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Notions of clinical excellence in hospital medicine: a brief reflection on specific case studies

Susrutha Kotwal, Eric Howell, Daniel Brotman, Scott Wright


Background: The individuals who are being admitted to our hospitals are generally sicker and more medically complex than ever before. These patients rely on highly skilled healthcare providers for this acute medical care, yet clinical excellence in hospital medicine has not been well described in the literature. 

Objective: The intention of this manuscript is to highlight examples of clinical excellence in hospital medicine, from published literature, as they relate to the definition formulated by the Miller-Coulson Academy of Clinical Excellence.  

Results: Exemplary case reports and research studies in hospital medicine were identified to describe each of the domains of excellence: communication and interpersonal skills, professionalism and humanism, diagnostic acumen, skillful negotiation of the healthcare system, knowledge and having scholarly approach to clinical practice.

Conclusion: Applying the definition of clinical excellence to hospital medicine can establish the standards for which physicians and trainees might aspire. Reflecting upon the efforts of commendable role models and praiseworthy teams in hospital medicine, may allow us all to improve along the continuum towards clinical mastery.


Clinical excellence, communication and interpersonal skills, diagnostic acumen, health system navigation, hospital medicine, humanism, medical knowledge, passion for patient care, person-centered healthcare, professionalism

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State of Hospital Medicine: Nationwide Demand Continues for Hospitalists. Available at: Accessed July 1, 2015.

Hospital Medicine News. Society of Hospital Medicine. Available at: Accessed July 1, 2015.

Christmas, C., Kravet, S.J., Durso, S.C. & Wright,. S.M. (2008). Clinical excellence in academia: perspectives from masterful academic clinicians. Mayo Clinic Proceedings 83 (9) 989-994.

PRISMA Statement Website. Available at: Accessed September 25, 2015.

Consensus decision making. Available at: Accessed September 25, 2015

Villanueva, T. (2010). Transitioning the patient with acute coronary syndrome from inpatient to primary care. Journal of Hospital Medicine 5 (Supplement 4) S8-14.

Society of Hospital Medicine. The core competencies in hospital medicine. Available at: Curriculum/Core_Competencies.htm. Accessed October 10, 2012.

Farnan, J.M., O'Leary, K.J., Didwania, A., Icayan, L., Saathoff, M., Bellam, S., Anderson, A., Reddy, S., Humphrey, H.J., wayne, D.B. & Arora, V.M. (2013). Promoting professionalism via a video-based educational workshop for academic hospitalists and housestaff. Journal of Hospital Medicine 8 (7) 386-389.

Austin, J.P. (2015). Trickle-down professionalism: hidden curriculum and the pediatric hospitalist. Hospital Pediatrics 5 (6) 352-354.

Ferrara, M. & Bernheisel, C. (2011). Hospitalist Rounds: nausea, fever, and weight loss. Journal of Family Practice 60 (7) E1-3.

Pinzur, M.S., Gurza, E., Kristopaitis, T., monsoon, R., Wall, M.J., Porter, A., Davuidson-Bell, V. & Rapp, T. (2009). Hospitalist-orthopedic co-management of high-risk patients undergoing lower extremity reconstruction surgery. Orthopedics 32 (7) 495.

Howell, E., Bessman, E., Marshall, R. & Wright, S. (2010). Hospitalist bed management effecting throughput from the emergency department to the intensive care unit. Journal of Critical Care 25 (2) 184-189.

Lee, C.F., Sun, M.S. & Tai, Y.K. (2014). Saxagliptin-induced recurrent acute pancreatitis. Internal Medicine Journal 53 (12) 1351-1354.

McMahon, L.F. Jr. (2007). The hospitalist movement-time to move on. New England Journal of Medicine 357 (25) 2627-2629.

Harrison, R., Hunter, A.J., Sharpe, B. & Auerbach, A.D. (2011). Survey of US academic hospitalist leaders about mentorship and academic activities in hospitalist groups. Journal of Hospital Medicine 6 (1) 5-9.

Reid, M.B., Misky, G.J., Harrison, R.A., Sharpe, B., Auerbach, A. & Glasheen, J.J. (2012). Mentorship, productivity, and promotion among academic hospitalists. Journal of General Internal Medicine 27 (1) 23-27.

Kul S, Barbieri A, Milan, E., Montag, I., Vanhaecht, K. & Panella, M. (2012). Effects of care pathways on the in-hospital treatment of heart failure: a systematic review. BMC Cardiovascular Disorders 25, 12 81.

Ban, A., Ismail, A., Harun, R., Abdul Rahman, A., Sulubng, S. & Syed Mohamed, A. (2012). Impact of clinical pathway on clinical outcomes in the management of COPD exacerbation. BMC Pulmonary Medicine 12, 27.

Kurtin, P. & Stucky, E. (2009). Standardize to excellence: improving the quality and safety of care with clinical pathways. Pediatric Clinics of North America 56 (4) 893-904.

Wright, S.M., Noon, M.J. & Greenough 3rd, W.B. (2015). Oral Rehydration Therapy and Feeding Replaces Total Parenteral Nutrition: A Clinical Vignette. Journal of General Internal Medicine 31 (2) 255-257.

Robert Wachter, MD. Chief of Hospital Medicine. UCSF Medical Center. Available at: Accessed July 2, 2015.

Mote, P.C., Solomon, B.S., Wright, S.M. & Crocetti, M. (2014). Clinical excellence in pediatrics. Clinical Pediatrics 53 (9) 879-884.

Ziegelstein, R.C. (2011). Clinical excellence in cardiology. American Journal of Cardiology 108, 607-611.

Chisolm, M.S., Peters, M.E., Burkhart, K. & Wright, S.M. (2012). Clinical excellence in psychiatry: a review of the psychiatric literature. Primary Care Companion for CNS Disorders 14 (2) doi: 10.4088/PCC.

Johnson, S. (2010). Where good ideas come from. New York, New York: Riverhead Books of Penguin Group (USA) Inc.



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