THECORECOMPETENCIESINHOSPITALMEDICINEA Framework for Curriculum DevelopmentBy the Society of Hospital MedicineEditorsMichael J. Pistoria, DO, FACPAssociate Program Director, Internal Medicine ProgramMedical Director, Hospitalist ServicesLehigh Valley HospitalAllentown, PAAssistant Professor of MedicineThe Pennsylvania State University College of MedicineHershey, PAAlpesh N. Amin, MD, MBA, FACPExecutive Director, Hospitalist ProgramVice Chair for Clinical Affairs and Quality, Department of MedicineAssociate Program Director, Internal Medicine ResidencyMedicine Clerkship DirectorUniversity of California, IrvineOrange, CADaniel D. Dressler, MD, MScDirector, Hospital Medicine ServicesEmory University HospitalAssistant Professor of MedicineEmory University School of MedicineAtlanta, GASylvia C. W. McKean, MDMedical DirectorBrigham and Womens Faulkner Hospitalist ServiceAssistant Professor of MedicineHarvard Medical SchoolBoston, MATina L. 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This paper meets the requirements of ANSI/NISO Z39.48-1992(Permanenceof Paper).THECORECOMPETENCIESINHOSPITALMEDICINEA Framework for Curriculum Developmentby the Society of Hospital MedicineTABLEOFCONTENTSAcknowledgement.................................................................................................................vEditors and Contributors ...................................................................................................viiIntroduction........................................................................................................................xvSection 1: CLINICAL CONDITIONS1.1 Acute Coronary Syndrome..............................................................................21.2 Acute Renal Failure........................................................................................41.3 Alcohol and Drug Withdrawal ........................................................................61.4 Asthma ..........................................................................................................81.5 Cardiac Arrhythmia.....................................................................................101.6 Cellulitis ......................................................................................................121.7 Chronic Obstructive Pulmonary Disease........................................................141.8 Community-Acquired Pneumonia..................................................................161.9 Congestive Heart Failure ..............................................................................181.10 Delirium and Dementia.................................................................................201.11 Diabetes Mellitus..........................................................................................221.12 Gastrointestinal Bleed...................................................................................241.13 Hospital-Acquired Pneumonia.......................................................................261.14 Pain Management .........................................................................................281.15 Perioperative Medicine .................................................................................301.16 Sepsis Syndrome ..........................................................................................321.17 Stroke ..........................................................................................................341.18 Urinary Tract Infection .................................................................................361.19 Venous Thromboembolism ...........................................................................38Section 2: PROCEDURES2.1 Arthrocentesis...............................................................................................422.2 Chest Radiograph Interpretation...................................................................442.3 Electrocardiogram Interpretation ...................................................................452.4 Emergency Procedures..................................................................................462.5 Lumbar Puncture ..........................................................................................502.6 Paracentesis..................................................................................................522.7 Thoracentesis................................................................................................542.8 Vascular Access ...........................................................................................56iiiSection 3: HEALTHCARE SYSTEMS3.1 Care of the Elderly Patient............................................................................603.2 Care of Vulnerable Populations.....................................................................623.3 Communication ............................................................................................633.4 Diagnostic Decision Making .........................................................................653.5 Drug Safety, Pharmacoeconomics and Pharmacoepidemiology.......................663.6 Equitable Allocation of Resources.................................................................683.7 Evidence Based Medicine .............................................................................693.8 Hospitalist as Consultant...............................................................................703.9 Hospitalist as Teacher...................................................................................723.10 Information Management ..............................................................................753.11 Leadership....................................................................................................763.12 Management Practices ..................................................................................783.13 Nutrition and the Hospitalized Patient ...........................................................793.14 Palliative Care..............................................................................................803.15 Patient Education ........................................................................................823.16 Patient Handoff ............................................................................................833.17 Patient Safety ...............................................................................................843.18 Practice Based Learning and Improvement ....................................................873.19 Prevention of Healthcare Associated Infections and Antimicrobial Resistance....883.20 Professionalism and Medical Ethics ..............................................................903.21 Quality Improvement ....................................................................................923.22 Risk Management .........................................................................................933.23 Team Approach and Multidisciplinary Care...................................................943.24 Transitions of Care .......................................................................................95APPENDICESI. AbbreviationsII. Organizations Cited in TextIII. Core Competencies in Hospital Medicine: Development and MethodologyDaniel D. Dressler, Michael J. Pistoria, Tina L. Budnitz, Sylvia C. W. McKean, and Alpesh N. AminReprinted from Journal of Hospital Medicine, Volume 1, Number 1, 2006, Pages 48-56IV. How to Use The Core Competencies in Hospital Medicine: A Framework for Curriculum DevelopmentSylvia C. W. McKean, Tina L. Budnitz, Daniel D. Dressler, Alpesh N. Amin, and Michael J. PistoriaReprinted from Journal of Hospital Medicine, Volume 1, Number 1, 2006, Pages 57-67iv