Letter from the Editor


Last month, we told you about an emerging trend to hire chief experience officers focused on making hospitals more pleasant for patients, families and staff. This month, we look at another trend rooted in patient-centered care: cultural competency. You've probably heard this term more frequently over the past decade as The Joint Commission and other groups have focused on improving physicians' knowledge of their increasingly diverse patient populations. Cultural competency training has become the norm at many institutions, and some states are now considering mandating such training as a condition of maintaining licensure (New Jersey has already done so). But is sensitivity to other cultures really something that can be taught, or do strict curricula and requirements run the risk of just reinforcing stereotypes? Our cover story explains how some hospitals are grappling with this dilemma.

Bariatric surgery has become increasingly popular in the U.S. According to the Agency for Healthcare Research and Quality, 121,055 surgeries were performed in 2004 compared with only 13,386 in 1998. With obesity on the rise as well, it's a good bet that hospitalists will be handling more perioperative care for gastric bypass patients. And although some aspects of the perioperative evaluation will be the same as for any other patient, these procedures can raise some unique issues, such as whether a pre-op problem is an independent risk factor or a result of a patient's excess weight. This issue contains a review of what to look for before and after gastric bypass, including sleep apnea, psychiatric problems, leaks and pulmonary embolism.

Finally, this issue showcases another new department, Success Story, which profiles hospitals and hospitalist programs solving problems and developing innovative work processes. This month, we look at how Crouse Hospital in Syracuse, N.Y. approached the problem of containing MRSA infection. Crouse's dedicated MRSA unit has helped save the hospital more than $1 million and has reduced the length of stay for MRSA patients from 30 days to 12. Read the story to find out how they did it.

Please let us know what you think of this new department and this issue in general. If you have a triumph to recount or any other comments to share, send them to acphospitalist[EACHAT]acponline.org. We look forward to hearing about your successes.

Sincerely,
Jennifer Kearney-Strouse
Editor, ACP Hospitalist