhmchat
Adam Rodman @AdamRodmanMD
I wonder if there's any evidence that hospital constipation has gotten worse. The use of opiate pain medication certainly has increased over the last 20 years. Some of those studies are rather old.#jhmchat
Med Peds Hospitalist @medpedshosp
RT @TWDFNR: @WrayCharles @RJmdphilly The study we're discussing looked at both treatment and prophylaxis. No benefit for either. #JHMChat
Avital O'Glasser, MD FACP FHM @aoglasser
@PetrilliMD @WrayCharles @TWDFNR #jhmchat even "cheap" drugs add up to expense when prescribed in large amounts
Vinny Arora MD MAPP @FutureDocs
The question you have all been waiting for.... on #jhmchat
Chris Petrilli @PetrilliMD
RT @TWDFNR: @WrayCharles @RJmdphilly The study we're discussing looked at both treatment and prophylaxis. No benefit for either. #JHMChat
Vinny Arora MD MAPP @FutureDocs
RT @JHospMedicine: T2 One of the recommendations from @TWDFNR is to remove docusate from your hospital formulary. Is this feasible? What a…
Charlie M. Wray @WrayCharles
RT @TWDFNR: This is the exact point made by the authors. But other, more serious, harms have occurred. https://t.co/wQeyEDxwzJ #JHMChat
Kristen Young @kristenyoung
RT @TWDFNR: @WrayCharles @RJmdphilly The study we're discussing looked at both treatment and prophylaxis. No benefit for either. #JHMChat
Benjamin P. Geisler @ben_geisler
is there any evidence for even this? what effect would "softening" the stool have? #jhmchat
Vinny Arora MD MAPP @FutureDocs
RT @PetrilliMD: @WrayCharles @TWDFNR #JHMChat just ask your Pharmacy team how much they spend on docusate every year...I predict it is surp…
Charlie M. Wray @WrayCharles
RT @TWDFNR: @WrayCharles @RJmdphilly The study we're discussing looked at both treatment and prophylaxis. No benefit for either. #JHMChat
Sonya TG @STangGirdwood
@PetrilliMD @WrayCharles @TWDFNR Paging @JCourterPharmD! How much do we spend on docusate at our hospital?? #JHMchat
J Hospital Medicine @JHospMedicine
RT @FutureDocs: The question you have all been waiting for.... on #jhmchat https://t.co/rPuwk1I93G
Chang Kim, MD @changkim211
RT @JHospMedicine: There are so many 'Things We Do For No Reason' (@TWDFNR), but @FutureDocs we'll be discussing 2: Docusate & Contact Prec…
Charlie M. Wray @WrayCharles
RT @JHospMedicine: T2 One of the recommendations from @TWDFNR is to remove docusate from your hospital formulary. Is this feasible? What a…
Society of Hospital Medicine @SocietyHospMed
There's still time to share your thoughts in tonight's #JHMChat on #ThingsWeDoForNoReason!
Michelle Brooks, MD, FACP, FHM @michellebr00ks
@RJmdphilly @laxswamy @WrayCharles NPO. All. Day. Long. #JHMChat
Grace Farris MD @gracefarris
@PetrilliMD @WrayCharles @TWDFNR #JHMchat one interesting finding from our recent QI initiative w docusate deprescribing was that miralax much more $$$
Chris Petrilli @PetrilliMD
@STangGirdwood @WrayCharles @TWDFNR @JCourterPharmD #JHMChat #AntiConstipationStewardship
Brian McGillen, MD @bmcgillen26
A2. We've reduced PPI use (esp. gtts) via education and aligning with pharmacy...you'd think the same could happen with a little effectiveness / cost data! #JHMChat
Avital O'Glasser, MD FACP FHM @aoglasser
@michellebr00ks @RJmdphilly @laxswamy @WrayCharles #JHMchat another #TWDFNR... bring on the "clears until 2 hours"!!!
Zaven Sargsyan @sargsyanz
Creating social pressure can be very effective too. My resident showed me a discharge med list with docusate on it, signed with my name. Made me blush. #JHMChat
Sonya TG @STangGirdwood
@JHospMedicine @TWDFNR Have the EMR suggest other options when docusate is ordered? Prescribers don’t like having to click through several screens and will learn quickly. #JHMChat
Rebecca Jaffe @RJmdphilly
@michellebr00ks @laxswamy @WrayCharles "Except meds" #jhmchat
Charlie M. Wray @WrayCharles
@PetrilliMD @TWDFNR which gets you to the solution...show admin/pharm how much they are wasting #jhmchat
Med Peds Hospitalist @medpedshosp
T2- engaging pharmacy, GI, surgery, nutrition, IT - and have a compelling review of order sets. It is feasible - we can demonstrate the cost savings of not using a useless medication. #JHMChat
Vinny Arora MD MAPP @FutureDocs
RT @TWDFNR: This is the exact point made by the authors. But other, more serious, harms have occurred. https://t.co/wQeyEDxwzJ #JHMChat
Jen Readlynn, MD @jenreadlynn
A2: It's certainly feasible after months of going through therapeutics committee and clinical council and getting every specialist to agree. The education as to why is the bigger piece that needs to happen. #JHMChat
Michelle Brooks, MD, FACP, FHM @michellebr00ks
@aoglasser @PetrilliMD @WrayCharles @TWDFNR Except folate! A penny a pill, right @TWDFNR? #JHMChat
Rebecca Jaffe @RJmdphilly
@aoglasser @michellebr00ks @laxswamy @WrayCharles another #TWDFNR #JHMChat
Jennifer Madeline @jennifermcaputo
A2 Removing from formularies is strongest solution because it will make it easy for us to stop ordering. Next I’d say changing order sets. Increased education and awareness of ineffectiveness a weak solution #JHMChat
Chris Petrilli @PetrilliMD
@gracefarris @WrayCharles @TWDFNR #JHMChat I guess that makes sense since it works :-)
Rebecca Jaffe @RJmdphilly
RT @jennifermcaputo: A2 Removing from formularies is strongest solution because it will make it easy for us to stop ordering. Next I’d say…
Charlie M. Wray @WrayCharles
@AdamRodmanMD @michellebr00ks @RJmdphilly @laxswamy NPO does add a sense of gravitas, doesn't it #jhmchat
Vinny Arora MD MAPP @FutureDocs
this would make one helluva @SHMLive workshop or better yet a tweet up @WrayCharles @vineet_chopra @LekshmiMD @gracefarris #jhmchat
Vinny Arora MD MAPP @FutureDocs
RT @WolfsonD: T3 #JHMChat We have seen a focus on imaging, labs, antibiotics, telemetry & blood
Mark Shapiro MD @ETSshow
@FutureDocs #JHMChat Mark Shapiro here! Catching up, I’m late, my Twitter feed is very constipated. Anyone have any thoughts?
Rebecca Jaffe @RJmdphilly
@jenreadlynn Educating the small group of stakeholders more effective than educating all potential orderers... #JHMChat
Avital O'Glasser, MD FACP FHM @aoglasser
@WrayCharles @AdamRodmanMD @michellebr00ks @RJmdphilly @laxswamy #jhmchat doesn't anything derived from latin words??
Grace Farris MD @gracefarris
@SHMLive Yes! Partner w EMR oriented pharmacists and ortho PAs who are running the floor! #JHMchat
Things We Do For No Reason @TWDFNR
@AdamRodmanMD @WrayCharles @PetrilliMD Given how often it is used, there is money to be saved. #JHMChat https://t.co/ZyIDpMmhw3
Vinny Arora MD MAPP @FutureDocs
RT @RJmdphilly: @jenreadlynn Educating the small group of stakeholders more effective than educating all potential orderers... #JHMChat
Med Peds Hospitalist @medpedshosp
RT @SHMLive: There's still time to share your thoughts in tonight's #JHMChat on #ThingsWeDoForNoReason! https://t.co/x9vOhowNDr
Salah S. Qutaishat @salahq
A2: it may cause provider-indigestion, but I am sure it is doable. Keep in mind that there are organizational consitpators @sanjaysaint everywhere #JHMChat .
Chris Petrilli @PetrilliMD
@michellebr00ks @aoglasser @WrayCharles @TWDFNR #JHMChat - yeah but only if the folate is low #JustKiddingLenny @TWDFNR
Grace Farris MD @gracefarris
RT @PetrilliMD: @gracefarris @WrayCharles @TWDFNR #JHMChat I guess that makes sense since it works :-)
Grace Farris MD @gracefarris
RT @WrayCharles: @AdamRodmanMD @michellebr00ks @RJmdphilly @laxswamy NPO does add a sense of gravitas, doesn't it #jhmchat
Avital O'Glasser, MD FACP FHM @aoglasser
@TWDFNR @AdamRodmanMD @WrayCharles @PetrilliMD #JHMchat and then you add in potential LOS issues...
J Hospital Medicine @JHospMedicine
RT @salahq: A2: it may cause provider-indigestion, but I am sure it is doable. Keep in mind that there are organizational consitpators @san
J Hospital Medicine @JHospMedicine
RT @STangGirdwood: @JHospMedicine @TWDFNR Have the EMR suggest other options when docusate is ordered? Prescribers don’t like having to cli…
Med Peds Hospitalist @medpedshosp
RT @ETSshow: @FutureDocs #JHMChat Mark Shapiro here! Catching up, I’m late, my Twitter feed is very constipated. Anyone have any thoughts?
