Back to the Future: Past RIV Winners Talk About What the Recognition Meant for Their Careers

Larry Beresford

Disclosures

The Hospitalist. 2013;17(9):1,35-38. 

In This Article

Kristin Wise, MD, FHM

Title: Assistant professor of medicine

Institution: Medical University of South Carolina, Charleston

Year: 2009

Riv: "Intensivists versus Hospitalists in the ICU: A Prospective Cohort Study Comparing Mortality and Length of Stay Between Two Staffing Models" (research)

Citation: Wise KR, Akopov VA, Williams BR, Ido MS, Leeper KV, Dressler DD. Hospitalists and intensivists in the medical ICU: a prospective and observational study comparing mortality and length of stay between two staffing models. J Hosp Med. 2012;7(3):183–189.

Dr. Wise was recognized for research that began while she worked at Emory University in Atlanta, comparing hospitalists and intensivists in such outcomes as length of stay and mortality rates for patients in the ICU. The study was one of the first statistically rigorous examinations of this critical quality question. With an eye toward improving patient safety, national quality advocates such as the Leapfrog group have called for hospitals to employ intensivists (critical-care specialists) to manage the care of ICU patients. In reality, Dr. Wise says, there aren't enough intensivists to meet the need.

"Hospitalists are in the ICU anyway," she says. "We just don't have enough data to answer how well they do [in comparison to intensivists]."

Through a prospective cohort study of more than 1,000 patients, Dr. Wise's group found that there was essentially no statistical difference in mortality rates between patients treated by intensivist teams or hospitalist ICU teams.

"We were also able to look at some of the intermediate-acuity patients—fairly complicated but not requiring ventilators," she explains. "Our study wasn't sufficiently powered for this subgroup, but it was an interesting piece of data to raise the question: Where should we deploy this scarce resource of intensivists? Which pockets of patients?"

Presenting her abstract at SHM's annual meeting was a "good experience."

"I'd done public speaking before, but never with an audience of about 500 people," she says. "To go out there and field their questions was a real professional growing experience. Several people interested in the topic sought me out at the conference, introduced themselves, and we have subsequently stayed in touch."

The manuscript published in JHM has been cited four times, including in a position paper from SHM and the Society of Critical Care Medicine.[3] Another outgrowth of the research was being asked to contribute a chapter on hospitalists' role in the ICU to a textbook on hospital medicine. Based on her still-fresh HM presentation, Dr. Wise was one of the few publicly identified experts on the subject. The chapter, co-authored by fellow Emory hospitalist Michael Heisler, MD, MPH, "The Role of the Hospitalist in Critical Care" was included in Principles and Practices of Hospital Medicine.[4]

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