Quality Movement Research Articles

Determining Quality Movement Through Acceleration And Self-perception

Determining Quality Movement Through Acceleration And Self-perception

Healthcare quality improvement: It's time to update the Donabedian approach with a complex systems perspective.

There is broad consensus that healthcare systems are complex systems, which as a result, face complex problems. From this perspective, quality of care can be conceptualised as an emergent outcome of the healthcare system, that is more than the sum of individual components of care (in terms of inputs and processes), and quality improvement as a complex systems problem. However, traditional approaches, such as Donabedian's structure/process/outcome framework, are rooted in a linear, reductionist perspective, that fails to recognise that quality of care is created in the context of complex healthcare systems, and the many interactions and uncertainties at play that shape quality of care and health outcomes. A paradigm shift is needed from a reductionist to a systems thinking approach if we are to better understand and improve quality of care. Such a shift begins with asking different research questions, situated within the system context, that focus on identifying how interventions may contribute to system improvement, as opposed to seeking to directly link interventions with quality of care outcomes. In contrast to traditional healthcare quality measures focusing on single components of the system in isolation, research needs to explicitly consider quality of care as an emergent system outcome and identify new indicators and methods of assessment that provide insight into how the healthcare system functions as an interconnected whole. It is an opportune moment to harness the energy of the international healthcare quality movement to drive the innovation needed in research and practice to adopt a systems thinking approach.

Practitioner perspectives on the implementation of the Lee Silverman Voice Treatment BIG® program

BackgroundThe Lee Silverman Voice Treatment BIG® (LSVT BIG®) intervention, originally designed for the patients with Parkinson’s disease, is a high amplitude, high repetition therapy protocol that encourages bigger, more quality movements. The purpose of this study was to understand practitioner utilization and perspectives of the LSVT BIG® intervention as there is no published work in this area. MethodsAn electronic survey with optional debriefings was distributed to LSVT BIG® certified practitioners via the Facebook page run by parent company, LSVT Global Inc. ResultsForty-seven practitioners engaged in this study. Practitioners were largely in the outpatient setting. Forty-seven percent reported utilizing the LSVT BIG® intervention for patient populations outside of the Parkinson’s disease diagnosis. Sixty-one percent of respondents reported using the same assessment tools and ninety-five percent reported billing insurance for their services. Twenty-three percent reported offering the LSVT BIG® intervention via telehealth. Debriefings identified barriers to implementation. ConclusionPractitioners are implementing the LSVT BIG® intervention across settings and are most likely to be in the outpatient setting, serving patients who possess a neurological diagnosis, and focus their assessment on lower extremity, gait, and balance. When billing insurance, practitioners routinely select the three CPT® codes: Neuromuscular Re-Education, Therapeutic Activity, and Therapeutic Procedure/Exercise. Practitioners identified several barriers to implementing the LSVT BIG® program, such as the high frequency of in-clinic visits. Practitioners are currently unsystematically modifying the program to meet patient and practitioner needs. Further research should continue to explore the practitioner perspectives on implementation of the LSVT BIG® intervention.

Japanese Postwar Success: The Impact of Moral Re-Armament and the Quality Movement

Japanese Postwar Success: The Impact of Moral Re-Armament and the Quality Movement

ASCO Domestic Quality Programs.

A growing sense of the need to define good-quality cancer care has emerged in the past decade of the 20th century. The goals were to assess, improve, and reward quality. Animated debates between cancer care delivery academic and community organizations, governmental agencies, and insurance companies have led to multiple initiatives and pilot projects. ASCO was on the cutting edge of quality in oncology movement. We can define three phases, overlapping rather than sequential, in ASCO's journey. The first phase was generating definitions of good-quality care characterized by the publication of ASCO guidelines. The second phase was the creation of the tools to measure the implementation of standards of care with the creation of the Quality Oncology Practice Initiative (QOPI). The third phase was the launch of a comprehensive approach to cancer care quality as illustrated by QOPI Certification, then the more complete iteration, ASCO Certified Program. The latter is the most elaborate program to define quality from the patient and health care providers' perspective on one hand and governmental agencies and insurance providers' perspective on the other. Since the publication of the Ensuring Quality Cancer Care Report in 1998 to the ASCO Certified in 2023, a quarter century has elapsed. ASCO did not operate in a vacuum. Through collaborative efforts, reacting to and interacting with various players, it has advocated for positive change. During this period, ASCO has led the movement of quality in oncology intelligently and with the upmost sense of responsibility toward the patients, health care professionals, and society at large. While many of these efforts began domestically, their reach is extending globally through research, education, and the promotion of equitable care.

