Vol 26, Issue 3
Carlton Moore, MD Associate Chief, Quality Improvement & Scholarship
UNC Division of Hospital Medicine¶
Hospitalist Happenings¶
VIEW FROM THE NINTH FLOOR¶
Quality Improvement and Research¶
Division of Hospital Medicine Awarded Institute for Quality Improvement (IHQI) Grant¶
Congratulations to Aaron Fried and team for securing an IHQI grant for the 2025-26 academic year. This grant will enable the implementation of a daily rounding checklist on hospital medicine teaching teams. The checklist will encompass essential items such as the ongoing necessity of Foley catheters, intravenous antibiotics, and intravenous opioids (as illustrated in the accompanying figure).
Theabovedriveoffersarepresentativesampleofmanybutnotallofthedriversweaimtoaddresswith ourinpatient checklist.
RoundingReportChecklist,²pairedwithbowelregimenassessment¶
How do I get data for my Quality Improvement (QI) project?¶
Do you need Epic data pulled for your QI project but don't know who to turn to, have I got great news for you!
The UNC Health Office of Quality Excellence (OQE) offers a free consult service to pull data for UNC healthcare providers conducting QI projects. In my experience the turnaround time to get data is about 2-weeks.
| QI &Research | 1-2 |
|---|---|
| Announcements | 2 |
| Faculty Development | 3 |
| Consults | 4-5 |
| Hospitalist Highlight | 6 |
Just navigate to the OQE website (https://unchcs.sharepoint.com/sites/MCOQE?web=1) and under the 'Data' drop -down list, click on 'Data Request Hospital' (see figure). The website can only be accessed if you're on the UNC Health network, either on -campus or remotely on your Citrix desktop.
So, if you're involved in a QI project that needs Epic data pulled, try this out. If you run into problems or just want to talk about requesting data pulls for QI projects let me know and I'm happy to help.
The project holds significant potential to enhance patient safety, thereby reducing the length of stay and mitigating the incidence of hospitalacquired infections. We will provide further details about the project and solicit your feedback on its implementation at a future works in progress meeting.
Hospitalist Happenings¶
Hospital Medicine Support for Scholarly Activity¶
Escher Howard-Williams has protected time to help folks write manuscripts and abstracts for their projects. Over the past year, Escher has worked with faculty to support and publish several manuscripts and abstracts. Escher is amazing and has been a great resource for the HM Division. Let me or Escher know if you have a project you're considering for publication. We can discuss how best to utilize Escher's time to get your work published. Please see below for information that's helpful for Escher to know for her to speed up the process.
| Research Manuscripts | Case Reports |
|---|---|
| 1. Outline, draft, or abstract | 1. MRN and date of hospitalization |
| 2. All available data and IRB status | 2. Key discussion points |
| 3. Methods of data analysis (if applicable) | 3. Literature review references |
| 4. References used from literature reviews for study | 4. List of authors to be included |
| 5. Key discussion points and Study limitations | 5. Draft or abstract (if available) |
| 7. List of authors to be included and target journals | 6. Target journal (if known), patient consent |
Announcements¶
Upcoming DHM Faculty Meetings¶
Noon -1:00 | PECR3 & Webex
August 13th: Agile Pathways w/ Shah Farooq & Sepsis Order Set w/ Dave Hemsey
August 20th: Journal Club w/ Christina Kahl
August 27th: Opportunities for AI w/ Michael Neuss
DHM Operations Weekly Huddle¶
Mondays, 12:30-1:00 | Zoom
Patrick O'Shea- Aug. 11th¶
Danicela Younce - Aug. 12th¶
Vibha Dholakia - Aug. 14th¶
Jessica Guidici - Aug. 15th¶
Dana Mabry - Aug. 15th¶
Saranya Sahadevan - Aug. 17th¶
Please email Sharon Baker ([email protected]) if you would like to recognize a fellow peer, share a personal work achievement, family/coworkers photos, or submit an announcement to be featured in future newsletters.
Faculty Development Didactic Schedule¶
I thought it would be worth laying out the schedule for our DHM Faculty Development sessions planned for this year. The schedule will largely be the same as last year with some minor adjustments. As always, if you have a suggestion for content, I would love to hear it!
Third Wednesday Sessions¶
These talks will have rotating content, aimed towards stimulating both thought and discussion about topics relevant to hospital medicine and the wider practice of medicine. They will again happen at noon on the third Wednesday of each month (unless conflicting with a major holiday) and we will try to provide ice cream!