Mark Shapiro MD @ETSshow
@FutureDocs @SHMLive @WrayCharles @vineet_chopra @LekshmiMD @gracefarris @gracefarris has to do a cartoon of everyone’s face as they take a swig of lactulose. Would make for a fine coffee table book #JHMchat
J Hospital Medicine @JHospMedicine
RT @medpedshosp: T2- engaging pharmacy, GI, surgery, nutrition, IT - and have a compelling review of order sets. It is feasible - we can de…
Benjamin P. Geisler @ben_geisler
not sure -- but this could've also happened to liquid senna or miralax.. 😬 point is, it's unnecessary and as other said might preclude Rx of effective meds #jhmchat
Michelle Brooks, MD, FACP, FHM @michellebr00ks
I feel like #organizationalconstipators is my new favorite term for systemic barriers to change. #JHMChat
Grace Farris MD @gracefarris
@ETSshow @FutureDocs Welcome @ETSshow ! #JHMChat
J @dulcimer1978
RT @AdamRodmanMD: Does docusate prescribing in the inpatient setting actually harm anybody? It might if it prevents you from prescribing an…
J Hospital Medicine @JHospMedicine
RT @SHMLive: There's still time to share your thoughts in tonight's #JHMChat on #ThingsWeDoForNoReason! https://t.co/x9vOhowNDr
J Hospital Medicine @JHospMedicine
RT @TWDFNR: If you can change the formulary, that is the most durable. But, that's not possible for everyone, immediately. #JHMChat https:…
Sean Lena @seanlena
Docusate is in the admission order set where I work. It’s an easy click. #jhmchat
Charlie M. Wray @WrayCharles
@FutureDocs @SHMLive @vineet_chopra @LekshmiMD @gracefarris Sounds fun and gross. I'm in. Wonder if the @SHMLive IRB would approve ...?#jhmchat
Med Peds Hospitalist @medpedshosp
Indeed - we all are prominent stakeholders - the more people we engage - the higher the likelihood of success #JHMChat
Avital O'Glasser, MD FACP FHM @aoglasser
RT @medpedshosp: Indeed - we all are prominent stakeholders - the more people we engage - the higher the likelihood of success #JHMChat htt…
Med Peds Hospitalist @medpedshosp
RT @TWDFNR: @AdamRodmanMD @WrayCharles @PetrilliMD Given how often it is used, there is money to be saved. #JHMChat https://t.co/ZyIDpMmh…
Grace Farris MD @gracefarris
RT @ETSshow: @FutureDocs @SHMLive @WrayCharles @vineet_chopra @LekshmiMD @gracefarris @gracefarris has to do a cartoon of everyone’s face a…
Jennifer K. Chen, MD FAAP @DrJenChen4kids
@JHospMedicine @TWDFNR #JHMChat T2: Many peds places got rid of meds w codeine, so removing from formulary is one option. De-implementation still requires education if it’s been entrenched in training/culture
Things We Do For No Reason @TWDFNR
Order sets are wonderful, until they aren't. #JHMChat
Mara M. @mara_emm
#JHMChat pre-med interested in EBM and currently working at a nursing/rehab facility. During wound care rounds, the doc is annoyed that contact precautions slow him down. He is less likely to see the patient (esp. if something small).
J Hospital Medicine @JHospMedicine
RT @DrJenChen4kids: @JHospMedicine @TWDFNR #JHMChat T2: Many peds places got rid of meds w codeine, so removing from formulary is one optio…
Jen Readlynn, MD @jenreadlynn
@RJmdphilly Fair. But I think educating all the current orderers, even a little, needs to happen. No one likes to be told what to do without some background as to why. And again, I'm not the one ordering it. #JHMChat
Med Peds Hospitalist @medpedshosp
RT @michellebr00ks: I feel like #organizationalconstipators is my new favorite term for systemic barriers to change. #JHMChat https://t.co…
J Hospital Medicine @JHospMedicine
RT @michellebr00ks: Michelle Brooks from VCU Health in Richmond, VA. We got rid of contact precautions in 2008 or 2010 (?) for MRSA/VRE.…
Jonathan Berry @jlberrymd
A bit late but wanted to introduce myself: Jonathan, an Internal Medicine resident in Boston. #JHMChat
Avital O'Glasser, MD FACP FHM @aoglasser
@mara_emm #jhmchat so glad you're interest and awareness of EBM is starting so early!!
J Hospital Medicine @JHospMedicine
RT @mara_emm: #JHMChat pre-med interested in EBM and currently working at a nursing/rehab facility. During wound care rounds, the doc is an…
Med Peds Hospitalist @medpedshosp
RT @TWDFNR: Order sets are wonderful, until they aren't. #JHMChat https://t.co/DqPZrdAwCP
Rebecca Jaffe @RJmdphilly
RT @michellebr00ks: I feel like #organizationalconstipators is my new favorite term for systemic barriers to change. #JHMChat https://t.co…
J Hospital Medicine @JHospMedicine
@mara_emm Hang tight coming up on #JHMChat and welcome to a premed!
Matt Anderson @CCInquisitivist
RT @JHospMedicine: T1 In @TWDFNR series, Docusate is not an evidence-based way of treating constipation. Why do we do it? #JHMChat https:/…
J Hospital Medicine @JHospMedicine
RT @TWDFNR: Order sets are wonderful, until they aren't. #JHMChat https://t.co/DqPZrdAwCP
Grace Farris MD @gracefarris
RT @jlberrymd: A bit late but wanted to introduce myself: Jonathan, an Internal Medicine resident in Boston. #JHMChat
R Logan Jones, M.D. @rloganjonesmd
T1: But you guys, the box says it’s the #1 recommended OTC stool softener and adverts/packaging doesn’t lie...does it? #JHMchat https://t.co/bQSV2MaF37
Grace Farris MD @gracefarris
RT @mara_emm: #JHMChat pre-med interested in EBM and currently working at a nursing/rehab facility. During wound care rounds, the doc is an…
Things We Do For No Reason @TWDFNR
@AdamRodmanMD @WrayCharles @PetrilliMD Maybe. But, I often see docusate used as a "backbone" treatment. Everyone gets it PLUS something else. #JHMchat
Benjamin P. Geisler @ben_geisler
the @JHospMedicine #TWDFNR mentioned $60K - I presumed that was per Canadian hospital per year.. I personally think the adverse effects are not counted (e.g., increased LOS) #jhmchat
Michelle Brooks, MD, FACP, FHM @michellebr00ks
@jlberrymd Welcome! Fair warning -- lots of poop puns tonight. #JHMChat
Med Peds Hospitalist @medpedshosp
RT @rloganjonesmd: T1: But you guys, the box says it’s the #1 recommended OTC stool softener and adverts/packaging doesn’t lie...does it? #…
Delia Takagi @dltkgi
A2. Changing the formulary is a good answer, but it takes a long time to make foundation changes in emr templates. Outpt standpoint, pcps can also educate pts. #JHMChat
Guilherme Barcellos @brhospitalist
RT @TWDFNR: @JHospMedicine Culture is winning in a landslide. So, who did we all learn this from? And how can we change the culture? #jhmc
Avital O'Glasser, MD FACP FHM @aoglasser
@rloganjonesmd #jhmchat I'm going to tattle on you to @VPrasadMDMPH on terms of how you're interpreting quality of evidence
Benjamin P. Geisler @ben_geisler
what an interesting thought! how do you quantify constipation though? #jhmchat
Jonathan Berry @jlberrymd
@sargsyanz I fully agree with this. Having learned of the lack of evidence, while it's easier to just continue a med someone is already on, I hate the idea of seeing my name on a discharge summary for a med I know will not be effective #JHMChat
Sonya TG @STangGirdwood
@FutureDocs @SHMLive @WrayCharles @vineet_chopra @LekshmiMD @gracefarris Please pick a conference room as close to the restrooms as possible, or better yet, with bathrooms in the room! #JHMChat #somanyinappropriategifs
Rebecca Jaffe @RJmdphilly
@jenreadlynn Sure - but maybe a "we are removing x from formulary (or orderset, or whatever) and here is why" is a more effective way to get large scale or quick change. Agree though people like to feel engaged. #jhmchat
Med Peds Hospitalist @medpedshosp
We use it with senna and polyethylenglycol. And sometimes an extra magnesium oxide. #JHMChat
Anika Kumar, MD @freckledpedidoc
@FutureDocs @SHMLive @WrayCharles @vineet_chopra @LekshmiMD @gracefarris Chocolate sennosides are ok... and are OTC I really know too much about the taste of medications 🤦🏾‍♀️ #JHMChat
Jen Readlynn, MD @jenreadlynn
@TWDFNR @AdamRodmanMD @WrayCharles @PetrilliMD True. Very few are on docusate alone in the hospital. Maybe only if it's what on their outpatient med rec. #JHMChat
Charlie M. Wray @WrayCharles
@ben_geisler @JHospMedicine totally agree, Ben. Attribution would be difficult #jhmchat
Vinny Arora MD MAPP @FutureDocs
RT @michellebr00ks: @jlberrymd Welcome! Fair warning -- lots of poop puns tonight. #JHMChat
J Hospital Medicine @JHospMedicine
T3 up in a moment...#JHMChat
Vinny Arora MD MAPP @FutureDocs
RT @ben_geisler: the @JHospMedicine #TWDFNR mentioned $60K - I presumed that was per Canadian hospital per year.. I personally think the ad…
Brian McGillen, MD @bmcgillen26
@freckledpedidoc @FutureDocs @SHMLive @WrayCharles @vineet_chopra @LekshmiMD @gracefarris Chocolate, you say? Hershey likes this idea! #JHMChat
Sonya TG @STangGirdwood
@Bwkuiper Does it stop you for ordering the Miralax? If so, the EMR intervention technically works but perhaps with the less-than-ideal outcome. #JHMChat
Guilherme Barcellos @brhospitalist
RT @TWDFNR: @WrayCharles @RJmdphilly The study we're discussing looked at both treatment and prophylaxis. No benefit for either. #JHMChat
Steven Chen @DrStevenTChen
Sorry, I’ve been lurking on #jhmchat. I should probably introduce myself instead of furtively liking posts.... Steven, dermatologist/internist from Boston.
