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SHM White Papers

As a part of SHM's mission, we strive to provide our members with up-to-date research on hospital medicine, as well as opinions from various thought-leaders throughout the specialty.

These thoughts and research are reflected in special publications from SHM. Our white papers provide facts and opinions on several different areas of hospital medicine. Through the work of SHM's various committees, task forces and specialists in each area, these publications are born to be a resource for hospitalists.

What Every Hospitalist Should Know about Seizures and Epilepsy
Management of Seizures and Epilepsy: A Practical Guide for the Hospitalist

Hospitalists frequently find themselves as the frontline providers of neurological care and involved in the evaluation and management of patients with seizures and epilepsy. In some cases, the seizure is a symptom of another condition or a side effect of medication; in other cases, the seizure is actually epilepsy.

A working knowledge of seizure management and the breadth of issues facing these patients and their providers is critical. The Society of Hospital Medicine (SHM) has gathered an expert panel – led by SHM member David Likosky, MD, SFHM – to provide our members with information and tools to help elevate the standard of care for these patients. Dr. Likosky is joined by leading hospitalists, neurohospitalists and an epileptologist. 

Click here to view campaign materials

Society of Hospital Medicine / American Society of Health-System Pharmacists Joint Pharmacoeconomics Survey

A joint survey was conducted by the Society of Hospital Medicine (SHM) and the American Society of Health-System Pharmacists (ASHP) to analyze the use of pharmacoeconomics in making formulary decisions in hospitals. Pharmacoeconomic methods evaluate the value of effects compared to the cost of pharmaceutical products when making decisions on changes to the formulary system. The survey found pharmacoeconomic methods rank low as a decision influencer on formulary changes. In the study, 87 percent of physicians and pharmacists working in hospitals felt that pharamacoeconomic methods should be used when considering additions or deletions to their hospital formulary. However, when making formulary decisions, respondents reported that clinical and therapeutic factors contribute most to these decisions (54 percent), followed by drug costs (24 percent), pharmacoeconomic methods (13 percent), and patient quality of life (9 percent).

View the final report from the Pharmaeconomics Survey

The Co-Management White Paper

"A Guide to Hospitalist/Orthopedic Surgery Co-Management" is the work of an expert panel comprising hospitalists, orthopedic surgeons, nurses, hospital administrators, pharmacist, and other key stakeholders engaged in building and establishing effective co-management programs. Recognizing that hospitalists have an increasing role in the medical management of surgical patients, SHM's Co-Management Advisory Panel identified recommendations and best practices that will assist institutions in developing comprehensive plans for program development and avoiding potential pitfalls. Topics of interest include: developing a service agreement, financial considerations, recommended metrics, and defining patient inclusion criteria.

View A Guide to Hospitalist/Orthopedic Surgery Co-Management White Paper

The Observation Unit White Paper

"The Observation Unit: An Operational Overview for the Hospitalist" is the work of the SHM Expert Panel on Observation Units. As there is an increasing role for the Hospitalist in Observation Medicine, the panel wrote this paper for Hospitalists and Hospital Medicine administrators to better understand both the implications of Observation Medicine for the Hospitalist and the basics of observation unit operations.

The white paper summarizes key findings with respect to observation unit operations and staffing, clinical care and outcomes, economics, and performance measurement.  Sample admission and discharge criteria, clinical protocols and suggested performance measures are included as a "starter set" for those considering a new program.

Convened in 2007, SHM's Expert Panel on Observation Units included physicians, pharmacists, nurses and case managers with expertise in hospital medicine, emergency and observation medicine, and cardiology. 

View the Observation Unit White Paper

Career Satisfaction White Paper

The first white paper, titled "A Challenge for a New Specialty: A White Paper on Hospitalist Career Satsifaction", is the work of the SHM Career Satisfaction Task Force. The Task Force wrote this paper for hospitalists, hospital medicine programs, and hospitals to use as a resource to improve job satisfaction.

The white paper is divided into what the Task Force identified as the four pillars of career satisfaction – autonomy/control, workload/schedule, reward/recognition and community/environment. For each of the four pillars, the paper outlines recommendations and specifies tools that hospitalist employers can use to improve the work environment.  Also included within the paper is a questionnaire that individual hospitalists can use to identify what factors are important to them in a job and how their current position is meeting their needs.

Formed in 2005, SHM's Career Satisfaction Task Force was assembled to identify opportunities to promote an environment to create hospitalist job satisfaction. The main mission is to 'identify specific working conditions in hospital medicine that promote success and wellness; to provide resources to enhance career satisfaction and to promote more research into hospitalist career satisfaction and help avoid burnout.'

View the Career Satisfaction White Paper.

Dashboard White Paper

The second white paper in the series is titled, "Measuring Hospitalist Performance: Metrics, Reports, and Dashboards." This white paper is the work of SHM's Benchmarks Committee.

The 'Dashboard White Paper' identifies 10 key performance metrics for hospitalists which are divided into three categories: descriptive, operational and clinical. In addition to identifying metrics and describing measurement issues, the paper outlines a five step process for developing a customized approach to performance reporting.

SHM's Benchmarks Committee began their work on this white paper in 2005 and set out with the goal to help hospitalists develop a common language and conceptual framework for monitoring performance. During the process, the committee kept these three common questions from hospital medicine groups in mind:

• What aspects of performance should we monitor?
• How and where do we get the information we need?
• What should we do with the information once we have it?

The paper addresses these and related questions, while making general recommendations based on best practices.

View or Purchase a copy of Measuring Hospitalist Performance: Metrics, Reports, and Dashboard.

Advocacy White Paper

An additional white paper authored by SHM's Public Policy Committee, "Hospitalists: Leading the Way to More Effective, Higher Quality Health Care", was created to introduce policymakers to hospitalists and their role in the U.S. health care system. The paper is intended to help legislators adopt policies and implement programs that recognize the value that hospitalists bring to the delivery of healthcare.

Following a brief overview of the evolution to hospital medicine, the paper provides demographic information on hospitalists, and explores their practice models, as well as education and training. The paper also examines the value hospitalists bring to health care and concludes with policy recommendations that could further define the value of hospitalists in improving the delivery of healthcare.

View a copy of Hospitalists: Leading the Way to More Effective, Higher Quality Health Care