Raising the Bar for Procedural Competency Among Hospitalists
Authors: Jonathan T. Crocker, Caleb P. Hale, Anita Vanka, Daniel N. Ricotta, Jakob I. McSparron, Grace C. Huang
Journal: Annals of Internal Medicine (2019)

Ideas and Opinions7 May 2019Raising the Bar for Procedural Competency Among HospitalistsJonathan T. Crocker, MD, Caleb P. Hale, MD, Anita Vanka, MD, Daniel N. Ricotta, MD, Jakob I. McSparron, MD, and Grace C. Huang, MDJonathan T. Crocker, MDHarvard Medical School and Beth Israel Deaconess Medical Center, Boston, Massachusetts (J.T.C., C.P.H., A.V., D.N.R., G.C.H.), Caleb P. Hale, MDHarvard Medical School and Beth Israel Deaconess Medical Center, Boston, Massachusetts (J.T.C., C.P.H., A.V., D.N.R., G.C.H.), Anita Vanka, MDHarvard Medical School and Beth Israel Deaconess Medical Center, Boston, Massachusetts (J.T.C., C.P.H., A.V., D.N.R., G.C.H.), Daniel N. Ricotta, MDHarvard Medical School and Beth Israel Deaconess Medical Center, Boston, Massachusetts (J.T.C., C.P.H., A.V., D.N.R., G.C.H.), Jakob I. McSparron, MDUniversity of Michigan, Ann Arbor, Michigan (J.I.M.), and Grace C. Huang, MDHarvard Medical School and Beth Israel Deaconess Medical Center, Boston, Massachusetts (J.T.C., C.P.H., A.V., D.N.R., G.C.H.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M18-3007 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Hospitalists hold a central role in the delivery of high-quality medical care as providers, advocates, and leaders of safety and quality improvement initiatives. These facets of the hospitalist's professional identity intersect in bedside procedures. The core competencies of hospitalists include 5 such procedures: arthrocentesis, central venous catheter placement, lumbar puncture, abdominal paracentesis, and thoracentesis (1), all of which are associated with real risks to patients (for example, 4% risk for thoracentesis-associated pneumothorax [2] and 3% risk for paracentesis-associated hemorrhage [3]). However, there is neither uniformity in nor guidance about the assessment of these skills. Moreover, generalists are doing fewer procedures ...References1. Nichani S, Fitterman N, Lukela M, Crocker J; Society of Hospital Medicine. The Core Competencies in Hospital Medicine 2017 Revision. Section 2: procedures. J Hosp Med. 2017;12:S44-54. [PMID: 28411300] doi:10.12788/jhm.2728 CrossrefMedlineGoogle Scholar2. Ault MJ, Rosen BT, Scher J, Feinglass J, Barsuk JH. Thoracentesis outcomes: a 12-year experience. Thorax. 2015;70:127-32. [PMID: 25378543] doi:10.1136/thoraxjnl-2014-206114 CrossrefMedlineGoogle Scholar3. De Gottardi A, Thévenot T, Spahr L, Morard I, Bresson-Hadni S, Torres F, et al. Risk of complications after abdominal paracentesis in cirrhotic patients: a prospective study. Clin Gastroenterol Hepatol. 2009;7:906-9. [PMID: 19447197] doi:10.1016/j.cgh.2009.05.004 CrossrefMedlineGoogle Scholar4. Ault MJ, Rosen BT. Proceduralists — leading patient-safety initiatives [Letter]. 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[PMID: 29340341] doi:10.12788/jhm.2917 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, Massachusetts (J.T.C., C.P.H., A.V., D.N.R., G.C.H.)University of Michigan, Ann Arbor, Michigan (J.I.M.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M18-3007.Corresponding Author: Grace C. Huang, MD, 330 Brookline Avenue, E-ES/202A, Boston, MA 02215; e-mail, [email protected]harvard.edu.Current Author Addresses: Drs. Crocker, Hale, Vanka, Ricotta, and Huang: 330 Brookline Avenue, PBS/2, Boston, MA 02215.Dr. McSparron: 1500 East Medical Center Drive, SPC 5361, Ann Arbor, MI 48109.Author Contributions: Conception and design: J.T. Crocker, A. Vanka, J.I. McSparron, G.C. Huang.Analysis and interpretation of the data: J.T. Crocker, D.N. Ricotta, J.I. McSparron, G.C. Huang.Drafting of the article: J.T. Crocker, D.N. Ricotta, J.I. McSparron, G.C. Huang.Critical revision of the article for important intellectual content: J.T. Crocker, J.I. McSparron, G.C. Huang.Final approval of the article: J.T. Crocker, C.P. Hale, A. Vanka, D.N. Ricotta, J.I. McSparron, G.C. Huang.Statistical expertise: G.C. Huang.Administrative, technical, or logistic support: J.T. Crocker, A. Vanka, D.N. Ricotta, G.C. Huang.Collection and assembly of data: J.T. Crocker, D.N. Ricotta.This article was published at Annals.org on 23 April 2019. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoRaising the Bar for Procedural Competency Among Hospitalists Joseph G. Weigel Raising the Bar for Procedural Competency Among Hospitalists Daniel N. Ricotta , Jakob I. McSparron , and Grace C. Huang Metrics Cited byAdvancing Internal Medicine Training: Experience of a Bedside Procedure Service as a Resident ElectiveMedical Procedure Services in Internal Medicine Residencies in the US: a Systematic Review and Meta-AnalysisCohort study of hospitalists' procedural skills: baseline competence and durability after simulation-based trainingSee One, Do One, Forget One: Early Skill Decay After Paracentesis TrainingProcedural Competency Among Hospitalists: A Literature Review and Future ConsiderationsRaising the Bar for Procedural Competency Among HospitalistsJoseph G. Weigel, MD 7 May 2019Volume 170, Issue 9Page: 654-655KeywordsDisclosureHospital medicineHospitalistsMedical educationQuality improvementRadiologistsResidencySafetySurgeryUltrasound imaging ePublished: 23 April 2019 Issue Published: 7 May 2019 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...