Things We Do For No Reason @TWDFNR
@JHospMedicine We're curious. Who has actually succeeded in getting doscusate off their hospital formulary? #jhmchat
Adam Rodman @AdamRodmanMD
fun unrelated laxative fact. Senna actually appears in the materia Medica.#jhmchat
Jennifer K. Chen, MD FAAP @DrJenChen4kids
@STangGirdwood @AdamRodmanMD @freckledpedidoc @jmomdphd @JHospMedicine @TWDFNR Haha, we also do formula taste testing (now some of those are disgusting, esp the hydrolyzed ones! @shortandsnark) #JHMchat
J Hospital Medicine @JHospMedicine
RT @TWDFNR: @JHospMedicine We're curious. Who has actually succeeded in getting doscusate off their hospital formulary? #jhmchat
Chris Petrilli @PetrilliMD
RT @TWDFNR: @JHospMedicine We're curious. Who has actually succeeded in getting doscusate off their hospital formulary? #jhmchat
Grace Farris MD @gracefarris
@JHospMedicine #JHMChat https://t.co/Mc44igcu0w
Zaven Sargsyan @sargsyanz
How would a pharmacy/therapeutics committee feel about adding other homeopathic stuff to the formulary? Then let’s subtract one. #JHMChat
Benjamin P. Geisler @ben_geisler
wait - it's gentle AND effective #aggresivebowelreg #jhmchat
Benji Mathews @benjikmathews
@JHospMedicine @TWDFNR Evaluate major drivers of overuse (culture of healthcare consumption, provider attitudes/biases/past interactions, patient unawareness of no evidence etc). For providers: Education, reflection, feedback, role-modeling. For patients: educate! Have them partner in DX/TX #JHMChat
Charlie M. Wray @WrayCharles
RT @TWDFNR: @JHospMedicine We're curious. Who has actually succeeded in getting doscusate off their hospital formulary? #jhmchat
Society of Hospital Medicine @SocietyHospMed
RT @TWDFNR: @JHospMedicine We're curious. Who has actually succeeded in getting doscusate off their hospital formulary? #jhmchat
Adam Rodman @AdamRodmanMD
RT @gracefarris: @JHospMedicine #JHMChat https://t.co/Mc44igcu0w
Chris Petrilli @PetrilliMD
@DrStevenTChen Welcome to #jhmchat - it's a pleasure to have you! Just remember to post with #JHMChat each time so everyone can see your post! Enjoy!
Vinny Arora MD MAPP @FutureDocs
A+ #jhmchat
Med Peds Hospitalist @medpedshosp
RT @gracefarris: @JHospMedicine #JHMChat https://t.co/Mc44igcu0w
Mark Shapiro MD @ETSshow
@AdamRodmanMD @gracefarris @FutureDocs Hey everyone! Adam! You’re still awake!? You must be tired, every patient says it awful! #JHMchat
Med Peds Hospitalist @medpedshosp
RT @benjikmathews: @JHospMedicine @TWDFNR Evaluate major drivers of overuse (culture of healthcare consumption, provider attitudes/biases/p…
Chris Petrilli @PetrilliMD
@ben_geisler https://t.co/CFpIC7guo4 #JHMChat
Benjamin P. Geisler @ben_geisler
time for a cost-effectiveness analysis #biased #jhmchat
Sonya TG @STangGirdwood
@DrJenChen4kids @AdamRodmanMD @freckledpedidoc @jmomdphd @JHospMedicine @TWDFNR @shortandsnark A GI doc did that once for a lecture. I was surprised how gross Pedialyte tastes and we recommend it all the time on #PedsHM and outpatient! #JHMChat
J Hospital Medicine @JHospMedicine
⚠️ warning! we are about to switch gears from constipation to contact precautions. Hang on to your seats on #JHMChat @TWFNR editions @tony_breu
Benjamin P. Geisler @ben_geisler
SAD! #jhmchat
Avital O'Glasser, MD FACP FHM @aoglasser
@PetrilliMD @ben_geisler #jhmchat THANKS so much...my 8yo walked up to my computer while I took a break to set the table, and started playing this clip...
Charlie M. Wray @WrayCharles
RT @gracefarris: @JHospMedicine #JHMChat https://t.co/Mc44igcu0w
Guilherme Barcellos @brhospitalist
#jhmchat Do you have Bisacodyl data? Do you use it? Here in Brazil it’s common a combination of Docusate + Bisacodyl...
Avital O'Glasser, MD FACP FHM @aoglasser
@PetrilliMD @ben_geisler #jhmchat #worklifebalance
Jen Readlynn, MD @jenreadlynn
@RJmdphilly Absolutely agree. #JHMChat
J Hospital Medicine @JHospMedicine
T3 In @TWDFNR, Contact isolation for MSRA and VRE was described as ineffective & potentially harmful. @TWDFNR recommends discontinuing this practice in hospitals with low endemic rates & high hand hygiene rates (>90%). Can anyone try this? #JHMChat https://t.co/XNZ9iDZh7Z
Vinny Arora MD MAPP @FutureDocs
RT @JHospMedicine: ⚠️ warning! we are about to switch gears from constipation to contact precautions. Hang on to your seats on #JHMChat @TW
Society of Hospital Medicine @SocietyHospMed
RT @JHospMedicine: ⚠️ warning! we are about to switch gears from constipation to contact precautions. Hang on to your seats on #JHMChat @TW
Vinny Arora MD MAPP @FutureDocs
RT @JHospMedicine: T3 In @TWDFNR, Contact isolation for MSRA and VRE was described as ineffective & potentially harmful. @TWDFNR recommen…
Avital O'Glasser, MD FACP FHM @aoglasser
@JHospMedicine @TWDFNR #jhmchat @rloganjonesmd want to take the helm on this one for what just changed at OHSU??
Jennifer K. Chen, MD FAAP @DrJenChen4kids
@JHospMedicine @TWDFNR I also got extra wary of docusate after the Burkholderia contamination issues https://t.co/4P4pwDSyPR #JHMChat
Med Peds Hospitalist @medpedshosp
@brhospitalist Guillherme! Welcome! This is Moises! We don’t use bisacodyl that much at Cleveland Clinic. #JHMChat
Guilherme Barcellos @brhospitalist
RT @TWDFNR: @JHospMedicine We're curious. Who has actually succeeded in getting doscusate off their hospital formulary? #jhmchat
Jennifer Madeline @jennifermcaputo
A3 we’ve just this month implemented physician ability to discontinue droplet precautions (most commonly placed when patient gets flu swab in ED) so it will be an uphill battle to remove mrsa/vre precautions #JHMChat
Michelle Brooks, MD, FACP, FHM @michellebr00ks
@JHospMedicine @TWDFNR Our hospital was progressive in this, and the ID folks have #donetheirresearch on this. We got rid of contact precautions for MRSA and VRE I think over 10 years ago. #JHMChat
Things We Do For No Reason @TWDFNR
RT @JHospMedicine: T3 In @TWDFNR, Contact isolation for MSRA and VRE was described as ineffective & potentially harmful. @TWDFNR recommen…
Med Peds Hospitalist @medpedshosp
At @CleClinicMD we do not isolate for MRSA or VRE #JHMChat
R Logan Jones, M.D. @rloganjonesmd
@JHospMedicine @TWDFNR T3 : Hey @TWDFNR, we're taking step in this direction #jhmchat --> https://t.co/ppv4mBODiC
J Hospital Medicine @JHospMedicine
Our #tweetiatricians game is strong tonight on #JHMChat !
Adam Rodman @AdamRodmanMD
my institution doesn't have contact precautions for MRSA. But our satellite hospitals do. I just ignore them. That's probably not the right way to go about it. #jhmchat
Salah S. Qutaishat @salahq
#JHMChat contact precautions for these organisms is a waste of healthcare dollars
Jen Readlynn, MD @jenreadlynn
A3: We did a few years ago and it's been great. The problem we run into is that not all of the nursing homes locally have moved to this, so we're unknowingly waiting for private rooms for discharge because they're not on precautions as inpatient. #JHMChat
Things We Do For No Reason @TWDFNR
RT @rloganjonesmd: @JHospMedicine @TWDFNR T3 : Hey @TWDFNR, we're taking step in this direction #jhmchat --> https://t.co/ppv4mBODiC
J Hospital Medicine @JHospMedicine
RT @michellebr00ks: @JHospMedicine @TWDFNR Our hospital was progressive in this, and the ID folks have #donetheirresearch on this. We got r…
Omi @Omi_082
RT @JHospMedicine: T3 In @TWDFNR, Contact isolation for MSRA and VRE was described as ineffective & potentially harmful. @TWDFNR recommen…
Sonya TG @STangGirdwood
@JHospMedicine @TWDFNR Our hospital still requires contact isolation for both...however, @RebeccaSteuart is part of a QI project at our institution that has providers review PPE orders everyday to take patients out ASAP. Could definitely implement something similar for this issue. #JHMChat
Grace Farris MD @gracefarris
RT @DrJenChen4kids: @JHospMedicine @TWDFNR I also got extra wary of docusate after the Burkholderia contamination issues https://t.co/4P4pw…
Society of Hospital Medicine @SocietyHospMed
RT @JHospMedicine: T3 In @TWDFNR, Contact isolation for MSRA and VRE was described as ineffective & potentially harmful. @TWDFNR recommen…
Rachel Johnson @DoubleDawgMD
#JHMChat. If the well controlled environments in RCTs show contact isolation to be ineffective...how much less effective is it in real community hospitals where doctors, techs, visitos haphazardly toss the gown over their head and blaze in?
