Background: Residents receive extensive medical training, but critical aspects of patient care associated with discharge, such as communication, escalation of care, discharge disposition, and safe transitions, are often inadequately covered. Memorial Hermann Hospital is one of four training sites for UT Houston Internal Medicine residents. To address the educational gaps around safe transitions of care, we standardized the experience by offering a monthly, interactive, small-group workshop.
Purpose: Our goal is to improve residents’ comfort with 12 key aspects of safe discharge within the Internal Medicine service line. By increasing the baseline weighted average comfort score from 3.28 in June 2024 to 4.0 by October 2025, we aim to enhance residents’ readiness to ensure safe and effective patient transitions of care.
Description: In June 2024, we hosted the first “Journey to a Safe Discharge” workshop for 60 Internal Medicine, Med-Peds, and Prelim interns at Memorial Hermann Hospital. The workshop featured interactive stations: Overview of the Medicine Service Line, Escalation of Care, MDDR/Post-Discharge Disposition, Inpatient Communication, and Day of Discharge Planning [Table 1]. Each 1-hour session had 12-minute rotations at each station, with participants engaging in small-group learning and answering questions for prizes based off patient clinical vignettes. Since then, we have continued monthly multidisciplinary refresher workshops for both residents and interns rotating on inpatient wards, and have expanded to Family Medicine and Neurology residents.
Conclusions: From June 2024 to Oct 2025, 168 interns and residents participated, completing 168 pre-surveys and 157 post-surveys. Each question measured comfort levels on a scale of 5 options: 1-extremely uncomfortable, 2-somewhat uncomfortable, 3-neither comfortable nor uncomfortable, 4-somewhat comfortable, and 5-extremely comfortable. The weighted average across 12 questions increased, from 3.28 in the pre-survey to 4.21 in the post-survey, with the results for individual questions below significantly significant (p< 0.001), with p value calculated using chi-squared test [Table 2]. 90% of residents surveyed wanted this monthly workshop to continue. A patient’s inpatient journey involves more than diagnosing medical conditions; it requires overcoming communication barriers, escalating care, and coordinating discharge, skills that residents often lack when starting residency. Traditional training methods like PowerPoints and pamphlets have proven ineffective. To address this, we designed in-person, small-group workshops using game-style questioning, teach-back techniques, and expert-led sessions, repeated regularly. These workshops have significantly improved resident confidence across crucial areas of safe transitions of care. Next steps are to include more complex patient discussions and expand to additional service lines including surgical residents and advance practice providers (APPs).
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