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Original Research Research Letters Journal of Hospital Medicine NO. MAY 2018 5 VOL. 13 www.journalofhospitalmedicine.com An Official Publication of the Society of Hospital Medicine Original Research Reviews Returns to Emergency Department, Observation, When are Oral Antibiotics a Safe and Effective or Inpatient Care Within 30 Days After Choice for Bacterial Bloodstream Infections? Hospitalization in 4 States, 2009 and 2010 An Evidence-Based Narrative Review Versus 2013 and 2014 Andrew J. Hale, et al Teryl K. Nuckols, et al Shorter Versus Longer Courses of Antibiotics EDITORIAL Patient-Centered, Payer-Centered, Volume 13, Number 5, May 2018 Volume for Infection in Hospitalized Patients: or Both? The 30-Day Readmission Metric A Systematic Review and Meta-Analysis Craig A. Umscheid and S. Ryan Greysen Stephanie Royer, et al Caregiver Perspectives on Communication EDITORIAL The Maturing Antibiotic Mantra: During Hospitalization at an Academic Pediatric “Shorter Is Still Better” Institution: A Qualitative Study Brad Spellberg Lauren G. Solan, et al ® EDITORIAL Engaging Families as True Partners Choosing Wisely : Things We Do During Hospitalization For No Reason Alisa Khan, et al Things We Do for No Reason—The “48 Hour Improving Teamwork and Patient Outcomes with Rule-out” for Well-Appearing Febrile Infants Daily Structured Interdisciplinary Bedside Rounds: Carrie Herzke, et al A Multimethod Evaluation Robyn Clay-Williams, et al Clinical Care Conundrum Hospitalist Perspective of Interactions with Scratching Beneath the Surface Medicine Subspecialty Consult Services Michael A. Santos, et al Traci N. Adams, et al Perspectives in Hospital Medicine Research Letters The Harm We Do: The Epidemiology and Clinical Associations The Environmental Impact of Medicine of Portal Vein Thrombosis in Hospitalized Patients Julia Schoen and Vineet Chopra With Cirrhosis: A Nationwide Analysis From the National Inpatient Sample Shawn L. Shah, et al Days of Therapy Avoided: A Novel Method for Measuring the Impact of an Antimicrobial Stewardship Program to Stop Antibiotics Pages 289–364 Siddhant Datta, et al EDITOR-IN-CHIEF Christopher P. Bonafide, MD, MSCE Joanna E. Thomson, MD, MPH THE SOCIETY OF HOSPITAL The Children’s Hospital of Philadelphia Cincinnati Children’s Hospital Medical Andrew Auerbach, MD, MPH, Center MEDICINE OFFICERS Anthony C. Breu, MD, FHM MHM Harvard Medical School Eduard Vasilevskis, MD Nasim Afsar, MD, SFHM University of California, San Vanderbilt University President Vineet Chopra, MD, FHM Francisco University of Michigan Medical Center Chad T. Whelan, MD, FHM Christopher Frost, MD, SFHM University of Chicago President-Elect Peter Cram, MD, MBA Danielle Scheurer, MD, MSRC, SFHM FOUNDING EDITOR UHN and Mt. Sinai Hospitals Jeffrey G. Wiese, MD, FACP, FHM Tulane University Treasurer Daniel D. Dressler, MD, MSc, SFHM Mark V. Williams, MD, MHM Emory University School of Medicine Tracy Cardin, ACNP-BC, SFHM University of Kentucky Center for Secretary Health Services Research Kathleen M. Finn, MD, FHM, FACP EDITORIAL BOARD Massachusetts General Hospital Ron Greeno, MD, FCCP, MHM Douglas W. Carlson, MD, SFHM Immediate Past President SENIOR DEPUTY EDITORS Ryan Greysen, MD Washington University University of California, San Francisco Patrick Conway, MD, MSc, FAAP, Daniel J. Brotman, MD, MHM SFHM BOARD MEMBERS Johns Hopkins Medical Center Christine Jones, MD, MS Cincinnati Children’s Hospital Medical University of Colorado Steven B. Deitelzweig, MD, MMM, Center Margaret Fang, MD, MPH, FHM FACC, FACP, SFHM University of California, San Francisco Lisa Kirkland, FACP Sunil Kripalani, MD, MSc, SFHM Mayo Clinic, Rochester Howard R. Epstein, MD, SFHM Shoshana J. Herzig, MD, MPH Vanderbilt University Beth Israel Deaconness Medical Center Nita S. Kulkarni, MD Kris Rehm, MD, SFHM Northwestern Medicine Joseph Ming Wah Li, MD, SFHM Tara Lagu, MD, MPH Beth Israel Deaconess Medical Center Bradley Sharpe, MD, FACP, SFHM Baystate Health Center for Quality of Brian P. Lucas, MD, MS, FHM Peter Lindenauer, MD, MSc, FHM Care Research White River Junction Vermont VAMC Jerome C. Siy, MD, SFHM Baystate Medical Center-Tufts Medical Luci K. Leykum, MD, MBA, MSc Anil Makam, MD, MAS School Rachel Thompson, MD, MPH, SFHM University of Texas Health Science Center UT Southwestern Medical Center Jennifer S. Myers, MD, FHM