Study on Lean Six Sigma methodology from the Indian context: an investigation of literature

PurposeIndia liberalized its economy in 1991, which resulted in intense global competition, quality-conscious and demanding customers. Additionally, significant technological advancements lead to enhancements in products and processes. These forced Indian organizations to adopt innovative business strategies in the past 30 years. Meanwhile, the Lean Six Sigma methodology has significantly grown with vast applicability during the past 30 years. Thus, the purpose of this study is to develop the learning on Lean Six Sigma methodology in the Indian context through investigation of literature.Design/methodology/approachA three-stage systematic literature review approach was adopted to investigate the literature during the present study. In total, 187 articles published in 62 journals/conference proceedings from 2005 to 2022 (18 years) were shortlisted. The first part of the article summarizes the significant milestones towards the quality journey in the Indian context, along with the evolution of the Lean Six Sigma methodology. The second part examines the shortlisted papers on Lean Six Sigma frameworks, their applicability in industrial sectors, performance metrics, outcomes realized, publication trends, authorship patterns and leading researchers from the Indian perspective.FindingsLean Six Sigma has emerged as a highly acclaimed and structured business improvement strategy worldwide. The Indian economy has seen remarkable growth in the past decade and is one of the fastest-growing economies in the 21st century. Lean Six Sigma implementation in India has significantly increased from 2014 onward. The study revealed that researchers have proposed several different frameworks for Lean Six Sigma implementation, the majority of which are conceptual. Furthermore, the balanced applicability of Lean Six Sigma in manufacturing and service sectors was observed with the highest implementation in the health-care sector. Additionally, the widely adopted tools, techniques along with performance metrics exploring case studies were reported along with a summary of eminent and leading researchers in the Indian context.Research limitations/implicationsThis study is confined to reviewed papers as per the research criteria with a significant focus on the Indian context and might have missed some papers due to the adopted papers selection strategy.Originality/valueThe present study is one of the initial attempts to investigate the literature published on Lean Six Sigma in the Indian context, including perspective on the Indian quality movement. Therefore, the present study will provide an understanding of Lean Six Sigma methodology in the Indian context to graduating students in engineering and management and entry-level executives. The analysis and findings on Lean Six Sigma frameworks, research approach, publications details, etc., will be helpful to potential research scholars and academia. Additionally, analysis of case studies on Lean Six Sigma implementation by Indian industries will assist the managers and professionals in decision making.

Evaluation on the Level of Functional Movement Screen (FMS) and Functional Training VIS-À-VIS Sprint Performance of College Track and Field Athletes

This study selected 56 sprint student-athletes from the track and field team of Hechi University in Guangxi, China, as test subjects. Before the experiment, all athletes were assessed with the Functional Movement Screen (FMS) test, and a detailed analysis and comparison of the athletes' FMS scores were conducted from an objective perspective. After 12 weeks of functional training intervention, a second FMS test assessment was carried out on the participating athletes. The survey results showed that before the training, the movement quality and functional movement ability of the student-athletes were average. Among them, the scores for core stability, lower limb explosive power, and multi-joint movement tests were evaluated as 3 points, showing excellent core stability and lower limb strength. However, the scores for agility, upper limb coordination, and the 100-meter test were rated as 2, which was average. Before and after training, the overall average score of the Functional Movement Screen (FMS) for the student-athlete respondents increased from 15.4500 to 18.1786, and the t-value was -14.140, indicating a significant difference in functional movement levels before and after training. Participants showed noticeable improvements in flexibility, stability, and overall movement quality after the training intervention. Data from the 100-meter test showed that the average score before training was 2.3571 and post-training was 2.9464, with a calculated t-value of -8.883, indicating a significant difference in sprint performance before and after the training. Therefore, introducing this new theory of FMS into future sprint teaching and training practice can not only help correct athletes' physical function deficits and cultivate correct movement patterns, but it can also serve as an effective complement to track and field training methods, providing a theoretical basis for scientifically-informed coaching.

