Background: As new residents start their Internal Medicine training in July, many studies have raised concerns about patient safety associated with inexperienced residents, also termed the “July effect.” Based on surveys conducted at our Internal Medicine residency program, there is considerable variation in the inpatient experiences and skills of incoming interns starting residency training. Reviews [...]

Background: Leading healthcare improvement requires skills not often taught in undergraduate medical education (UME). While teaching quality and safety is required in resident education, inadequate emphasis exists in UME to ingrain skills needed to lead transformation of clinical systems. Targeting such content to UME students offers a key opportunity to accelerate mastery for future physicians. [...]

Background: Adverse events and medical errors have important implications for the physicians involved, who are often “second victims” affected by medical errors. Having committed an error is positively associated with subsequent distress and burnout and high levels of burnout correlate with increased self‐reported errors. The negative feelings associated with adverse events can also lead to [...]

Background: Interprofessional healthcare teams enhance care coordination for individual patients. However, such teams do not typically have a mandate or design which promotes vision‐setting, innovation, or leadership beyond immediate clinical care delivery. Purpose: To describe development of a unit‐based interprofessional leadership infrastructure and evaluate themes of participant motivation. Description: From front‐line providers of a care [...]

Background: Many hospital medicine groups have hospitalists with individualized job descriptions who work variable types and numbers of shifts. This creates challenges in crafting a universally applicable productivity metric, as different shifts target different types and volumes of work. An effective yet equitable system that accounts for differences in work schedules is needed. Purpose: Our [...]

Background: At the University of New Mexico Hospital inpatients with cystic fibrosis were previously admitted to the on‐call general medicine ward team. The team would round on these patients on their own, often with the attending physician and intern rounding separately, and await recommendations from the pulmonary/cystic fibrosis team later in the day. Because the [...]

Background: Inpatient care of Oncology patients is a specialized field with care typically provided by Oncologists. These patients are usually very sick with multiple co‐morbidities, high case mix indices, long lengths of stay and high mortality. Our hospital is associated with a specialized outpatient Cancer Center staffed by more than 20 Oncologists. Responsibility for caring [...]

Background: Indwelling vascular and urinary catheters are critical in the care of hospitalized patients. However, they can also lead to potentially life‐threatening infectious and non‐infectious complications, such as bloodstream and urinary infections and thromboembolism. A key strategy in preventing these adverse outcomes is early removal of catheters that are clinically unnecessary. Yet, recent studies show [...]

Background: Electronic Health Records (EHRs) have enabled significant progress in the area of medication safety. However, there remain challenges in optimizing medication titrations and adjustments in high risk medications such as insulin, heparin, and antibiotics. As an example, continuous infusions of unfractionated heparin are commonly utilized among hospitalists and have been identified as a high [...]

Background: In the landmark 1999 publication To Err Is Human, the Institute of Medicine documented the problem of patient harm in US hospitals. They estimated up to 98,000 deaths per year in US hospitals were due to medical errors. Since then, there has been little progress in reducing serious harm events. Recently, best practices from [...]