Background: Hospital medicine (HM) is a well-established clinical specialty within Internal Medicine, yet its research footprint has lagged its clinical impact. Clarity of top HM research priorities may identify target areas for investment in HM research infrastructure and define areas of hospital medicine expertise.
Methods: The Society of Hospital Medicine’s (SHM) Research Committee formed a subcommittee to determine the research priorities for HM in that culminated in a 20-item survey. A comprehensive list of 8 key topic domains, each with 5-9 subdomains, was iteratively developed with committee input and feedback from HM leaders outside the committee (Table). For each domain and subdomain, the survey asked respondents to rank each item on a scale, with one being the highest priority and “x” (total number of items per domain/subdomain) being the lowest priority. The survey included respondent demographic data including gender, race, institution type, and years in practice. The subcommittee first identified key academic stakeholders to survey including leaders in HM (e.g., division chiefs) and SHM (e.g., committee chairs) followed by a snowball approach to include additional HM faculty including junior faculty. The survey was sent electronically (9/26/2023 – 1/11/2024) with up to 3 follow-up emails sent weekly to non-responders. Descriptive statistics included counts and medians. The University of Chicago institutional review board deemed this study exempt.
Results: Of the 92 surveys sent 36 (39%) were completed. Respondents were majority male (22/36, 61%), of white race (24/36, 67%), and worked in academic settings (28/36; 78%); half (18/36) reported practicing for 11 or more years. Of the 8 key topic domains, the range of priorities was a median of two to seven (ranked 1 to 8 with 1 = highest priority). The top three domains were “innovation in care delivery” (median 2), “value-based care” (median 3.5), and “health disparities” (median 4). The top subdomains were: “informatics” (within “innovation,” median 2.5); “high-value care” (within “value-based care,” median 1); and “social determinants of health” (within “disparities,” median 2). Other top-rated subdomains included: select medicine-specific diseases (median 1.5), “diagnostic error” (within “patient safety,” median 1.5), “communication” (within “patient experience,” median 2), and “implementation science” (within “methodologies,” median 2). (Table)
Conclusions: This national survey of hospitalist leaders clarifies top HM research priorities. Systems-based topics (e.g., innovations in care delivery and value-based care) and health-disparities were the highest priority areas, which aligns with our identity as a specialty that is focused on improving systems of care and addressing inequities in care. Next steps include ongoing data collection among junior faculty and HM leaders and utilization of these results to advocate for further investment in these top priorities to catalyze research.
