Value of Palliative Care Shines Clearly in a Crisis Hospitalists Have Played a Key Role

August 2020 MEDICAL RECORDS PEDIATRICS COVID-19 Volume 24 No. 8 SHM research offers PHM designation remains Multidisciplinary coalition p9 insight on EMRs p12 hot topic p22 manages pandemic See the CAREER GUIDE on p14 Value of palliative care shines clearly in a crisis Hospitalists have played a key role By Larry Beresford or some palliative care professionals, the COVID-19 pandemic, particularly in viral hot spots like New York City, represents a “moment” that could lead to greater aware- Fness of what this service offers to seriously ill Dr. Rab Razzak, patients in a crisis. hospitalist and They say it has provided an opportunity to show clinical director of what palliative care teams can contribute to the dif- geriatrics and palliative ficult circumstances of patients with severe symp- medicine, University toms, isolated and alone in quarantined hospitals, Hospitals Cleveland with poor survival rates, perhaps sedated for extend- Medical Center ed stays on scarce ventilators – and for their family members, who are able to visit them only virtually via telephone or tablet. But it has also highlighted gaps – including in- sufficient staffing for some palliative care teams. ENTER Hospitalists and other clinicians in the hospital need C to learn the basics of primary palliative care, such EDICAL M as how to communicate bad news, initiate goals of care conversations, and address common symptoms LEVELAND C of serious illness, such as pain. That way, they could shoulder more of the demand for this kind of care OSPITALS H when palliative care specialists are in short supply. Hospitalists, some of whom also have pursued a NIVERSITY /U specialization in palliative care, have played key roles ATICA Continued on page 24 F ® IM K the-hospitalist.org THE BOARD ROOM COMMENTARY Darlene Tad-y, Swati Mehta, MD, SFHM MD Dear 2020, where do we go The ‘6H model’: How to 500 PERMIT p8 from here? Reflections on p13 truly connect with your Denville, NJ 07834-3000 NJ Denville, PA HARRISBURG PAID P.O. Box 3000, 3000, Box P.O. POSTAGE U.S. HM and the future. patients. CHANGE SERVICE REQUESTED SERVICE CHANGE THE HOSPITALIST THE STD PRSRT 01_24_25_HOSP20_08.indd 1 7/22/2020 3:40:34 PM FROM THE SOCIETY August 2020 Volume 24 No. 8 Coming soon: PHYSICIAN EDITOR THE SOCIETY OF HOSPITAL MEDICINE Weijen W. Chang, MD, SFHM, FAAP Phone: 800-843-3360 [email protected] Fax: 267-702-2690 Website: www.HospitalMedicine.org The 2020 SoHM Report! PEDIATRIC EDITOR Anika Kumar, MD, FHM, FAAP Chief Executive Officer [email protected] Eric E. Howell, MD, MHM By Leslie Flores, MHA, SFHM COORDINATING EDITORS Dennis Chang, MD Marketing Communications Manager THE FUTURE HOSPITALIST Brett Radler n behalf of SHM’s Prac- [email protected] tice Analysis Committee, Keri Holmes-Maybank, MD, FHM I am excited to announce KEY CLINICAL GUIDELINES Marketing Communications Specialist CONTRIBUTING WRITERS Caitlin Cowan the scheduled September [email protected] O2020 release of the 2020 State of Larry Beresford Thomas R. Collins Hospital Medicine Report (SoHM)! Aron Egelko, MD SHM BOARD OF DIRECTORS For reasons all too familiar, this Leslie Flores, MHA, SFHM President year’s SoHM survey process was un- Alicia Gallegos Danielle Scheurer, MD, MSCR, SFHM President-Elect like any in SHM’s history. We were Lesley B. Gordon, MD, MS Elizabeth L. Herrle, MD Jerome C. Siy, MD, SFHM still collecting survey responses John Hessburg Treasurer from a few stragglers in early March Anjali Jaiman Rachel Thompson, MD, MPH, SFHM Secretary Chandra Lingisetty, MD, MBA, MHCM when the entire world shut down al- Kris Rehm, MD, SFHM Kayla Matthews Immediate Past President most overnight to flatten the curve Swati Mehta, MD of a deadly pandemic. Hospital Christopher Frost, MD, SFHM Leigh Page Board of Directors medicine group (HMG) leaders were Ms. Flores is a partner at Nelson Venkataraman Palabindala, MD, MBA, SFHM Tracy Cardin, ACNP-BC, SFHM Flores Hospital Medicine Darlene Tad-y, MD, SFHM Steven B. Deitelzweig, MD, Monica L. Wang, ScD, MS Consultants in La Quinta, Calif. MMM, FACC, SFHM Bryce Gartland, MD, FHM She serves on SHM’s Practice FRONTLINE MEDICAL Flora Kisuule, MD, MPH, SFHM Analysis and Annual Conference COMMUNICATIONS EDITORIAL STAFF Mark W. Shen, MD, SFHM Committees and helps to Executive Editor Kathy Scarbeck, MA Darlene Tad-y, MD, SFHM Editor Richard Pizzi Chad T. Whelan, MD, FACP, FHM coordinate SHM’s biannual State of Creative Director Louise A. Koenig Hospital Medicine survey. Director, Production/Manufacturing FRONTLINE MEDICAL suddenly either up to their eyeballs Rebecca Slebodnik COMMUNICATIONS ADVERTISING STAFF trying to figure out how to safely EDITORIAL ADVISORY BOARD National Account Manager care for huge influxes of COVID-19 they