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Letter from the Editor

From the November ACP Hospitalist, copyright © 2009 by the American College of Physicians

This issue features the results of our second annual Top Hospitalists competition. Like last year, we asked our readers to nominate the best and brightest hospitalists they knew to be profiled in our pages. And like last year, we were excited about the response. The 10 hospitalists in our cover feature, chosen by our editorial advisory board, are a varied group of professionals working in different ways to make the field of hospital medicine better. You may recognize some of the names and faces of our Top Ten, but we also hope that some will be new to you. One of our favorite aspects of this annual feature is its ability to call some well-deserved attention to excellent work by inspiring people. Keep an eye on these pages for our 2010 call for nominations.

Also this month, we take a look at a thorny question for hospitalists: observation status. Physicians decide daily whether particular patients should be admitted as inpatients or monitored in observation units, but misclassification may soon become more costly. Medicare has started cracking down on admissions to the wrong service, planning to audit one-day admissions and recoup costs when its recovery audit contractors determine that observation would have been more appropriate. And even though the stakes are high, Medicare’s criteria for determining observation status are far from clear, experts say. Stacey Butterfield tackles the observation dilemma and outlines three different ways to help physicians make the right call.

Our latest Success Story looks at the Medical University of South Carolina Medical Center’s solution to managing blood glucose levels in the intensive care unit. With the help of a multi-disciplinary diabetes task force, clinicians at MUSC researched available options and algorithms for administering IV insulin but found nothing that fit their particular needs. Undaunted, they decided to create one. Their Web-based tool helped mean blood glucose drop from 153.8 to 117.6 mg/dL in patients with type 2 diabetes, and the percentage of patients not reaching target levels within 48 hours decreased from 26% to 5%. Read on to find out more.

As always, we’d like to know what you think of this issue. If you have a comment about our Top Hospitalists, or a Success Story to share, e-mail us.

Sincerely,

Jennifer Kearney-Strouse

Executive Editor, ACP Hospitalist

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ACP Hospitalist provides news and information for internists about the practice of medicine and reports on the policies, products and activities of ACP. All published material, which is covered by copyright, represents the views of the contributor and does not reflect the opinion of the American College of Physicians or any other institution unless clearly stated