Disparate home range dynamics reflect nutritional inadequacies on summer range for a large herbivore

AbstractThe spatial distribution of animals has consequences for nutrition, predator–prey dynamics, spread of diseases, and population dynamics in general. Animals must establish a home range to secure adequate resources to fuel their energy needs. Home ranges, therefore, are temporally and spatially dynamic, given the changing requirements of an animal and the availability of resources on the landscape. We used data from two populations of bighorn sheep with contrasting population dynamics following pneumonia epizootics and different habitat quality on their summer range to test the hypothesis that the distribution and size of home ranges are influenced by environmental conditions and reproductive status. We used a combination of data from 768 vegetation transects and remotely sensed metrics to index forage quality of consecutive biweekly home ranges for 27 bighorn sheep, June–August 2019–2021. There were population differences in home range dynamics that were consistent with resource limitations in the population declining in abundance. Animals in both populations increased the size of their home range through the summer in association with declining forage quality indexed by plant phenology. Furthermore, animals in the Whiskey Mountain population without offspring had home ranges more than twice the size of animals with offspring, whereas there were no differences in the home range size between animals with and without offspring in Jackson. We demonstrated that limitations young offspring impose on space use of a mother may have consequences for animals living where larger home ranges are needed to secure adequate resources—sheep on Whiskey Mountain had to travel 1000 m from escape terrain to access the same amount of biomass that the Jackson sheep could access directly adjacent to escape terrain. Forage quality and availability influence movement and space use. In the presence of disease, movement and space use may influence pathogen transmission and persistence. Thus, forage availability may play an indirect role in population dynamics in the presence of disease, which is another line of evidence for how environmental and nutritional conditions may influence population dynamics when coping with disease.

Explore 3D Dance Generation via Reward Model from Automatically-Ranked Demonstrations

This paper presents an Exploratory 3D Dance generation framework, E3D2, designed to address the exploration capability deficiency in existing music-conditioned 3D dance generation models. Current models often generate monotonous and simplistic dance sequences that misalign with human preferences because they lack exploration capabilities.The E3D2 framework involves a reward model trained from automatically-ranked dance demonstrations, which then guides the reinforcement learning process. This approach encourages the agent to explore and generate high quality and diverse dance movement sequences. The soundness of the reward model is both theoretically and experimentally validated. Empirical experiments demonstrate the effectiveness of E3D2 on the AIST++ dataset.

Online pain neuroscience education and graded exposure to movement in breast cancer survivors: protocol of a randomized controlled trial.

Cancer-related chronic pain is an important sequelae that damages the quality of life of breast cancer survivors. Pain neuroscience education and graded exposure to movement are therapeutic tools that have been shown to be effective in the management of chronic pain in other populations. However, there are no previous studies that combine them after breast cancer. To evaluate the effectiveness of an online physiotherapy focused-person program which combines pain neuroscience education and graded exposure to movement for quality of life improvement in breast cancer survivors. This protocol is a randomized controlled trial with a sample size of 40 breast cancer survivors with pain in the last 6 months. Participants will be allocated to the experimental or control group using a fixed size block randomization method. The evaluator and statistician will be blinded to participant allocation. Participants in the experimental group will receive a 12-week intervention based on pain neuroscience education and therapeutic yoga as a graded exposure to movement exercise; participants in the control group will continue with their usual cancer-related symptoms care. Both groups will receive an education booklet. The main outcome will be quality of life, measured by the Functional Assessment of Cancer Therapy - Breast (FACT-B+4); secondary, four outcomes related to pain experience (catastrophising, self-efficacy, kinesiophobia and fear-avoidance behaviors) will be also assessed. All variables will be assessed by two blinded evaluators at four timepoints. A mixed-model analyses of variance ANOVA (2 × 4) will be used to study the effects of the treatment on the dependent variables. All statistical tests will be performed considering a confidence interval of 95%. SPSS program will be used for the data analysis. This research is expected to contribute to breast cancer rehabilitation field. The proposed intervention is also expected to improve self-care skills related to chronic pain and to empower women regarding the management of their symptoms and quality of life.Clinical trial registration: https://clinicaltrials.gov/, NCT04965909.

