Gender differences in COVID-19-related manuscript authorship by hospitalists during the pandemic: A bibliometric analysis.

BACKGROUND: Hospital medicine (HM) has a well-described gender disparity related to academic work and promotion. During the COVID-19 pandemic, female authorship across medicine fell further behind historical averages. OBJECTIVE: Examine how COVID-19 affected the publication gender gap for hospitalists. DESIGN, SETTINGS, AND PARTICIPANTS: Bibliometric analysis to determine gender and specialty of US-based physician first and last authors of COVID-19 articles published March 1, 2020 to February 28, 2021 in the four highest impact general medical journals and two highest impact HM-specific journals. MAIN OUTCOME AND MEASURES: We characterized the percentage of all physician authors that were women, the percentage of physician authors that were hospitalists, and the percentage of HM authors that were women. We compared author gender between general medical and HM-specific journals. RESULTS: During the study period, 853 manuscripts with US-based first or last authors were published in eligible journals. Included manuscripts contained 1124 US-based physician first or last author credits, of which 34.2% (384) were women and 8.8% (99) were hospitalists. Among hospitalist author credits, 43.4% (n = 43/99) were occupied by women. The relative gender equity for hospitalist authors was driven by the two HM journals where, compared to the four general medical journals, hospitalist authors (54.1% [33/61] vs. 26.3% [10/38] women, respectively, p = .002) and hospitalist last authors (51.9% [14/27] vs. 20% [4/20], p = .03) were more likely to be women. CONCLUSIONS: Across COVID-19-related manuscripts, disparities by gender were driven by the high-impact general medical journals. HM-specific journals had more equitable inclusion of women authors, demonstrating the potential impact of proactive editorial policies on diversity.

COVID-19-Related Publications by Hospitalists in the United States.

Objective To determine the degree to which hospitalists published academic manuscripts related to COVID-19 during the first year of the pandemic. Patients and methods The study was a cross-sectional analysis of the author's specialty, defined by byline or professional online biography, from articles related to COVID-19 published between March 1, 2020, and February 28, 2021. It included the top four internal medicine journals by impact factor: New England Journal of Medicine, Journal of the American Medical Association, Journal of the American Medical Association Internal Medicine, and Annals of Internal Medicine. Participants were all United States (US)-based physician authors contributing to COVID-19 publications. Our primary outcome was the percentage of US-based physician authors of COVID-19 articles who were hospitalists. Subgroup analyses characterized author specialty by authorship position (first, middle, last) and article type (research vs. non-research). Results Between March 1, 2020, and February 28, 2021, the top four US-based medical journals published 870 articles related to COVID-19 of which 712 articles with 1940 US-based physician authors were included. Hospitalists accounted for 4.2% (82) of authorship positions including 4.7% (49/1038) of authorship positions in research articles and 3.7% (33/902) of authorship positions in non-research articles. First, middle, and last authorship positions were held by hospitalists at 3.7% (18/485), 4.4% (45/1034), and 4.5% (19/421) of the time, respectively. Conclusions Despite caring for a large number of patients with COVID-19, hospitalists were rarely involved in disseminating COVID-19 knowledge. Limited authorship by hospitalists could constrain the dissemination of inpatient medicine knowledge, impact patient outcomes, and affect the academic promotion of early-career hospitalists.

Reducing Discharge Delay Through Resident-Pharmacist Colocation: A Pilot Study.

BACKGROUND AND OBJECTIVES: Discharge delay of hospitalized patients is costly, inefficient, and can impede care of pending admissions. Through pharmacist colocation and daily discharge medication reconciliation meetings, we aimed to improve discharge efficiency and decrease the number of electronic pages. METHODS: We conducted a quality improvement initiative on the family medicine inpatient teaching service at a large academic medical center using two interventions: colocation and daily discharge medication reconciliation meetings of pharmacist and family medicine residents. We assessed: (1) discharge delay, defined as the time between discharge order and pharmacist's completion of discharge medication reconciliation and patient education; (2) the number of electronic messages between the pharmacist and family medicine team, assessed 1 month before and 1 month after implementation of the interventions. We also assessed team members' postinitiative views on collaboration, discharge safety, and timeliness, and knowledge acquisition using three 5-point Likert statements. RESULTS: Ninety-five preintervention and 54 postintervention patients met eligibility criteria. Discharge delay prior to intervention was 72.7±58.4 minutes and 47.6±37.4 minutes postintervention. The number of electronic messages between pharmacist and family medicine team pager decreased from 118 to 14 during the months studied. Team members felt collaboration, safe and timely discharges, and acquisition of new knowledge improved. CONCLUSIONS: Colocation of workspaces and daily medication reconciliation meetings were associated with decreased discharge delay and decreased pages between team members. Further study is needed to assess its reproducibility, impact on resident education and patient satisfaction, cost-effectiveness, and ability to scale to other services.