Med Peds Hospitalist @medpedshosp
RT @rloganjonesmd: @JHospMedicine @TWDFNR T3 : Hey @TWDFNR, we're taking step in this direction #jhmchat --> https://t.co/ppv4mBODiC
Avital O'Glasser, MD FACP FHM @aoglasser
@rloganjonesmd @JHospMedicine @TWDFNR #jhmchat https://t.co/ppY45z72Uv
J Hospital Medicine @JHospMedicine
@michellebr00ks @TWDFNR Any thoughts on how and why this was successful @michellebr00ks ?#jhmchat
J Hospital Medicine @JHospMedicine
RT @rloganjonesmd: @JHospMedicine @TWDFNR T3 : Hey @TWDFNR, we're taking step in this direction #jhmchat --> https://t.co/ppv4mBODiC
Med Peds Hospitalist @medpedshosp
Go Peds and Med-Peds! #JHMChat
J Hospital Medicine @JHospMedicine
RT @DoubleDawgMD: #JHMChat. If the well controlled environments in RCTs show contact isolation to be ineffective...how much less effective…
Michael Sinha MD, JD, MPH @DrSinhaEsq
RT @JHospMedicine: #JHMChat is TONIGHT at 9pET on @TWDFNR with @tony_breu, moderated by @FutureDocs with live sketches by @gracefarris— Con…
Michael Sinha MD, JD, MPH @DrSinhaEsq
RT @JHospMedicine: Don't forget! Tomorrow night's #JHMChat w/ @FutureDocs & @tony_breu who will be discussing 2 @TWDFNR. Monday, March 11…
Kristen Young @kristenyoung
@JHospMedicine @TWDFNR In the process, initially the idea of Discontinuing CP for MRSA and VRE was a resident/hospitalist led project, working with ID & IP/IC. In 2017, we discontinue historical MRSA CP, and followed rates. Now following a systematic approach, looking to further reduce. #JHMchat
Chris Petrilli @PetrilliMD
RT @JHospMedicine: T3 In @TWDFNR, Contact isolation for MSRA and VRE was described as ineffective & potentially harmful. @TWDFNR recommen…
Jonathan Berry @jlberrymd
@AdamRodmanMD Having had MRSA/VRE precautions in med school and at other hospitals we rotate at, I love their absence at our hospital -- one less barrier to checking in on patients throughout the day #JHMChat
Charlie M. Wray @WrayCharles
RT @DoubleDawgMD: #JHMChat. If the well controlled environments in RCTs show contact isolation to be ineffective...how much less effective…
Things We Do For No Reason @TWDFNR
I'm already sensing a lot of "No Precautions" sentiment. What drives this? Though there is more than one issue, what's the biggest? #jhmchat
Rebecca Jaffe @RJmdphilly
ugh in case anyone is wondering the bedtime TOC did not work. Success is way worse than my readmission rate for what it's worth #JHMChat @FutureDocs
Jennifer K. Chen, MD FAAP @DrJenChen4kids
@JHospMedicine @TWDFNR #JHMchat T3: Fortunately don’t get much VRE in #PedsHM (yet) but we do contact precautions for MRSA and ESBL. Unfortunately we’re seeing more of both, so not sure we fall under “low endemic” category.
Vinny Arora MD MAPP @FutureDocs
RT @DoubleDawgMD: #JHMChat. If the well controlled environments in RCTs show contact isolation to be ineffective...how much less effective…
Adam Rodman @AdamRodmanMD
sometimes I wish we could just get everybody from JHM chat together and open our own hospital. #jhmchat
Benjamin P. Geisler @ben_geisler
A3 makes sense that contact precautions decrease pt contact (both anecdotal and by data) - downstream effects longer LOS, worse pt experience, other AEs... #jhmchat - and it doesn't even help with MRSA/VRE
Avital O'Glasser, MD FACP FHM @aoglasser
@AdamRodmanMD #jhmchat omg that would be awesome!!
Zaven Sargsyan @sargsyanz
Retweeting an old sentiment for #JHMchat . And correction: depending on the indication, indeed unnecessary.
Med Peds Hospitalist @medpedshosp
Systematic continuous improvement projects w trainees can lead big changes in the healthcare system #JHMChat
J Hospital Medicine @JHospMedicine
Local experts do tip the scales #JHMChat
Society of Hospital Medicine @SocietyHospMed
RT @TWDFNR: I'm already sensing a lot of "No Precautions" sentiment. What drives this? Though there is more than one issue, what's the big…
Things We Do For No Reason @TWDFNR
@AdamRodmanMD You'd make us use the old René Laennec stethoscopes! #JHMChat
J Hospital Medicine @JHospMedicine
RT @ben_geisler: A3 makes sense that contact precautions decrease pt contact (both anecdotal and by data) - downstream effects longer LOS,…
Rebecca Jaffe @RJmdphilly
@TWDFNR You know I wonder whether people react to this one on a logical level or gut/emotional level...and then retrofit the logic. #JHMChat
J Hospital Medicine @JHospMedicine
RT @kristenyoung: @JHospMedicine @TWDFNR In the process, initially the idea of Discontinuing CP for MRSA and VRE was a resident/hospitalist…
Charlie M. Wray @WrayCharles
@DoubleDawgMD Great point. Can't tell you how many times I've seen this happen right after I walked out of CP room all gowned up (usually to be a "good attending" and follow the rules) to see someone else waltz right in. Frustrating to say the least #jhmchat
Renee Dversdal @DRsonosRD
@rloganjonesmd @JHospMedicine @TWDFNR A3: I have nothing helpful to add beyond this excellent @OHSUIMRes resident thread, so proud! #JHMchat https://t.co/kHQ4lJQdkU
Adam Rodman @AdamRodmanMD
The reason that contact precautions Russell my Jimmy's is that patients get poor care with them. I can't even see on my own floor that nurses and CNAs are less likely to go into the rooms let alone the medical teams. #jhmchat
Salah S. Qutaishat @salahq
We took an aggressive approach in eliminating contact precautions in a 9-hospital health system for MDRO. The majority of physicians jumped on board easily #JHMChat
Grace Farris MD @gracefarris
@RJmdphilly @FutureDocs Are you playing this- #JHMChat https://t.co/qJbYKcvY5p
Med Peds Hospitalist @medpedshosp
@AdamRodmanMD Would be really cool! #JHMChat
Vinny Arora MD MAPP @FutureDocs
@RJmdphilly im feeling you - if you only knew what was going on here #jhmchat
Jonathan Berry @jlberrymd
RT @AdamRodmanMD: The reason that contact precautions Russell my Jimmy's is that patients get poor care with them. I can't even see on my o…
Med Peds Hospitalist @medpedshosp
RT @JHospMedicine: Local experts do tip the scales #JHMChat https://t.co/IqoMxobrd0
R Logan Jones, M.D. @rloganjonesmd
@JHospMedicine @tony_breu I think this is the phrase you meant to go for....@aoglasser #JHMchat https://t.co/PMGmdcU7d7
Benjamin P. Geisler @ben_geisler
so true - worse outcomes and higher spending! #jhmchat
Charlie M. Wray @WrayCharles
@AdamRodmanMD Count me in #jhmchat
Jennifer Madeline @jennifermcaputo
RT @TWDFNR: I'm already sensing a lot of "No Precautions" sentiment. What drives this? Though there is more than one issue, what's the big…
Guilherme Barcellos @brhospitalist
RT @AdamRodmanMD: The reason that contact precautions Russell my Jimmy's is that patients get poor care with them. I can't even see on my o…
Mara M. @mara_emm
Happens ALL the time #jhmchat
Vinny Arora MD MAPP @FutureDocs
i am crying laughing #jhmchat #toddlerlife #bedtime #DaylightSavingsTime
Charlie M. Wray @WrayCharles
RT @gracefarris: @RJmdphilly @FutureDocs Are you playing this- #JHMChat https://t.co/qJbYKcvY5p
Mike Stevens @Dr_Mike_Stevens
@michellebr00ks @JHospMedicine @TWDFNR @mike_edmond @gonzalobearman Also, here are some of our local data on discontinuing CP for MRSA/ VRE: https://t.co/e4GMa1IWxm, https://t.co/ECzCXnPSXv, https://t.co/p2nbWyA6kq #JHMChat @ICHEJournal @SHEA_Epi
Guilherme Barcellos @brhospitalist
RT @ben_geisler: A3 makes sense that contact precautions decrease pt contact (both anecdotal and by data) - downstream effects longer LOS,…
Michelle Brooks, MD, FACP, FHM @michellebr00ks
One metaanalysis of the data - favors stopping contact precautions. #JHMChat https://t.co/Nc4iNmxQQh
Vinny Arora MD MAPP @FutureDocs
RT @salahq: We took an aggressive approach in eliminating contact precautions in a 9-hospital health system for MDRO. The majority of physi…
Med Peds Hospitalist @medpedshosp
Contact precautions lead to patient isolation. Damage the overall quality of care. #JHMChat
Things We Do For No Reason @TWDFNR
@gracefarris @RJmdphilly @FutureDocs I'm currently on the "daddy, can I work in the office with you?" square. [I love that square]. #JHMChat
Mark Shapiro MD @ETSshow
@FutureDocs @SHMLive @WrayCharles @vineet_chopra @LekshmiMD @gracefarris Before I forget, someone in this auspicious #JHMchat makes their Explore The Space podcast debut tomorrow morning! Stay tuned, it’s really good!