The Effect of Baby Massage on Nursing Care for Healthy Babies to Improve Sleep Quality and Smooth Defecation

Baby massage is a form of physical touch that provides many benefits for babies, including improving sleep quality and smooth bowel movements. This study aims to determine the effect of baby massage on nursing care for healthy babies to improve sleep quality and smooth defecation in babies in Purwakarta Regency, Indonesia. This research is experimental research with a pre-test and post-test design. The research sample was 30 healthy babies aged 3-12 months who were grouped into two groups, namely the intervention group (15 babies) and the control group (15 babies). The intervention group was given baby massage for 10 minutes every day for 7 days. The control group was not given any treatment. Data on sleep quality and bowel movement were collected before and after the intervention. The results showed that there were significant differences between the intervention group and the control group in terms of sleep quality and smooth defecation. The intervention group showed greater improvements in sleep quality and smooth defecation compared to the control group. Based on the results of this research, it can be concluded that baby massage has a positive influence on improving sleep quality and smooth defecation in healthy babies.

Awareness Through Movement and Swiss Ball Exercise on Muscle Weakness among Subjects with Postural Syndrome

Background: A general definition of Postural syndrome is a lack of muscle strength or the quality or quantityof movements. This is typically accompanied by one or more of the following all of the joints in the body havean effect on body posture, which is the alignment of a person’s body parts with respect to one another and theirsurroundings at a specific moment in time.Purpose: To compare the effectiveness of Awareness through movements and swiss ball exercise on posturalsyndrome patients.Materials and Methods: A total of 28 individuals were chosen based on the inclusion and exclusion criteria from SaiCharan physiotherapy clinic ,Arakkonam, Ranipet, Tamil Nadu ,India. After explaining the treatment’s safety andease of use to the participants, a signed agreement was acquired. Group A [14N] Awareness through movementsare given GroupB[14N] Swiss ball movements are given. The pre test and post test results were obtained throughPatient specific functional scale.Study duration : 4 Weeks . The entire process was performed from November 2022to March 2023.Results: As a result, swiss ball exercise is more effective than awareness through movement by analyzing thestatistical values of pre test and post test.Conclusion: The study’s goal is to evaluate its effects. of swiss ball movement exercise and awareness throughmovements postural syndrome individuals in the society.

Abnormal stability of spontaneous neuronal activity as a predictor of diagnosis conversion from major depressive disorder to bipolar disorder

ObjectiveBipolar disorder (BD) is often misdiagnosed as major depressive disorder (MDD) in the early stage, which may lead to inappropriate treatment. This study aimed to characterize the alterations of spontaneous neuronal activity in patients with depressive episodes whose diagnosis transferred from MDD to BD. Methods532 patients with MDD and 132 healthy controls (HCs) were recruited over 10 years. During the follow-up period, 75 participants with MDD transferred to BD (tBD), and 157 participants remained with the diagnosis of unipolar depression (UD). After excluding participants with poor image quality and excessive head movement, 68 participants with the diagnosis of tBD, 150 participants with the diagnosis of UD, and 130 HCs were finally included in the analysis. The dynamic amplitude of low-frequency fluctuations (dALFF) of spontaneous neuronal activity was evaluated in tBD, UD and HC using functional magnetic resonance imaging at study inclusion. Receiver operating characteristic (ROC) analysis was performed to evaluate sensitivity and specificity of the conversion prediction from MDD to BD based on dALFF. ResultsCompared to HC, tBD exhibited elevated dALFF at left premotor cortex (PMC_L), right lateral temporal cortex (LTC_R) and right early auditory cortex (EAC_R), and UD showed reduced dALFF at PMC_L, left paracentral lobule (PCL_L), bilateral medial prefrontal cortex (mPFC), right orbital frontal cortex (OFC_R), right dorsolateral prefrontal cortex (DLPFC_R), right posterior cingulate cortex (PCC_R) and elevated dALFF at LTC_R. Furthermore, tBD exhibited elevated dALFF at PMC_L, PCL_L, bilateral mPFC, bilateral OFC, DLPFC_R, PCC_R and LTC_R than UD. In addition, ROC analysis based on dALFF in differential areas obtained an area under the curve (AUC) of 72.7%. ConclusionsThe study demonstrated the temporal dynamic abnormalities of tBD and UD in the critical regions of the somatomotor network (SMN), default mode network (DMN), and central executive network (CEN). The differential abnormal patterns of temporal dynamics between the two diseases have the potential to predict the diagnosis transition from MDD to BD.

