This document provides a table of contents for the Core Competencies in Hospital Medicine project by the Canadian Society of Hospital Medicine (CSHM). It outlines general clinical skills, common clinical conditions, and procedures that hospitalists should be competent in. The document acknowledges contributions and lists executive and expert committees for the CSHM project. It also provides brief histories of hospitalist programs and the current state of hospital medicine in Canada.

1. Please
visit
www.canadianHospitalist.ca
for
more
information
on
the
Core
Competencies
in
Hospital
Medicine
project.
Copyright
©
2015
CSHM
All
Rights
Reserved.
Core
Competencies
in
Hospital
Medicine
Care
of
the
Medical
Inpatient
Phase
1
–
September
2015

2. 2
Canadian
Society
of
Hospital
Medicine
–
Core
Competencies
in
Hospital
Medicine
Care
of
the
Medical
Inpatient
Table
of
contents
Please
visit
www.canadianHospitalist.ca
for
more
information
on
the
Core
Competencies
in
Hospital
Medicine
project.
Copyright
©
2015
CSHM
All
Rights
Reserved.
Core
Competencies
in
Hospital
Medicine
Table
of
contents
ACKNOWLEDGEMENTS
......................................................................................................................................................................................
4
CORE
COMPETENCIES
IN
HOSPITAL
MEDICINE
(CCHM
2015)
COMMITTEES
............................................................................................................................................
4
CCHM
2015
EXECUTIVE
COMMITTEE
.................................................................................................................................................................................................................
4
CCHM
2015
EXPERT
COMMITTEE
.......................................................................................................................................................................................................................
5
INTRODUCTION
...............................................................................................................................................................................................
10
PREFACE
..................................................................................................................................................................................................................................................................
10
CSHM
CORE
COMPETENCIES
IN
HOSPITAL
MEDICINE:
DEFINITIONS
AND
FUTURE
DIRECTIONS
..........................................................................................................
11
HISTORY
OF
CANADIAN
HOSPITALIST
PROGRAMS
...........................................................................................................................................................................................
16
CURRENT
CLIMATE
OF
HOSPITAL
MEDICINE
IN
CANADA
...............................................................................................................................................................................
21
CANADIAN
HOSPITALISTS:
WORKING
IN
TEAMS
TO
PROVIDE
QUALITY
INPATIENT
CARE
.......................................................................................................................
29
GENERAL
CLINICAL
SKILLS,
COMMON
CLINICAL
CONDITIONS,
AND
PROCEDURES
FRAMEWORKS
....................................................................
40
HOW
DOES
THE
CCHM
DOCUMENT
NUMBERING
SYSTEM
WORK?
...............................................................................................................................................................
40
1.
GENERAL
CLINICAL
SKILLS:
MANAGEMENT
OF
A
STANDARD
MEDICAL
ADMISSION
..............................................................................................................................
41
2.
GENERAL
CLINICAL
SKILLS:
ANTIMICROBIALS
–
PREVENTING
RESISTANCE
..........................................................................................................................................
43
3.
GENERAL
CLINICAL
SKILLS:
ANTIMICROBIALS
–
STEWARDSHIP
..............................................................................................................................................................
45
4.
GENERAL
CLINICAL
SKILLS:
COMPLEX
AND
FRAIL
ELDERLY
......................................................................................................................................................................
48
5.
GENERAL
CLINICAL
SKILLS:
DIAGNOSTIC
DECISION
MAKING
....................................................................................................................................................................
51
6.
GENERAL
CLINICAL
SKILLS:
DRUG
SAFETY
AND
MEDICATION
RECONCILIATION
...................................................................................................................................
54
7.
GENERAL
CLINICAL
SKILLS:
INFORMATION
MANAGEMENT
.......................................................................................................................................................................
57
8.
GENERAL
CLINICAL
SKILLS:
NUTRITION
AND
THE
HOSPITALIZED
PATIENT
...........................................................................................................................................
60
9.
GENERAL
CLINICAL
SKILLS:
HOSPICE
PALLIATIVE
CARE
............................................................................................................................................................................
62
10.
CLINICAL
CONDITIONS:
ACUTE
LIFE
OR
LIMB
THREATENING
EMERGENCIES
ON
THE
WARD:
ACUTE
CORONARY
SYNDROME
(ACS)
......................................
64
11.
CLINICAL
CONDITIONS:
ACUTE
LIFE
OR
LIMB
THREATENING
EMERGENCIES
ON
THE
WARD:
ACUTE
SPINAL
CORD
COMPRESSION
(ASCC)
..........................
67
12.
CLINICAL
CONDITIONS:
ACUTE
LIFE
OR
LIMB
THREATENING
EMERGENCIES
ON
THE
WARD:
ACUTE
STROKE/TIA
....................................................................
70
13.
CLINICAL
CONDITIONS:
ACUTE
LIFE
OR
LIMB
THREATENING
EMERGENCIES
ON
THE
WARD:
SEVERE
DRUG
ADVERSE
OR
ALLERGIC
REACTIONS
.................
72