Med Peds Hospitalist @medpedshosp
RT @gracefarris: @RJmdphilly @FutureDocs Are you playing this- #JHMChat https://t.co/qJbYKcvY5p
Vinny Arora MD MAPP @FutureDocs
RT @WrayCharles: @DoubleDawgMD Great point. Can't tell you how many times I've seen this happen right after I walked out of CP room all gow…
Guilherme Barcellos @brhospitalist
RT @kristenyoung: @JHospMedicine @TWDFNR In the process, initially the idea of Discontinuing CP for MRSA and VRE was a resident/hospitalist…
Vinny Arora MD MAPP @FutureDocs
RT @JHospMedicine: Local experts do tip the scales #JHMChat https://t.co/IqoMxobrd0
Benjamin P. Geisler @ben_geisler
and you would put up the painting on the wall @AdamRodmanMD #jhmchat
Guilherme Barcellos @brhospitalist
RT @DoubleDawgMD: #JHMChat. If the well controlled environments in RCTs show contact isolation to be ineffective...how much less effective…
Vinny Arora MD MAPP @FutureDocs
RT @sargsyanz: Retweeting an old sentiment for #JHMchat . And correction: depending on the indication, indeed unnecessary. https://t.co/zzB…
Michelle Brooks, MD, FACP, FHM @michellebr00ks
@kristenyoung @JHospMedicine @TWDFNR Welcome @Dr_Mike_Stevens to supply you with the laundry list. Please say hi to one of the experts everyone! #JHMChat
Michelle Brooks, MD, FACP, FHM @michellebr00ks
RT @Dr_Mike_Stevens: @michellebr00ks @JHospMedicine @TWDFNR @mike_edmond @gonzalobearman Also, here are some of our local data on discontin…
Rebecca Jaffe @RJmdphilly
@medpedshosp We are still solidly in the "trying to improve adherence rates" stage of change on this issue. #JHMChat
Med Peds Hospitalist @medpedshosp
RT @Dr_Mike_Stevens: @michellebr00ks @JHospMedicine @TWDFNR @mike_edmond @gonzalobearman Also, here are some of our local data on discontin…
Med Peds Hospitalist @medpedshosp
RT @michellebr00ks: One metaanalysis of the data - favors stopping contact precautions. #JHMChat https://t.co/Nc4iNmxQQh
R Logan Jones, M.D. @rloganjonesmd
@michellebr00ks @JHospMedicine @TWDFNR You've got @gonzalobearman with you out there at VCU. He's really trying to move the needle to evidence based and rational contact isolation #JHMchat
Med Peds Hospitalist @medpedshosp
RT @ETSshow: @FutureDocs @SHMLive @WrayCharles @vineet_chopra @LekshmiMD @gracefarris Before I forget, someone in this auspicious #JHMchat
J Hospital Medicine @JHospMedicine
T4. Horizontal strategies to prevent infection spread include chlorhexidine gluconate (CHG) bathing, which has been associated with reduced C diffe. What are some important considerations for implementing daily CHG bathing for all patients? #JHMChat
Nathan Varady @nathanvarady
RT @JHospMedicine: T3 In @TWDFNR, Contact isolation for MSRA and VRE was described as ineffective & potentially harmful. @TWDFNR recommen…
Grace Farris MD @gracefarris
RT @FutureDocs: i am crying laughing #jhmchat #toddlerlife #bedtime #DaylightSavingsTime https://t.co/LsgDyuoAUh
Med Peds Hospitalist @medpedshosp
@ETSshow @FutureDocs @SHMLive @WrayCharles @vineet_chopra @LekshmiMD @gracefarris Can’t wait! #JHMChat
Grace Farris MD @gracefarris
RT @TWDFNR: @gracefarris @RJmdphilly @FutureDocs I'm currently on the "daddy, can I work in the office with you?" square. [I love that squ…
Things We Do For No Reason @TWDFNR
What are some of the "rational" uses of contact precautions that people see? #JHMChat
Jennifer K. Chen, MD FAAP @DrJenChen4kids
@jennifermcaputo Oh yes, it’s annoying when a patient automatically gets precautions just because a certain test was ordered (eg airborne for TB even if low on differential). If clinical suspicion is there, sure, add the precautions to protect staff/other patients #JHMChat
Michelle Brooks, MD, FACP, FHM @michellebr00ks
@Dr_Mike_Stevens @JHospMedicine @TWDFNR @mike_edmond @gonzalobearman @ICHEJournal @SHEA_Epi Hey @Dr_Mike_Stevens - when did we discontinue precautions? I feel like I was still a resident. #solongago #idontrememberwhen #JHMChat
Michelle Brooks, MD, FACP, FHM @michellebr00ks
RT @rloganjonesmd: @michellebr00ks @JHospMedicine @TWDFNR You've got @gonzalobearman with you out there at VCU. He's really trying to move…
Benjamin P. Geisler @ben_geisler
I had to look that one up! #jhmchat
Benjamin P. Geisler @ben_geisler
#renelaennecstethoscope #jhmchat https://t.co/Ir5Azyyrqo
Vinny Arora MD MAPP @FutureDocs
@AdamRodmanMD my husband has had a similar joke - collect all the hospitalists you love and take out an ad saying hospitalist group for hire #jhmchat (he's a health economist)
Things We Do For No Reason @TWDFNR
@ben_geisler @AdamRodmanMD brings them on rounds... #JHMChat
Michelle Brooks, MD, FACP, FHM @michellebr00ks
@rloganjonesmd @JHospMedicine @TWDFNR @gonzalobearman He chimed in prior to #JHMChat!
J Hospital Medicine @JHospMedicine
#JHMChat
Society of Hospital Medicine @SocietyHospMed
RT @JHospMedicine: T4. Horizontal strategies to prevent infection spread include chlorhexidine gluconate (CHG) bathing, which has been ass…
Rebecca Jaffe @RJmdphilly
@salahq Silly question - what are JC standards around contact precautions? Is it a "set your own policy and stick by it" kind of issue, or are there basic standards that must be met? #JHMChat
Jonathan Berry @jlberrymd
@TWDFNR @ben_geisler @AdamRodmanMD Can confirm. #JHMChat
Vinny Arora MD MAPP @FutureDocs
RT @TWDFNR: What are some of the "rational" uses of contact precautions that people see? #JHMChat https://t.co/lvGSbVoiPN
Vinny Arora MD MAPP @FutureDocs
RT @JHospMedicine: T4. Horizontal strategies to prevent infection spread include chlorhexidine gluconate (CHG) bathing, which has been ass…
Grace Farris MD @gracefarris
So much of this tonight! It’s like, why not ask it at 4am when we’re both awake for the day #JHMChat
Salah S. Qutaishat @salahq
A4: skin, skin, skin! #JHMChat
Med Peds Hospitalist @medpedshosp
T4- this is mostly used in the ICU on patients w central lines #JHMChat
Charlie M. Wray @WrayCharles
RT @TWDFNR: What are some of the "rational" uses of contact precautions that people see? #JHMChat https://t.co/lvGSbVoiPN
Vinny Arora MD MAPP @FutureDocs
@michellebr00ks @kristenyoung @JHospMedicine @TWDFNR @Dr_Mike_Stevens welcome to #JHMChat great to have experts in the house!
Michelle Brooks, MD, FACP, FHM @michellebr00ks
@rloganjonesmd - #JHMChat
J Hospital Medicine @JHospMedicine
RT @FutureDocs: @michellebr00ks @kristenyoung @JHospMedicine @TWDFNR @Dr_Mike_Stevens welcome to #JHMChat great to have experts in the hous…
Brian McGillen, MD @bmcgillen26
A4. We have had big issues with patients doing daily CHG baths for #PICCs. Many tend to not like them after the first 1 or 2! Course, could also be in how we do/don't set expectations... #JHMChat
J Hospital Medicine @JHospMedicine
RT @michellebr00ks: @kristenyoung @JHospMedicine @TWDFNR Welcome @Dr_Mike_Stevens to supply you with the laundry list. Please say hi to on…
Grace Farris MD @gracefarris
RT @ben_geisler: #renelaennecstethoscope #jhmchat https://t.co/Ir5Azyyrqo
Benjamin P. Geisler @ben_geisler
so true! if hawthorne effect from trial (cohort study) gone - effect size even smaller? #jhmchat
Sonya TG @STangGirdwood
@TWDFNR Working with kids who cough and sneeze in your face and put their drool-covered hands all over your clothes and stethoscope, sometimes having a barrier just makes me feel better. Is that rational or irrational? #JHMChat
Guilherme Barcellos @brhospitalist
RT @michellebr00ks: One metaanalysis of the data - favors stopping contact precautions. #JHMChat https://t.co/Nc4iNmxQQh
Eric Soriano, MD @EricLSoriano
@JHospMedicine @TWDFNR We are behind...we require 3 negative MRSA surveillance swabs before contact can be discontinued and even then it is very hard to remove from the chart. We do have an initiative to swab outpatients in an attempt to remove the precautions! #jhmchat
Grace Farris MD @gracefarris
RT @FutureDocs: @michellebr00ks @kristenyoung @JHospMedicine @TWDFNR @Dr_Mike_Stevens welcome to #JHMChat great to have experts in the hous…
Jennifer K. Chen, MD FAAP @DrJenChen4kids
@TWDFNR I think contact + for concern C diff or norovirus is reasonable. We had a nasty norovirus outbreak a couple years ago w lots of kids vomiting 🤢🤮 #JHMChat
Salah S. Qutaishat @salahq
A4: did I hear C. diff? Am I missing something? Are we back to poop? #jhmchat
Mike Stevens @Dr_Mike_Stevens
@TWDFNR Also have to consider opportunity costs for your system's #InfectionPrevention program. CP focuses $$$ and time on individual pathogens-when there is likely more bang for your $ focusing on interventions that affect multiple pathogens simultaneously (like hand hygiene) #JHMChat
Michelle Brooks, MD, FACP, FHM @michellebr00ks
@AdamRodmanMD Then we'd all be in the same time zone too! #JHMChat https://t.co/ro6KffEDxP
Sonya TG @STangGirdwood
@TWDFNR But also when we have babies under 28 days who will get tapped if they get a fever, I also feel like wearing gloves or something will protect them from whatever is floating around in the hospital. #JHMChat #pedsproblems
Benjamin P. Geisler @ben_geisler
haha... there's LESS VRE without CP in this meta-analysis? #jhmchat
Charlie M. Wray @WrayCharles
@ben_geisler you had me at hawthorne effect, Ben #jhmchat
Rebecca Jaffe @RJmdphilly
@michellebr00ks @kristenyoung @JHospMedicine @TWDFNR @Dr_Mike_Stevens what do you guys isolate for? #JHMChat
Sonya TG @STangGirdwood
@freckledpedidoc @TWDFNR And vomited on! Sometimes pooped on too! #JHMChat
Charlie M. Wray @WrayCharles
RT @Dr_Mike_Stevens: @TWDFNR Also have to consider opportunity costs for your system's #InfectionPrevention program. CP focuses $$$ and tim…
Michael Sinha MD, JD, MPH @DrSinhaEsq
#JHMChat A bit late checking in, but lurking in Boston. Mostly here for the @gracefarris cartoons... 😀
Jennifer K. Chen, MD FAAP @DrJenChen4kids
@STangGirdwood @TWDFNR After having many kids cough/sneeze into my face, in winter I’ll often wear a mask even in non-droplet precaution rooms 😅 #JHMChat #PedsHM
Med Peds Hospitalist @medpedshosp
RT @Dr_Mike_Stevens: @TWDFNR Also have to consider opportunity costs for your system's #InfectionPrevention program. CP focuses $$$ and tim…
J Hospital Medicine @JHospMedicine
@salahq You saw what we did there #JHMChat https://t.co/sO7Umi7fRJ
Rebecca Jaffe @RJmdphilly
RT @JHospMedicine: T4. Horizontal strategies to prevent infection spread include chlorhexidine gluconate (CHG) bathing, which has been ass…
Things We Do For No Reason @TWDFNR
@ben_geisler This meta-analysis included quasi-experimental studies where they looked at rates of hospital-acquired MRSA/VRE after CPs were discontinued. #JHMChat
Rebecca Jaffe @RJmdphilly
RT @TWDFNR: What are some of the "rational" uses of contact precautions that people see? #JHMChat https://t.co/lvGSbVoiPN
Michelle Brooks, MD, FACP, FHM @michellebr00ks
A4 - patients don't like the sticky feeling. #JHMChat
Vinny Arora MD MAPP @FutureDocs
@DrJenChen4kids @STangGirdwood @TWDFNR but do you wear a mask at home? #jhmchat I give up.