Sleep disturbances in the memory clinic: Associations with clinical features and neuropsychological performance

AbstractBackgroundThe prevalence of sleep disturbances increases in ageing and may further increase in neurodegeneration. In a memory and cognition (MC) clinic setting, our study aims to: 1) determine the rates of various sleep disturbances including obstructive sleep apnoea (OSA), short and long sleep duration, insomnia, sleep quality, and rapid eye movement sleep behaviour disorder (RBD); and 2) examine whether these sleep disturbances are associated with neuropsychological performance in older adults without dementia.MethodWe captured data between 2009 and 2022 from a MC clinic for older adults aged over 50 with new cognitive and/or mood concerns. Self‐reported history, pulse oximetry, and polysomnography (PSG) captured rates of OSA. Actigraphy (>7 days) was used to measure sleep duration (defined short duration as <6 hours and long duration as >9 hours). Validated self‐report questionnaires were used to capture insomnia, sleep quality, and RBD. We examined group differences between those with and without sleep disturbances in the following cognitive composites: verbal learning and memory, processing speed, executive function, and language skills.ResultsWe recruited 1016 participants (mean age = 66.9 (SD = 9.0), mean MMSE = 28.3 (SD = 2.2), male = 436 (43%)). For rates of OSA, 15% (n = 152/1016) self‐reported history of OSA, 76% (n = 383/504) had OSA as classified by PSG, 84% (n = 115/137) had OSA as classified by pulse oximetry. From actigraphy data, 10% (n = 55/566) had short sleep and 5% (n = 29/566) had long sleep duration. From self‐report data, 15% (n = 85/579) had moderate or severe clinical insomnia, 61% (n = 544/893) reported having poor sleep quality, 10% (n = 56/579) had RBD. Individuals with OSA (from PSG) performed worse in verbal learning compared to those without OSA (p<0.05). Individuals who had long sleep duration performed worse on both verbal learning (p<0.05) and memory (p<0.05) than those with short sleep and normal sleep duration. There were no other significant group differences in cognition outcomes, amongst the other sleep disturbance groups (p>0.05).ConclusionIn MC clinics, there are very high rates of sleep disturbance in this at‐risk population. The large discrepancy in rates of OSA between self‐reported history and PSG suggests OSA is under‐diagnosed. Sleep disturbances may be associated with cognitive outcomes, in particular learning and memory.

The Updated Global Malnutrition Composite Score Clinical Quality Measure: Its Relevance to Improving Inpatient Clinical Outcomes and Health Equity

Quality improvement has existed in health care for centuries with a dramatic transformation over time, largely motivated by the academic health quality movement. Throughout this evolution, the Centers for Medicare and Medicaid Services have been at the forefront of the development and provision of quality measures for health care in a variety of settings, including acute care. Quality initiatives aid in the evaluation of patient care to encourage quality improvement efforts, determine pay-for-performance rates, and help patients and consumers evaluate their care providers. The addition of the Global Malnutrition Composite Score as an electronic Clinical Quality Measure in 2022 highlights the key role nutrition plays in outcomes and quality of hospitalized patients. With this, credentialed nutrition and dietetics practitioners lie front and center for the development of quality improvement processes to help promote high quality standards of nutrition care, improve length of stay, and reduce health care costs and readmissions while addressing malnutrition, health equity, and nutrition care as a human right. As the Global Malnutrition Composite Score steward, it is the obligation of the Academy of Nutrition and Dietetics and the Commission on Dietetic Registration to promote the measure and support credentialed nutrition and dietetics practitioners in advocating for the implementation of this measure. Therefore, the purpose of this practice update is to provide necessary information to credentialed nutrition and dietetics practitioners and other health care leaders related to the history and implementation of the Global Malnutrition Composite Score, along with relevant updates to the measure and practice implications.

Society for Maternal-Fetal Medicine Special Statement: Clinical quality measures in obstetrics

This article provides an updated overview and critique of clinical quality measures relevant to obstetrical care. The history of the quality movement in the USA and the proliferation of quality metrics over the past quarter century are reviewed. Common uses of quality measures are summarized: payment programs, accreditation, public reporting, and quality improvement projects. We present listings of metrics that are reported by physicians or hospitals, either voluntarily or by mandate, to government agencies, payers, “watchdog” ratings organizations, and other entities. The costs and other burdens of extracting data and reporting metrics are summarized. The potential for unintended adverse consequences of the use of quality metrics is discussed along with approaches to mitigating adverse consequences. Finally, some recent attempts to develop simplified core measure sets are presented, with the promise that the complex and burdensome quality-metric enterprise may improve in the near future.

