Title: Assistant professor of medicine pediatrics; director of the general internal-medicine comprehensive consultation service
Institution: Johns Hopkins Hospital, Baltimore
RIV: “An Internet-Based Consult Curriculum for Hospitalists” (innovations)
Dr. Feldman’s poster described an online CME curriculum for hospitalists acting as medical consultants. The concept grew out of a perceived deficiency in his own medical education when, in 2004, he was asked to lead the consultation service at Johns Hopkins—just six months after finishing his residency.
“I had no idea what I was doing as a general-internal-medicine consultant,” he says. “I maybe received two weeks of experience as a consultant during my residency. I was willing to take it on, learning on the job and asking for help. But it occurred to me that I’m probably not alone in feeling unprepared.”
In his quest for self-education, Dr. Feldman wondered whether he should write a textbook on the subject. “But the information changes so quickly, I thought I’d have a better chance to reach people online,” he notes.
After talking to publishers and CME companies, he came up with the concept of learning modules on perioperative and consultative medicine topics, which could be taken online while earning CME credits. Johns Hopkins served as the CME certifier, and medical-education company Advanced Studies in Medicine joined as a partner. Once the project got off the ground, a medical advisory committee was convened.
“Winning the SHM poster competition is a great honor to have on a CV. It really helps to legitimize your name in the world of hospital medicine,” Dr. Feldman says. “It also provided confirmation that we were on the right track with the curriculum project. People valued what we were doing.”
Dr. Feldman and SHM have since become affiliated, and the “Consultative and Perioperative Medicine Essentials for Hospitalists” modules are available on SHM’s website (www.shmconsults.com). The site has 12,000 registered members completing 500 CME modules every month.
“I do a lot of the editing still,” Dr. Feldman says. “We update the modules every two years and are still creating new ones.”
Dr. Feldman also pursues a number of clinical-research interests, including resident education and costs of care.
Title: Assistant professor of medicine
Institution: Medical University of South Carolina, Charleston
RIV: “Intensivists versus Hospitalists in the ICU: A Prospective Cohort Study Comparing Mortality and Length of Stay Between Two Staffing Models” (research) Citation: Wise KR, Akopov VA, Williams BR, Ido MS, Leeper KV, Dressler DD. Hospitalists and intensivists in the medical ICU: a prospective and observational study comparing mortality and length of stay between two staffing models. J Hosp Med. 2012;7(3):183-189.
Dr. Wise was recognized for research that began while she worked at Emory University in Atlanta, comparing hospitalists and intensivists in such outcomes as length of stay and mortality rates for patients in the ICU. The study was one of the first statistically rigorous examinations of this critical quality question. With an eye toward improving patient safety, national quality advocates such as the Leapfrog Group have called for hospitals to employ intensivists (critical-care specialists) to manage the care of ICU patients. In reality, Dr. Wise says, there aren’t enough intensivists to meet the need.
“Hospitalists are in the ICU anyway,” she says. “We just don’t have enough data to answer how well they do [in comparison to intensivists].”
Through a prospective cohort study of more than 1,000 patients, Dr. Wise’s group found that there was essentially no statistical difference in mortality rates between patients treated by intensivist teams or hospitalist ICU teams.