Letter from the Editor

This month's issue includes articles on catheter-associated urinary infections, recreational marijuana, disorders of consciousness, and more.

Catheter-associated urinary tract infections (CAUTIs) seem like a relatively simple target in the ongoing struggle against hospital-acquired infections. But, according to recent data from the CDC, CAUTIs have proven more difficult to reduce than more complicated infections; rates actually went up between 2009 and 2013, despite hospitals' targeting of the condition. In this month's cover story, experts debate whether the best solution is for hospitals to increase or revise efforts to prevent CAUTIs or for the health care system to change methods of measuring and penalizing hospitals for them.

Changes in penalties motivated another story in this issue, which looks at the consequences of legalized marijuana use. Hospitalists in Colorado are on the forefront of this topic, since marijuana has been available for sale to residents and tourists in their state since January 2014. In this issue, they describe the health care consequences that physicians can expect in Washington and Oregon (which have also legalized recreational use) and any other states that follow this trend.

If anyone can make palliative care trendy, it may be surgeon/author Atul Gawande, MD. We have coverage from his keynote lecture at the annual meeting of the American Academy of Hospice and Palliative Medicine. Palliative care experts at the conference also offered their advice on helping patients and families at the end of life with tough decisions regarding hip fracture treatment, cessation of life-sustaining therapies, and organ donation.

This month's issue also includes some good news about communication. A feature story describes new research into the beneficial effects of talking to minimally conscious patients, while our Q&A describes how one hospital's implementation of an electronic health record improved patients' perception of interactions with their physicians. Our Success Story describes how a 3-way phone call system made it easier to get patients admitted through the emergency department and into the right bed quickly.

You'll also find the latest installment of our Brief Case feature, with cases submitted by physicians from Massachusetts General Hospital. We welcome your Brief Case submissions, and any other comments.

Stacey Butterfield
Editor-in-Chief, ACP Hospitalist