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Brendon Shank
Associate Vice President, Communications
Society of Hospital Medicine
Tel: 267-702-2639


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 (

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 patients.

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 effectiveness.

“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, SFHM.

“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 Frost.

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 Wisely lists.

“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,” says Cassell.

SHM's Recommendations: Development and Implementation
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 (, 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 Recommendations

  1. Do not place, or leave in place, urinary catheters for incontinence or convenience or monitoring of output for non-critically ill patients.

  2. Do not prescribe medications for stress ulcer prophylaxis to medical inpatients unless at high risk for gastrointestinal (GI) complications.

  3. 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.

  4. Do not order continuous telemetry monitoring outside of the intensive care unit without using a protocol that governs continuation.

  5. 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 Recommendations

  1. Don't order chest radiographs in children with uncomplicated asthma or bronchiolitis.

  2. Don't routinely use bronchodilators in children with bronchiolitis.

  3. Don't use systemic corticosteroids in children under 2 years of age with an uncomplicated lower respiratory tract infection.

  4. Don't treat gastroesophageal reflux in infants routinely with acid suppression therapy.

  5. Don't use continuous pulse oximetry routinely in children with acute respiratory illness unless they are on supplemental oxygen.
For full details, rationales and evidence supporting all SHM Choosing Wisely recommendations, visit


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

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