- Health Equity -led by Josh Garcia
- Clinical Reasoning -led by Ann Marie Kumfer
- Humanities -led by Rimma Osipov
- Journal Club -led by Christina Kahl
Fourth Wednesday Sessions¶
These talks follow a larger curriculum plan of major topics, including large-group presentations, giving feedback, career tracks within hospital medicine, and applying for an IRB. We will also include quarterly M&Ms in this space, led by Paul Ossman. The sessions will continue on the fourth Wednesday of each month at noon (other than November/December). If anyone is interested in seeing or has suggestions for modifying the curriculum, I would be happy to share.
Triangle SHM Events¶
There are two upcoming events for the Triangle SHM Chapter, which is led by our very own Amy Tierney.
Tobacco Road Social Event¶
The next event will be a networking and membership-drive session, planned for August 16 th at 6 pm at the Tobacco Road Sports Café in Durham. The Bulls will be playing during the event, so you also get some free baseball! You can sign up here: https://www.eventzilla.net/e/shm-nc-triangle-chapter-event-2138660066
Triangle SHM RIV Competition¶
The next abstract competition and poster session is already scheduled, for October 14 at 5:30 pm at the North Carolina Biotechnology Center in Research Triangle Park. The call for abstracts is open with a due date of August 15 th at 11:59 pm! This is a great way to present scholarly material and network with your colleagues. Here is the link to the submission site: https://duke.qualtrics.com/jfe/form/SV_eUMfw9broSYjxWe
John Stephens, MD Associate Chief, Education & Faculty Development
Hospitalist Happenings¶
Hi everyone!¶
I have an exciting new update that will be going live on the consults service likely in the next couple weeks. There is soon to be a pilot regarding nephrology and medicine consults.
- First, to increase the educational value of general medicine consults for residents rotating through and provide them with a more typical experience of what non-academic hospitalists see during consults;
- And second, to triage more straightforward consults from the nephrology consult team so that focus can be on more complex patients.
To do this, specific consult questions will be fielded by the nephrology fellow on call and reviewed with the attending. If felt appropriate for a medicine consult team, the nephrology fellow will reach out to the medicine consult team resident and pass along the consult. The nephrology fellow will also inform the consulting team of the triage decision if the consult is triaged to the medicine consult team. It may happen that the patient's clinical status changes and nephrology needs to be re -engaged. To address this, we provide instructions for when nephrology must be re-engaged, and outside of these requirements, leave it to the discretion of the medicine consult team.
The following conditions are covered:
- Non-severe hyponatremia
- Non-severe hypernatremia
- Hypertension
Below are flowsheets that will be used to determine how these consults should be triaged. As always, for questions or to give feedback, please reach out 919-608-5633.
Thanks, Ashmita¶
Hyponatremia¶
*Nephrology fellow informs consulting team of triage and adds patient to shared list
Ashmita Chatterjee, MD Physician Service Leader, Consults¶
Hospitalist Happenings¶
Hypernatremia¶
Appropriate for a Med M consult unless very severe (eg, with Na > 160 or with simultaneous volume overload requiring close diuretic adjustment)
*Nephrology fellow informs consulting team of triage and adds patient to shared list
Hypertension¶
- No ICU patients (this would capture folks who may have cerebral edema as well)
- No pregnant patients (eg, those for whom preeclampsia or related conditions are being considered)
If patients have CKD 4 or 5, consider keeping nephrology on board on a case-by-case basis
*Nephrology fellow informs consulting team of triage and adds patient to shared list
Hospitalist Highlights¶
Grant Gosden¶
'I'm originally from Atlanta, Georgia, went to college at the University of Georgia (Go Dawgs!), and attended medical school at the Medical College of Georgia. After a lifetime in the Peach State, it was time for a change in scenery. I followed my wife, Rachel, to Salt Lake City for residency. I enjoyed three years of lots of snowboarding and beautiful hikes in the mountains, but we both knew that ultimately we wanted to be closer to family on the east coast.
Rachel is currently a neonatology fellow at UNC, and together we enjoy hiking and biking, trying new restaurants, and taking our dog, Ruthie, to the dog park.'
Anna Symmes¶
'I am no stranger to the Triangle, having gone to undergrad at Duke (yes, you will hear about that during basketball season) where I met my husband, Matthew. I majored in Spanish, but always with the goal of medical school in mind. I then moved to DC for medical school at Georgetown where some amazing hospitalists convinced me that since I actually wanted to talk to my patients and enjoyed rounding I should go into IM instead of anesthesia. Up next was Houston for my residency at Baylor where I really used my Spanish skills a lot! Since then, Matthew and I have moved around quite bit for his job as a football coach. He's working on offense at NC State right now. We've also been with the Steelers, East Carolina University, Valparaiso University and Northwestern since we got married in 2019. Our dog, Elmo (named for Elmo's diner in Durham) has been with us since 2021, and this year, we welcomed our daughter Ellie in January. Life outside the hospital right now is library story times, cooking creative dinners, stroller walks, and of course, going to Matthew's football games!'