Associate Vice President, Communications
Society of Hospital Medicine
Society of Hospital Medicine
Publishes Ten Recommendations for Choosing Wisely®
Recommendations Enable the Nation's 40,000
Hospitalists to Improve Decision Making for Patient Care
WASHINGTON, DC (February 21, 2013) — The
Society of Hospital Medicine (SHM) has published two lists of
recommendations intended to guide hospitalists toward high-value care
in the hospital as part of the Choosing Wisely® campaign,
an initiative of the ABIM Foundation (www.choosingwisely.org).
Based in Philadelphia, SHM is among only a handful of medical
societies participating in the Choosing Wisely campaign to
publish two lists of five recommendations each: one for hospitalists
caring for adult hospital patients and another for pediatric hospital
The recommendations include advisories against overuse of procedures
that can put hospitalized patients at risk for common but avoidable
problems, such as healthcare-acquired infections and adverse drug events
that can increase costs of care. They also warn against the use of
common, but inappropriately utilized, treatments that have limited
“The Choosing Wisely campaign provides hospitalists
and their patients with a critical opportunity to begin a conversation
about medical tests and procedures that are frequently performed but
may not improve outcomes,” says SHM President Shaun D. Frost, MD,
“The Society of Hospital Medicine offers a unique perspective
to the Choosing Wisely conversation in that its members play an
integral role in both pediatric and adult medical care,” says
SHM and Choosing Wisely
Releasing lists along with SHM today are 16 other organizations
representing more than 350,000 physicians, nurses, pathologists,
radiologists and other healthcare professionals. All the lists released
today as part of the Choosing Wisely campaign were developed
after months of careful consideration and review. Using the most
current evidence about management and treatment options within their
specialties, the societies believe the recommendations can make a
significant impact on patient care, safety and quality. In April 2012,
nine medical specialty societies each released Choosing
“Twenty-five of the nation's leading medical specialty
societies have now spoken up and shown leadership by identifying what
tests and treatments are common to their profession, but not always
beneficial,” says Christine K. Cassel, MD, president and CEO of
the ABIM Foundation.
“Millions of Americans are increasingly realizing that when it
comes to health care, more is not necessarily better. Through these
lists of tests and procedures, we hope to encourage conversations
between physicians and patients about what care they truly need,”
SHM's Recommendations: Development and
To develop its lists, SHM convened two expert panels – one for adult
hospital medicine, led by Dr. John B. Bulger, DO, MBA, Chief Quality
Officer for the Geisinger Health System, and another for pediatrics,
led by Dr. Ricardo Quinonez, MD, FAAP, FHM, Associate Professor in the
Section of Pediatric Hospital Medicine at Baylor College of
Medicine/Texas Children's Hospital.
More than 8,000 member hospitalists were surveyed to better
understand how SHM could help promote better choices for hospitalists
and patients. The expert panels then narrowed their recommendations down
to five for each list and provided the ABIM Foundation with the
rationales and evidence to support them.
SHM's involvement with the Choosing Wisely campaign will
continue throughout 2013. In May, the leaders of SHM's Choosing
Wisely initiatives will be presenting three different sessions
about implementing the recommendations at the largest national meeting
of hospitalists, Hospital Medicine 2013 in May in Washington, DC (www.hospitalmedicine2013.org), including a
comprehensive all-day course that provides participants with the
foundation for implementing the recommendations.
SHM will also be publishing the recommendations, methodology and an
in-depth discussion about them in its peer-reviewed journal, the
Journal of Hospital Medicine.
“In the coming year, we encourage hospitalists to adopt the
recommendations of the Choosing Wisely campaign through
education, advocacy and outreach to further promote excellence in the
practice of hospital medicine,” says SHM President Frost.
“We look forward to furthering the robust public dialogue the
campaign has already inspired, and anticipate collaborating with our
colleagues to lead the implementation of Choosing Wisely
efforts at our nation's hospitals,” says Frost.
SHM's Choosing Wisely Adult Hospital Medicine
- Do not place, or leave in place, urinary catheters for
incontinence or convenience or monitoring of output for non-critically
- Do not prescribe medications for stress ulcer prophylaxis to
medical inpatients unless at high risk for gastrointestinal (GI)
- Avoid transfusions of red blood cells for arbitrary hemoglobin or
hematocrit thresholds and in the absence of symptoms of active coronary
disease, heart failure or stroke.
- Do not order continuous telemetry monitoring outside of the
intensive care unit without using a protocol that governs
- Do not perform repetitive complete blood count (CBC) and
chemistry testing in the face of clinical and lab stability.
SHM's Choosing Wisely Pediatric Hospital Medicine
For full details, rationales and evidence supporting all SHM
Choosing Wisely recommendations, visit www.hospitalmedicine.org/choosingwisely.
- Don't order chest radiographs in children with uncomplicated
asthma or bronchiolitis.
- Don't routinely use bronchodilators in children with
- Don't use systemic corticosteroids in children under 2 years
of age with an uncomplicated lower respiratory tract
- Don't treat gastroesophageal reflux in infants routinely
with acid suppression therapy.
- Don't use continuous pulse oximetry routinely in children
with acute respiratory illness unless they are on supplemental
Representing the fastest growing specialty in modern healthcare, the
Society of Hospital Medicine (SHM) is the leading medical society for
more than 40,000 hospitalists and their patients. SHM is dedicated to
promoting the highest quality care for all hospitalized patients and
overall excellence in the practice of hospital medicine through quality
improvement, education, advocacy and research. Over the past decade,
studies have shown that hospitalists can contribute to decreased patient
lengths of stay, reductions in hospital costs and readmission rates, and
increased patient satisfaction.
For more information about SHM and
hospital medicine, visit www.hospitalmedicine.org.
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