helped issue and analyze a Hyung (Harry) Cho, MD, SFHM; Valerie Bednarz, 973-206-8954 Marina S. Farah, MD, MHA; cell 973-907-0230 [email protected] patients that overwhelmed estab- follow-up survey to investigate how Ilaria Gadalla, DMSc, PA-C; Classified Sales Representative lished systems of care or were try- HMGs adjusted their staffing and James Kim, MD; Heather Gonroski, 973-290-8259 ing to figure out how to staff in a operations in response to COVID! Ponon Dileep Kumar, MD, FACP, CPE; [email protected] Shyam Odeti, MD, MS, FHM; Linda Wilson, 973-290-8243 low-volume environment with few As I write this, we appear to be back Venkataraman Palabindala, MD, SFHM; [email protected] COVID patients, a relative trickle on schedule for a September SoHM Tiffani M. Panek, MA, SFHM, CLHM; Senior Director of Classified Sales of ED admissions, and virtually no release date, with the COVID supple- Adhikari Ramesh, MD, MS; Tim LaPella, 484-921-5001 Raj Sehgal, MD, FHM; cell 610-506-3474 [email protected] surgical care. And everywhere, hos- mental survey report to follow soon Kranthi Sitammagari, MD; pitals and their HMGs were quickly after. Thanks also to PAC committee Amith Skandhan, MD, FHM; Advertising Offices 7 Century Drive, stressed in ways that would have members who, despite their own Lonika Sood, MD, FACP, FHM; Suite 302, Parsippany, NJ 07054-4609 Amit Vashist, MD, FACP 973-206-3434, fax 973-206-9378 been unimaginable just a couple stresses, rose to the challenge of of months earlier – financially, op- participating in calls and planning erationally, epidemiologically, and the supplemental survey. THE HOSPITALIST is the official newspaper of the THE HOSPITALIST (ISSN 1553-085X) is published Society of Hospital Medicine, reporting on issues monthly for the Society of Hospital Medicine by culturally. Despite the pandemic, HMGs and trends in hospital medicine. THE HOSPITALIST Frontline Medical Communications Inc., 7 Century SHM offices closed, with all staff found survey participation valu- reaches more than 35,000 hospitalists, physician Drive, Suite 302, Parsippany, NJ 07054-4609. Print assistants, nurse practitioners, medical residents, and subscriptions are free for Society of Hospital Medi- working from home. And the tal- able. When all was said and done, health care administrators interested in the practice cine members. Annual paid subscriptions are avail- ented people who would normally we had a respectable number of and business of hospital medicine. Content for able to all others for the following rates: THE HOSPITALIST is provided by Frontline Medical have been working diligently on the respondent groups: 502 this year vs. Communications. Content for the Society Pages is Individual: Domestic – $195 (One Year), survey data were suddenly redirect- 569 in 2018. Although the number provided by the Society of Hospital Medicine. $360 (Two Years), $520 (Three Years), Canada/Mexico – $285 (One Year), $525 (Two Years), ed to focus on COVID-related issues, of respondent groups is down, the Copyright 2020 Society of Hospital Medicine. All $790 (Three Years), Other Nations - Surface – $350 including tracking government an- average group size has increased, rights reserved. No part of this publication may be (One Year), $680 (Two Years), $995 (Three Years), reproduced, stored, or transmitted in any form or by Other Nations - Air – $450 (One Year), $875 (Two nouncements that were changing so that an all-time high of 10,122 any means and without the prior permission in writing Years), $1,325 (Three Years) daily and providing needed resourc- employed/contracted full-time from the copyright holder. The ideas and opinions expressed in The Hospitalist do not necessarily Institution: United States – $400; es to SHM members. By the time equivalent (FTE) hospitalists (plus reflect those of the Society or the Publisher. The Canada/Mexico – $485 All Other Nations – $565 they could raise their heads and be- 484 locum tenens FTEs) are repre- Society of Hospital Medicine and Frontline Medical Student/Resident: $55 Communications will not assume responsibility for gin thinking about survey data, we sented in the data set. The respon- damages, loss, or claims of any kind arising from Single Issue: Current – $35 (US), $45 (Canada/ were months behind schedule. dents continue to be very diverse, or related to the information contained in this Mexico), $60 (All Other Nations) Back Issue – $45 publication, including any claims related to the (US), $60 (Canada/Mexico), $70 (All Other Nations) I need to give a huge shout-out representing all practice models products, drugs, or services mentioned herein. POSTMASTER: Send changes of address (with old to our survey manager extraordi- and every state – and even a couple Letters to the

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