J Hospital Medicine @JHospMedicine
RT @michellebr00ks: A4 - patients don't like the sticky feeling. #JHMChat https://t.co/GwGBTgxSK9
Shail Govani @ShailGovani
RT @JHospMedicine: Don't forget! Tomorrow night's #JHMChat w/ @FutureDocs & @tony_breu who will be discussing 2 @TWDFNR. Monday, March 11…
Things We Do For No Reason @TWDFNR
@jennifermcaputo Don't bring scabies into the #JHMChat
Med Peds Hospitalist @medpedshosp
@DrJenChen4kids @STangGirdwood @TWDFNR I wear the mask all the time! (In Peds, winter time). #JHMChat
Adam Rodman @AdamRodmanMD
this is going off on a tangent a bit, what does anyone still insist on using soap in water after leaving a C diff room?#jhmchat
J Hospital Medicine @JHospMedicine
RT @TWDFNR: @ben_geisler This meta-analysis included quasi-experimental studies where they looked at rates of hospital-acquired MRSA/VRE af…
J Hospital Medicine @JHospMedicine
RT @DrSinhaEsq: #JHMChat A bit late checking in, but lurking in Boston. Mostly here for the @gracefarris cartoons... 😀
Benjamin P. Geisler @ben_geisler
I guess if someone would advocate stopping CP for carbapenem-resistant enterobacteriaceae - the price for colistin would go through the roof #pharmabro #jhmchat
J Hospital Medicine @JHospMedicine
RT @ben_geisler: so true! if hawthorne effect from trial (cohort study) gone - effect size even smaller? #jhmchat https://t.co/nFKRkbVRzW
J Hospital Medicine @JHospMedicine
RT @michellebr00ks: One metaanalysis of the data - favors stopping contact precautions. #JHMChat https://t.co/Nc4iNmxQQh
Jennifer K. Chen, MD FAAP @DrJenChen4kids
@FutureDocs @STangGirdwood @TWDFNR Don’t have kids at home so no mask therr, but you’re right, many ppl who spend a lot of time around potentially sick kids (eg teachers) don’t usually have masks #JHMChat
Kristen Young @kristenyoung
@WrayCharles @DoubleDawgMD I studied this, we only have about a 60% compliance with posted signage - which is near what other studies have cited (50-60%). Dismal. Worse the hand hygiene rates plummet once the CP sign goes up. #JHMchat
Michelle Brooks, MD, FACP, FHM @michellebr00ks
@RJmdphilly @kristenyoung @JHospMedicine @TWDFNR @Dr_Mike_Stevens C diff, resistant GNRS - ESBL and KPC-producing, MDR Pseudomonas & Burkholderia. #JHMChat
J Hospital Medicine @JHospMedicine
RT @Dr_Mike_Stevens: @TWDFNR Also have to consider opportunity costs for your system's #InfectionPrevention program. CP focuses $$$ and tim…
Jen Readlynn, MD @jenreadlynn
@STangGirdwood @TWDFNR We're required to glove for every adult patient in our hospital. Peds was exempt due to low Cdiff rates. #washglovewash #JHMChat
J Hospital Medicine @JHospMedicine
RT @salahq: A4: did I hear C. diff? Am I missing something? Are we back to poop? #jhmchat https://t.co/6O0y2qm9gO
J Hospital Medicine @JHospMedicine
RT @DrJenChen4kids: @TWDFNR I think contact + for concern C diff or norovirus is reasonable. We had a nasty norovirus outbreak a couple ye…
Benjamin P. Geisler @ben_geisler
I'm wondering if the effect of chlorhexidine bathing differs dramatically according to the baseline MRSA (I don't think they did VRE) transmission rates #posthoc #jhmchat
Rebecca Jaffe @RJmdphilly
@TWDFNR I'm sort of assuming C diff and flu. And since we seem to go full on hazmat disseminated zoster...suspected meningococcus, TB (though these are airborn/strict precaution) #JHMChat
Med Peds Hospitalist @medpedshosp
@TWDFNR CRAB, ESBL. Scabies. #JHMChat
Kshitij Thakur @drkshitijthakur
@JHospMedicine We were successful in implementing this for our malignant Hematology cohort... needs a lot of reinforcement from the hospitalist at rounds. #jhmchat
Kristen Young @kristenyoung
@DrJenChen4kids @STangGirdwood @TWDFNR Same, and I think this speaks to the "rational" contact precautions and patient centered CP. #JHMchat
J Hospital Medicine @JHospMedicine
RT @drkshitijthakur: @JHospMedicine We were successful in implementing this for our malignant Hematology cohort... needs a lot of reinforce…
Michelle Brooks, MD, FACP, FHM @michellebr00ks
#JHMChat - for the tweetiatricians in the house!
Benjamin P. Geisler @ben_geisler
I always feel so ambivalent when I'm being asked to order MRSA/VRE swabs! 🤔 #jhmchat
Vinny Arora MD MAPP @FutureDocs
RT @JHospMedicine: @salahq You saw what we did there #JHMChat https://t.co/sO7Umi7fRJ
Vinny Arora MD MAPP @FutureDocs
@DrSinhaEsq @gracefarris aren't we all ? #jhmchat
Mike Stevens @Dr_Mike_Stevens
@michellebr00ks @JHospMedicine @TWDFNR @mike_edmond @gonzalobearman @ICHEJournal @SHEA_Epi April 2013! Time flies! #JHMChat
Med Peds Hospitalist @medpedshosp
@TWDFNR Also Cdiff, KPC. #JHMChat
Benjamin P. Geisler @ben_geisler
@jlberrymd @TWDFNR @AdamRodmanMD whaaat? #jhmchat
Med Peds Hospitalist @medpedshosp
RT @michellebr00ks: #JHMChat - for the tweetiatricians in the house! https://t.co/s5dQXW4UOX
J Hospital Medicine @JHospMedicine
T4 #JHMChat Please add closing thoughts on @TWDFNR with @tony_breu on constipation & contact precautions.