3. Canadian
Society
of
Hospital
Medicine
–
Core
Competencies
in
Hospital
Medicine
Care
of
the
Medical
Inpatient
Table
of
contents
3
Please
visit
www.canadianHospitalist.ca
for
more
information
on
the
Core
Competencies
in
Hospital
Medicine
project.
Copyright
©
2015
CSHM
All
Rights
Reserved.
14.
CLINICAL
CONDITIONS:
ACUTE
LIFE
OR
LIMB
THREATENING
EMERGENCIES
ON
THE
WARD:
SEPSIS
AND
SYSTEMIC
INFLAMMATORY
RESPONSE
SYNDROME
(SIRS)
......................................................................................................................................................................................................................................................................
74
15.
CLINICAL
CONDITIONS:
ACUTE
LIFE
OR
LIMB
THREATENING
EMERGENCIES
ON
THE
WARD:
SHOCK
.............................................................................................
76
16.
COMMON
CLINICAL
CONDITIONS:
ASSESSMENT
OF
ACUTE
ABDOMINAL
PAIN
.....................................................................................................................................
78
17.
COMMON
CLINICAL
CONDITIONS:
ANEMIA
AND
TRANSFUSION
MEDICINE
...........................................................................................................................................
80
18.
COMMON
CLINICAL
CONDITIONS:
ASTHMA
................................................................................................................................................................................................
82
19.
COMMON
CLINICAL
CONDITIONS:
CHRONIC
OBSTRUCTIVE
PULMONARY
DISEASE
(COPD)
.............................................................................................................
85
20.
COMMON
CLINICAL
CONDITIONS:
CONGESTIVE
HEART
FAILURE
(CHF)
..............................................................................................................................................
87
21.
COMMON
CLINICAL
CONDITIONS:
DELIRIUM
.............................................................................................................................................................................................
90
22.
COMMON
CLINICAL
CONDITIONS:
DIABETES
MELLITUS
..........................................................................................................................................................................
92
23.
COMMON
CLINICAL
CONDITIONS:
INTOXICATION,
OVERDOSE
AND
WITHDRAWAL
............................................................................................................................
94
24.
COMMON
CLINICAL
CONDITIONS:
GASTROINTESTINAL
(GI)
BLEEDING
...............................................................................................................................................
97
25.
COMMON
CLINICAL
CONDITIONS:
LIVER
DISEASE
–
ACUTE
....................................................................................................................................................................
99
26.
COMMON
CLINICAL
CONDITIONS:
LIVER
DISEASE
–
CHRONIC
..............................................................................................................................................................
101
27.
COMMON
CLINICAL
CONDITIONS:
ONCOLOGY
MANAGEMENT
INCLUDING
EMERGENCIES
...............................................................................................................
103
28.
COMMON
CLINICAL
CONDITIONS:
PAIN
MANAGEMENT
–
ACUTE
AND
CHRONIC
...............................................................................................................................
105
29.
COMMON
CLINICAL
CONDITIONS:
PNEUMONIA
–
COMMUNITY-­‐ACQUIRED
(CAP)
..........................................................................................................................
108
30.
COMMON
CLINICAL
CONDITIONS:
PNEUMONIA
–
HOSPITAL-­‐ACQUIRED
(HAP)
..............................................................................................................................
111
31.
COMMON
CLINICAL
CONDITIONS:
RENAL
FAILURE
–
ACUTE
................................................................................................................................................................
113
32.
COMMON
CLINICAL
CONDITIONS:
RENAL
FAILURE
–
CHRONIC
............................................................................................................................................................
115
33.
COMMON
CLINICAL
CONDITIONS:
SEIZURES
............................................................................................................................................................................................
116
34.
COMMON
CLINICAL
CONDITIONS:
SKIN
AND
SOFT
TISSUES
INFECTIONS
............................................................................................................................................
119
35.
COMMON
CLINICAL
CONDITIONS:
URINARY
TRACT
INFECTION
(UTI)
...............................................................................................................................................
121
36.
COMMON
CLINICAL
CONDITIONS:
VENOUS
THROMBOEMBOLIC
(VTE)
DISEASE
..............................................................................................................................
123
37.
PROCEDURES:
ARTHROCENTESIS
..............................................................................................................................................................................................................
125
38.
PROCEDURES:
LUMBAR
PUNCTURE
(LP)
.................................................................................................................................................................................................
127
39.
PROCEDURES:
PARACENTESIS
....................................................................................................................................................................................................................
129
40.
PROCEDURES:
THORACENTESIS
.................................................................................................................................................................................................................
131