Readmissions and other frustrations

This month's issue focuses on reducing heart failure readmissions, improving ICU care, and combating sexual harassment in medicine.

Readmissions for heart failure are frustrating to everyone involved. Patients don't want to be in the hospital, physicians don't want to feel like they're fruitlessly repeating the same work, and hospitals don't want to be hit with Medicare penalties. So why are readmissions still so common? This month's main story investigates why past and current efforts have failed to significantly improve outcomes for heart failure patients and what might be required to really make a difference on this front. Offering one such example, our Success Story describes how one hospital achieved higher rates of adherence to heart failure medications after discharge.

Many hospitalists are also frustrated by their responsibilities in the ICU, according to a recent national survey. A story in this issue dives into this problem, looking at what can be done to shrink the gap between hospitalists' critical care knowledge and skills and their sickest patients' needs. This month's Q&A brings up another area where subspecialist knowledge can be beneficial—research by an infectious diseases doctor found that consults were associated with reduced mortality among patients with drug-resistant infections.

Shifting from patient well-being to that of physicians, another story focuses on sexual harassment and assault in medicine. Inspired by the Me Too movement on social media, female physicians are increasingly talking about their own experiences in this area, and hospital program leaders and administrators are working to make sure such harassment is less frequent in the future.

This issue also includes two of our regular reader-written clinical features: Brief Case, with cases from Emory Division of Hospital Medicine and Yale University School of Medicine, and Expert Analysis, with a review of spontaneous heparin-induced thrombocytopenia syndrome. Please keep those submissions coming.

Stacey Butterfield