Patrick Torcson, MD, MMM, SFHM in San Antonio Andrew Masica, MD, MSCI, SFHM Hospital of the University of Pennsylvania Samir S. Shah, MD, MSCE, FHM Baylor Scott & White Health Sanjay Saint, MD, MPH Cincinnati Children’s Hospital Medical Hilary Mosher, MD University of Michigan Center University of Iowa Harold C. Sox, MD Sara Murray, MD Geisel School of Medicine at Dartmouth DEPUTY EDITORS University of California, San Francisco Robert M. Wachter, MD, MHM Vineet Arora, MD, FHM Aaron Neinstein, MD University of California, San Francisco University of Chicago University of California, San Francisco Winthrop F. Whitcomb, MD, MHM Leonard Feldman, MD, SFHM, FACP, Oanh Nguyen, MD, MAS University of Massachusetts Medical FAAP UT Southwestern Medical Center School Johns Hopkins Medical Center Michael Ong, MD, PhD Bradley Flansbaum, DO, MPH, FACP, UCLA, VA Greater Los Angeles SFHM Healthcare System NATIONAL CORRESPONDENTS Lenox Hill Hospital Jack M. Percelay, MD, MPH, FAAP, Keri Holmes-Maybank, MD Medical University of South Carolina Daniel Hunt, MD SFHM E.L.M.O. Pediatrics Emory University Nathan Houchens, MD Cleveland Clinic Foundation Somnath Mookherjee, MD Read G. Pierce, MD University of Colorado Medical Center University of Washington Bradley Monash, MD Rehan Qayyum, MD University of California, San Francisco Johns Hopkins Hospital ASSOCIATE EDITORS Andrew Odden, MD Gregory W. Ruhnke, MD, MPH Washington University, St. Louis Nasim Afsar, MD, SFHM University of Chicago Ronald Reagan UCLA Medical Center Andrew Olson, MD Danielle Scheurer, MD, MSc, SFHM University of Minnesota Eric J. Alper, MD, SFHM, FACP Medical University of South Carolina Lifespan Providence, Rhode Island Reza Sedighi Manesh, MD Jeffrey L. Schnipper, MD, MPH, FHM Johns Hopkins University Mel L. Anderson, MD, FACP Brigham and Women’s Hospital, Bradley Sharpe, MD University of Colorado School of Harvard Medical School Medicine University of California, San Francisco Ann M. Sheehy, MD, MS Andrew White, MD Robert N. Axon, MD University of Wisconsin Medical University of South Carolina University of Washington Heidi Sucharew, PhD Jeffrey H. Barsuk, MD, MS, FHM Cincinnati Children’s Hospital Medical Northwestern University Feinberg School Center of Medicine An Official Publication of the Society of Hospital Medicine Journal of Hospital Medicine Vol 13 | No 5 | May 2018 289 Publisher: The Journal of Hospital Medicine (Print ISSN 1553-5592; E-ISSN 1553- WEBSITE 5606) is published monthly for the Society of Hospital Medicine by Frontline Medical www.journalofhospitalmedicine.com Communications, with business offices at 7 Century Drive, Suite 302, Parsippany, NJ 07054-4609, telephone 973-206-3434, fax 973-206-9378. Periodicals postage paid at Parsippany, NJ and at additional mailing offices. EDITORIAL STAFF Postmaster: Send address changes to Journal of Hospital Medicine, Subscription Managing Editor Service, 151 Fairchild Ave, Suite 2, Plainview, NY 11803-1709. Susan D. Hite (240) 221-2471 [email protected] Copyright: Copyright © 2018 Society of Hospital Medicine. No part of this publication may be reproduced, stored or transmitted in any form or by any means without the prior permission in writing from the copyright holder. Authorization to photocopy items ART for internal and personal use is granted by the copyright holder for libraries and other users registered with their local Reproduction Rights Organization (RRO), e.g. Copyright Creative Director Clearance Center (CCC), 222 Rosewood Drive, Danvers, MA 01923, USA (www.copyright. Mary Ellen Niatas com), provided the appropriate fee is paid directly to the RRO. This consent does not Art Director extend to other kinds of copying such as copying for general distribution, for advertising John J. DeNapoli or promotional purposes, for creating new collective works or for resale. Disclaimer: The Publisher, Society of Hospital Medicine (SHM), and Editors cannot be PRODUCTION AND MANUFACTURING held responsible for errors or any consequences arising from the use of information contained in this journal; the views and opinions expressed do not necessarily reflect Production Manager those of the Publisher, SHM, and Editors, neither does the publication of advertisements Mike Wendt constitute any endorsement by the Publisher, SHM, and Editors of the products (973) 206-8010 advertised. 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