Rebecca Jaffe @RJmdphilly
@AdamRodmanMD @michellebr00ks @kristenyoung @JHospMedicine @TWDFNR @Dr_Mike_Stevens Assuming there's no data for that ;) Sometimes good sense and paranoia win out begs the question - maybe contact precautions would have been useful if the MRDA/VRE prevalence was lower? #JHMChat
Mark Shapiro MD @ETSshow
@medpedshosp @FutureDocs @SHMLive @WrayCharles @vineet_chopra @LekshmiMD @gracefarris It’s not @gracefarris #JHMChat
Michelle Brooks, MD, FACP, FHM @michellebr00ks
@RJmdphilly @TWDFNR We have a pathogen-specific isolation chart to refer to. #JHMChat
Salah S. Qutaishat @salahq
Great question. My answer is “fear” and protection of own #microbiome #JHMChat
Jennifer K. Chen, MD FAAP @DrJenChen4kids
@freckledpedidoc @JHospMedicine #JHMChat T4: adding to this, might be aggravating for many kids w sensitive skin too, especially complex ones w hardware like ostomies or Gtubes. Not sure how costs would compare to the contact precaution gowns
Grace Farris MD @gracefarris
😛 rampant bathroom humor tonight🚽 #JHMChat
Rebecca Jaffe @RJmdphilly
RT @FutureDocs: @AdamRodmanMD my husband has had a similar joke - collect all the hospitalists you love and take out an ad saying hospitali…
Rebecca Jaffe @RJmdphilly
@FutureDocs @AdamRodmanMD #dreamjob #jhmchat
Society of Hospital Medicine @SocietyHospMed
Share your final #JHMChat thoughts, then claim #CME! https://t.co/zJYslL00dW
Vinny Arora MD MAPP @FutureDocs
For a brief moment I thought you were taking vitals during the CHG bath (baths are often done in the middle of the night) but then I realized you talking bedtime! 😂😂😂🤣 #jhmchat
Michelle Brooks, MD, FACP, FHM @michellebr00ks
@Dr_Mike_Stevens @JHospMedicine @TWDFNR @mike_edmond @gonzalobearman @ICHEJournal @SHEA_Epi Hahaha. Much later than I thought! I thought it was 2010. #JHMChat
Sonya TG @STangGirdwood
@TWDFNR I do take the time when we’re gowning up to teach. Lots of people say there’s no time to teach our rounds when it’s high census in winter but I remind them that when the entire team is crowded around one closet and putting on equipment, you have their attention! #JHMChat #meded
Michael Sinha MD, JD, MPH @DrSinhaEsq
RT @gracefarris: 😛 rampant bathroom humor tonight🚽 #JHMChat https://t.co/R7wEPAOznk
Eric Soriano, MD @EricLSoriano
@ben_geisler #jhmchat same with a viral respiratory PCR panel because it means everyone gowns and masks for 24-48 hours while waiting to see if the patient has rhinovirus...
Med Peds Hospitalist @medpedshosp
RT @SHMLive: Share your final #JHMChat thoughts, then claim #CME! https://t.co/zJYslL00dW https://t.co/wUqgL1nNej
R Logan Jones, M.D. @rloganjonesmd
@salahq A4: if the title of this paper doesn't strike fear in your heart, then I don't know what could "The Potential for Airborne Dispersal of Clostridium difficile from Symptomatic Patients. " #jhmchat https://t.co/Va5PTp0msb
Things We Do For No Reason @TWDFNR
@RJmdphilly @AdamRodmanMD @michellebr00ks @kristenyoung @JHospMedicine @Dr_Mike_Stevens This is partly the argument made by @dr_dmorgan in this wonderful article. #JHMChat https://t.co/gvqT4sQRve https://t.co/lCzlR24wQQ
Matt Peters MD @petersm22
RT @JHospMedicine: T2 One of the recommendations from @TWDFNR is to remove docusate from your hospital formulary. Is this feasible? What a…
Benjamin P. Geisler @ben_geisler
I guess they defer to the @CDCgov https://t.co/wVL5yD1VdN #jhmchat
Renee Dversdal @DRsonosRD
@JHospMedicine T4: Seems like that would have pretty significant nursing time requirements? #JHMchat
Med Peds Hospitalist @medpedshosp
And toilets in hospital rooms have no cover! #JHMChat
Grace Farris MD @gracefarris
@FutureDocs Haha! I’m filing these parenting outpouches under #JHMchat bc #WorkLifeBalance
Avital O'Glasser, MD FACP FHM @aoglasser
@gracefarris @RJmdphilly @FutureDocs #jhmchat Ha! i just started re-watching the first hunger games at the gym the other night :) https://t.co/IaMEEZpRb1
Things We Do For No Reason @TWDFNR
@ben_geisler @CDCgov And the CDC still suggests the use of contact precautions. #JHMChat
Charlie M. Wray @WrayCharles
@JHospMedicine @TWDFNR @tony_breu Another great chat tonight! Love the broad participation -- with a strong showing from our #tweetrians (pediatricians). Overall: Reaffirmed my distaste of docusate and contact precautions #jhmchat
Anika Kumar, MD @freckledpedidoc
@JHospMedicine @TWDFNR @tony_breu It’s nice to have these discussions. Sometimes the medicine we practice in #PedsHM is an extrapolation from what our adult colleagues do. I appreciate the candid, literature-based discussions so we can understand how our adult colleagues approach similar concerns. #JHMChat
Things We Do For No Reason @TWDFNR
RT @WrayCharles: @JHospMedicine @TWDFNR @tony_breu Another great chat tonight! Love the broad participation -- with a strong showing from o…
Guilherme Barcellos @brhospitalist
@LuisCLCorreia and @tlisboa79: they are saying at #JHMchat that contact isolation for MRSA and VRE is just perceived safety, not real one. Accreditation consultants would fell like a boat without a sail... they need to do something!
Vinny Arora MD MAPP @FutureDocs
wow that was fast #JHMChat. thank you for participating in this rapid fire @TWDFNR chat with @tony_breu on Constipation and Contact Precautions. Lots of food for thought on de-implementation by partnering with our pharmacy/infection control colleagues.
Michelle Brooks, MD, FACP, FHM @michellebr00ks
CT - I didn't realize ditching the CP would be so controversial, since our hospital switched relatively easily. I feel like people will hang onto docusate longer than those blue (at our institution) or yellow gowns. #jhmchat
Grace Farris MD @gracefarris
RT @aoglasser: @gracefarris @RJmdphilly @FutureDocs #jhmchat Ha! i just started re-watching the first hunger games at the gym the other nig…
Benjamin P. Geisler @ben_geisler
I wonder if CHG baths work at all if antimicrobial patches (and other bundle measures) are in place #jhmchat
Mark Shapiro MD @ETSshow
@AdamRodmanMD In! #JHMchat
Grace Farris MD @gracefarris
RT @WrayCharles: @JHospMedicine @TWDFNR @tony_breu Another great chat tonight! Love the broad participation -- with a strong showing from o…
Salah S. Qutaishat @salahq
Thank you @SMcGrathICP .. #JHMChat
Charlie M. Wray @WrayCharles
@TWDFNR @RJmdphilly @AdamRodmanMD @michellebr00ks @kristenyoung @JHospMedicine @Dr_Mike_Stevens @dr_dmorgan Dan usually says smart things like this... #jhmchat
J Hospital Medicine @JHospMedicine
RT @TWDFNR: @RJmdphilly @AdamRodmanMD @michellebr00ks @kristenyoung @JHospMedicine @Dr_Mike_Stevens This is partly the argument made by @dr
Charlie M. Wray @WrayCharles
RT @FutureDocs: wow that was fast #JHMChat. thank you for participating in this rapid fire @TWDFNR chat with @tony_breu on Constipation and…
Avital O'Glasser, MD FACP FHM @aoglasser
@gracefarris #Jhmchat reminds of one of the times I got schooled as an intern on nights...got a 2am page from a nurse asking for a bowel regimen (probably docusate??), & when i said, "is the patient actually aware complaining of constipation" the answer was "YES, he's at the nurses station!"
J Hospital Medicine @JHospMedicine
RT @WrayCharles: @JHospMedicine @TWDFNR @tony_breu Another great chat tonight! Love the broad participation -- with a strong showing from o…
Charlie M. Wray @WrayCharles
RT @freckledpedidoc: @JHospMedicine @TWDFNR @tony_breu It’s nice to have these discussions. Sometimes the medicine we practice in #PedsHM i…
Guilherme Barcellos @brhospitalist
RT @TWDFNR: @RJmdphilly @AdamRodmanMD @michellebr00ks @kristenyoung @JHospMedicine @Dr_Mike_Stevens This is partly the argument made by @dr
J Hospital Medicine @JHospMedicine
RT @FutureDocs: wow that was fast #JHMChat. thank you for participating in this rapid fire @TWDFNR chat with @tony_breu on Constipation and…
Adam Rodman @AdamRodmanMD
great conversation! Thank you so much @tony_breu for moderating!#jhmchat
Avital O'Glasser, MD FACP FHM @aoglasser
@rloganjonesmd @medpedshosp #jhmchat what's the data on bacteria being aerosolized by flushing a toilet???
Things We Do For No Reason @TWDFNR
Thank you @FutureDocs for a wonderful #JHMchat!
Mark Shapiro MD @ETSshow
@FutureDocs @TWDFNR @tony_breu I love that, after those topics, you went with “food!” #nothungry! See you all at @SHMLive in a few weeks! #JHMchat
J Hospital Medicine @JHospMedicine
Thank you to our partners @SHMLive @CostsofCare and @ABIMFoundation for supporting #JHMChat! @TWDFNR edition
J Hospital Medicine @JHospMedicine
Thanks for a great #JHMchat. Don't forget to claim your #CME here https://t.co/7vP3slGkXR
Med Peds Hospitalist @medpedshosp
Many thanks to @FutureDocs @tony_breu @DocLennyF @TWDFNR for the excellent #JHMChat tonight! Learned a lot and enjoy the interaction!
Kshitij Thakur @drkshitijthakur
@DRsonosRD @JHospMedicine It can work in certain cohorts of patients with a favorable nurse to patient ratio. #jhmchat
Michelle Brooks, MD, FACP, FHM @michellebr00ks
RT @FutureDocs: wow that was fast #JHMChat. thank you for participating in this rapid fire @TWDFNR chat with @tony_breu on Constipation and…
Grace Farris MD @gracefarris
RT @aoglasser: @gracefarris #Jhmchat reminds of one of the times I got schooled as an intern on nights...got a 2am page from a nurse asking…
Benjamin P. Geisler @ben_geisler
@WrayCharles it's all about effectiveness no efficacy @WrayCharles #jhmchat
J Hospital Medicine @JHospMedicine
RT @bmcgillen26: A4. We have had big issues with patients doing daily CHG baths for #PICCs. Many tend to not like them after the first 1 or…
Jonathan Berry @jlberrymd
@michellebr00ks Making it my mission this month to deprescribe docusate left and right...but yes on a broader culture I think it will be here for a while #JHMChat
J Hospital Medicine @JHospMedicine
RT @DRsonosRD: @JHospMedicine T4: Seems like that would have pretty significant nursing time requirements? #JHMchat
Sonya TG @STangGirdwood
RT @freckledpedidoc: @JHospMedicine @TWDFNR @tony_breu It’s nice to have these discussions. Sometimes the medicine we practice in #PedsHM i…
J Hospital Medicine @JHospMedicine
RT @freckledpedidoc: @JHospMedicine @TWDFNR @tony_breu It’s nice to have these discussions. Sometimes the medicine we practice in #PedsHM i…
Avital O'Glasser, MD FACP FHM @aoglasser
@gracefarris #jhmchat wait! paging @alfandremd for the physician-ing/parenting crossover!!