Investigation of Amended Sandy Soil's Water Retention Characteristics

Purpose: Soil water retention studies are important for evaluating soil quality and water movement in soils. This study assesses the water content capacity and changes in the retention curve of sandy soil after using zeolite X, activated charcoal, and rice husk ash as amendments. Design/Methodology/Approach: Sandy soil samples were collected from the study area, Keta District of Ghana, and a core borer and a pot experiment were used to determine the pressure head and water content of the soil. One-way analysis of variance (One-way ANOVA) was used to analyze the data. Water retention curve analyses were conducted using COMSOL multi-physics simulation and experimental work. Research Limitation/Implication: The amendments used were restricted to zeolite X, activated charcoal, and rice husk ash. Practical Implications: The study contributes to the field of sustainable agriculture and land management by exploring amendments that can potentially reduce water usage in irrigation, mitigate soil erosion, and enhance soil fertility. This aligns with global efforts to promote sustainable and efficient resource use. Social Implications: These findings can be implemented for cases of poor yield by farming communities by applying zeolite X, activated charcoal, and rice husk ash to improve crop productivity.

Balls and Beats in Physical Education

Physical education teachers who are looking for creative activities that engage students and that meet national and state standards for learning, may find “Balls and Beats” as a perfect solution. “Balls and Beats”, in a fun and dynamic atmosphere, covers all the basic needs for effective student learning based upon the the national standards for K-12 physical education. The content provided in this article can help physical educators provide quality movement and learning experiences in a fun, success-oriented way.

Deep learning for estimation of fetal weight throughout the pregnancy from fetal abdominal ultrasound

Fetal weight is currently estimated from fetal biometry parameters using heuristic mathematical formulas. Fetal biometry requires measurements of the fetal head, abdomen, and femur. However, this examination is prone to inter- and intraobserver variability because of factors, such as the experience of the operator, image quality, maternal characteristics, or fetal movements. Our study tested the hypothesis that a deep learning method can estimate fetal weight based on a video scan of the fetal abdomen and gestational age with similar performance to the full biometry-based estimations provided by clinical experts. This study aimed to develop and test a deep learning method to automatically estimate fetal weight from fetal abdominal ultrasound video scans. A dataset of 900 routine fetal ultrasound examinations was used. Among those examinations, 800 retrospective ultrasound video scans of the fetal abdomen from 700 pregnant women between 15 6/7 and 41 0/7 weeks of gestation were used to train the deep learning model. After the training phase, the model was evaluated on an external prospectively acquired test set of 100 scans from 100 pregnant women between 16 2/7 and 38 0/7 weeks of gestation. The deep learning model was trained to directly estimate fetal weight from ultrasound video scans of the fetal abdomen. The deep learning estimations were compared with manual measurements on the test set made by 6 human readers with varying levels of expertise. Human readers used standard 3 measurements made on the standard planes of the head, abdomen, and femur and heuristic formula to estimate fetal weight. The Bland-Altman analysis, mean absolute percentage error, and intraclass correlation coefficient were used to evaluate the performance and robustness of the deep learning method and were compared with human readers. Bland-Altman analysis did not show systematic deviations between readers and deep learning. The mean and standard deviation of the mean absolute percentage error between 6 human readers and the deep learning approach was 3.75%±2.00%. Excluding junior readers (residents), the mean absolute percentage error between 4 experts and the deep learning approach was 2.59%±1.11%. The intraclass correlation coefficients reflected excellent reliability and varied between 0.9761 and 0.9865. This study reports the use of deep learning to estimate fetal weight using only ultrasound video of the fetal abdomen from fetal biometry scans. Our experiments demonstrated similar performance of human measurements and deep learning on prospectively acquired test data. Deep learning is a promising approach to directly estimate fetal weight using ultrasound video scans of the fetal abdomen.

The Hospitalist Movement 25 Years Later.

Hospitalists are generalists who specialize in the care of hospitalized patients. In the 25 years since the term hospitalist was coined, the field of hospital medicine has grown exponentially and established a substantial footprint in the medical community. There are now more hospitalists than practicing physicians in any other internal medicine subspecialty. Several key forces catalyzed the growth in the field of hospital medicine, including the quality, safety, and value movements; residency duty hour restrictions; the emergence of electronic health records; and the COVID-19 pandemic. Looking ahead, we see new opportunities in the realms of technology and telemedicine, and challenges persist in regard to balancing financial considerations with increasing workload and burnout. Hospitalists must remain nimble and seize emerging opportunities to continue supporting the field's prominence and growth.