J Hospital Medicine @JHospMedicine
RT @jlberrymd: @michellebr00ks Making it my mission this month to deprescribe docusate left and right...but yes on a broader culture I thin…
Benjamin P. Geisler @ben_geisler
#realworld #jhmchat
Society of Hospital Medicine @SocietyHospMed
RT @JHospMedicine: Thank you to our partners @SHMLive @CostsofCare and @ABIMFoundation for supporting #JHMChat! @TWDFNR edition
SystematicReviewBot @EvidenceRobot
RT @ben_geisler: haha... there's LESS VRE without CP in this meta-analysis? #jhmchat https://t.co/7wmhvibiCG
J Hospital Medicine @JHospMedicine
RT @TWDFNR: Thank you @FutureDocs for a wonderful #JHMchat!
J Hospital Medicine @JHospMedicine
@TWDFNR @FutureDocs Thank you @tony_breu #jhmchat
Sonya TG @STangGirdwood
What a fun #JHMChat tonight! Can’t wait for #PHMFellowJC tom. night on another topic that impacts adult HM, #PedsHM and subspecialities! Adult hospitalists: love to hear from you since the study was done on adult medicine rounds. @DrStevenTChen: were you involved w/this study?
Healthcare discovery @HealthTypes
RT @JHospMedicine: #JHMChat is TONIGHT at 9pET on @TWDFNR with @tony_breu, moderated by @FutureDocs with live sketches by @gracefarris— Con…
Chris Carroll MD MS @ChrisCarrollMD
RT @JHospMedicine: T3 In @TWDFNR, Contact isolation for MSRA and VRE was described as ineffective & potentially harmful. @TWDFNR recommen…
J Hospital Medicine @JHospMedicine
RT @michellebr00ks: CT - I didn't realize ditching the CP would be so controversial, since our hospital switched relatively easily. I feel…
R Logan Jones, M.D. @rloganjonesmd
@aoglasser @medpedshosp I think there are some questions best left unanswered #jhmchat
Avital O'Glasser, MD FACP FHM @aoglasser
@rloganjonesmd @medpedshosp #jhmchat https://t.co/V47fQjcxFG
Michelle Brooks, MD, FACP, FHM @michellebr00ks
So fun everyone! See you guys soon!! #JHMChat #HospMed19
Salah S. Qutaishat @salahq
I suggest that we form a panel to discuss the PCR panels added burden of precautions in healthcare #JHMChat
Rebecca Jaffe @RJmdphilly
@michellebr00ks Its funny - before reading @rloganjonesmd tweetorial i actually didn't realize that CP was controversial. I mean we are TRYING SO HARD to get people to wear the damn things. Didn't know it was an option to opt out. #JHMChat
J Hospital Medicine @JHospMedicine
RT @SHMLive: Share your final #JHMChat thoughts, then claim #CME! https://t.co/zJYslL00dW https://t.co/wUqgL1nNej
J Hospital Medicine @JHospMedicine
RT @gracefarris: 😛 rampant bathroom humor tonight🚽 #JHMChat https://t.co/R7wEPAOznk
The Curbsiders @thecurbsiders
We hear @KashlakHospital is hiring! #JHMChat
Avital O'Glasser, MD FACP FHM @aoglasser
@rloganjonesmd @medpedshosp #jhmchat because I wanted to confirm for you that i did not miss your earlier GIF... https://t.co/JlAenbDg16
J Hospital Medicine @JHospMedicine
RT @michellebr00ks: #JHMChat - for the tweetiatricians in the house! https://t.co/s5dQXW4UOX
J Hospital Medicine @JHospMedicine
RT @ben_geisler: I'm wondering if the effect of chlorhexidine bathing differs dramatically according to the baseline MRSA (I don't think th…
Avital O'Glasser, MD FACP FHM @aoglasser
@michellebr00ks #jhmchat got to start my day with @michellebr00ks and @RJmdphilly, got to end my day with them!! I love #medtwitter
Kristen Young @kristenyoung
@JHospMedicine @TWDFNR @tony_breu Thank you again for covering both of these topics, even better to see the vast opinions of both CP and docusate. #JHMchat
Vinny Arora MD MAPP @FutureDocs
love THIS #JHMChat meets #womeninmedicine #timesuphc
Rebecca Jaffe @RJmdphilly
@gracefarris @FutureDocs Yeah I keep not tagging #JHMChat when I get too off topic, but maybe I should just lump it all in because it's all part and parcel...
Michelle Brooks, MD, FACP, FHM @michellebr00ks
@aoglasser @RJmdphilly #besties #JHMChat https://t.co/1eUKiVrhws
Salah S. Qutaishat @salahq
Thanks #jhmchat team al. for a great chat https://t.co/PMvlOvPISe
Vinny Arora MD MAPP @FutureDocs
@RJmdphilly @gracefarris if its any consolation, as the moderator I feel like the side convo are an important capture of the purpose of #JHMchat - learn and support each other.
Avital O'Glasser, MD FACP FHM @aoglasser
@RJmdphilly @gracefarris @FutureDocs #jhmchat AND...because I just heard "ew, did you just eat your bugger" being said by my husband in the direction of the 5.5yo from across the house... https://t.co/EPOQ9spBva
Vinny Arora MD MAPP @FutureDocs
@aoglasser @michellebr00ks @RJmdphilly i need to get on this schedule #jhmchat
Rebecca Jaffe @RJmdphilly
@SMcGrathICP @salahq I know I can ask my infection control folks, but out of curiosity - are there generally accepted guidelines for local epi and determining facility risk? Seems like a worthwhile addition to a general #TWDFNR discussion (ie - for no reason, except in these situations...) #JHMChat
Avital O'Glasser, MD FACP FHM @aoglasser
#jhmchat thank you for the healthy dose of absurdism and excellent learning to end my Monday!! (must have been inspired by the puns...) https://t.co/ErAlLvl9RP
Avital O'Glasser, MD FACP FHM @aoglasser
@FutureDocs @michellebr00ks @RJmdphilly #jhmchat file this under "has #medtwitter or #JHMchat ever led to any scholarly collaborations?" :)
Benjamin P. Geisler @ben_geisler
thanks @JHospMedicine @TWDFNR @tony_breu @FutureDocs @WrayCharles for tonight's #JHMchat - good times! now #SIESTA https://t.co/gqijOBQ2Ty
J Hospital Medicine @JHospMedicine
Look forward to seeing everyone at #HospMed19 #jhmchat details on tweetup coming soon....
R Logan Jones, M.D. @rloganjonesmd
@medpedshosp @aoglasser A3: a research question always had : does the floor cleaning machine that goes down the hall ACTUALLY make the hospital MORE dirty/prone to spread of infection compared to old fashion mop (via aerosolized particulate matter on hard floors) #jhmchat #InfectionPrevention https://t.co/ePe3GqJAP8
Avital O'Glasser, MD FACP FHM @aoglasser
#JHMchat two weeks!!!
Vinny Arora MD MAPP @FutureDocs
RT @ben_geisler: thanks @JHospMedicine @TWDFNR @tony_breu @FutureDocs @WrayCharles for tonight's #JHMchat - good times! now #SIESTA https:/…
Vinny Arora MD MAPP @FutureDocs
RT @JHospMedicine: Look forward to seeing everyone at #HospMed19 #jhmchat details on tweetup coming soon....
Rebecca Jaffe @RJmdphilly
@aoglasser @michellebr00ks ...and @MargMChapman about whom we learned that her phone was named loosely after 80s-90s rap star who will go unnamed (for now) #jhmchat (taking all my self control not to add a gif!)
Society of Hospital Medicine @SocietyHospMed
RT @JHospMedicine: Look forward to seeing everyone at #HospMed19 #jhmchat details on tweetup coming soon....
Avital O'Glasser, MD FACP FHM @aoglasser
@rloganjonesmd @medpedshosp #jhmchat i feel like there have been roomba horror stories... https://t.co/T6flJIvYFZ
Michelle Brooks, MD, FACP, FHM @michellebr00ks
@RJmdphilly @aoglasser @MargMChapman HAHAHAHAHA!! She can't hotspot. #JHMChat
J Hospital Medicine @JHospMedicine
RT @kristenyoung: @JHospMedicine @TWDFNR @tony_breu Thank you again for covering both of these topics, even better to see the vast opinions…
Avital O'Glasser, MD FACP FHM @aoglasser
@michellebr00ks @RJmdphilly @MargMChapman #jhmchat yes, it was a very good monday!! https://t.co/U7d4ou2s4j
Grace Farris MD @gracefarris
RT @aoglasser: @RJmdphilly @gracefarris @FutureDocs #jhmchat AND...because I just heard "ew, did you just eat your bugger" being said by my…
Guilherme Barcellos @brhospitalist
#jhmchat
Grace Farris MD @gracefarris
RT @FutureDocs: @RJmdphilly @gracefarris if its any consolation, as the moderator I feel like the side convo are an important capture of th…
Sonya TG @STangGirdwood
@AdamRodmanMD @pccm_doc @freckledpedidoc @jmomdphd @JHospMedicine @TWDFNR Haha, I blame asthma on the brain. #JHMchat
#jhmchat content from Twitter.