Background: Hospitals around the country are facing patient flow issues. Late discharges on the inpatient floors are thought to contribute to overcrowding in the emergency department and increased evening admissions (Wertheimer, 2014). This can lead to decreased quality of care, patient satisfaction, and increased length of stay. Some hospitals have attempted to promote early discharges […]

Background:   Academic medical centers are complex healthcare delivery systems that are quickly adopting electronic health records (EHR) nationwide while still using alpha-numeric paging for physicians-in-training raised with cell phones, texting, messaging, and newer technologies.  Understanding workflow processes for these providers of patient care are key to finding solutions to improve healthcare quality and safety.   […]

Background: Despite advances in communication technology, alphanumeric paging remains a mainstay of hospital communication. High paging volume can lead to disruptions in clinical work. In this study, we sought to evaluate both the frequency and the content of paging messages from nurses to physicians. We subsequently implemented interventions aimed at decreasing unnecessary pages.   Methods: […]

Background: One target for improvement of effective patient centered care on the inpatient medical ward is the mechanism for communication among the multidisciplinary care team (MCT).  The medical service at Stanford Hospital and Clinics recently implemented morning “team care rounds” (TCRs) that provided space for the MCT members, including the physician (MD), nurse (RN), case […]

Background: Paging is a commonly used, yet limited means of communication. Despite text capability, one-way numeric paging remains the dominant method of communication at the University of Colorado Hospital (UCH). On a modified Hospital Survey on Patient Safety Culture performed on a medical floor, inefficiencies in provider to nursing communication were highlighted as an area […]

Background: As generalist physicians on the frontlines of hospital care for seriously ill patients across the country, hospitalists are optimally positioned to lead discussions regarding serious illness. Little is known about hospitalists’ confidence in serious illness communication, or the barriers that limit their engagement. Methods: To assess perspectives on serious illness communication, we surveyed hospitalists […]

Background: Geographic localization of inpatient physician services to nursing units has been suggested to improve teamwork and patient safety among health care professionals, while perceived lack of collaboration has been associated with worse patient outcomes. On our inpatient oncology units, we previously found that large discrepancies exist in perceptions of teamwork and collaboration among professionals, […]

Background: Hospital readmissions among HIV positive patients are high, and reducing 30-day readmissions is a priority of health systems and payers. Improved communication in the hospital may help decrease readmissions. Our objective was to determine the association between satisfaction with provider communication and 30-day readmissions among HIV positive patients. Methods: We performed a cross-sectional analysis […]

Background: Shared decision-making (SDM) has been shown to be an important tool for improving patient engagement and health care outcomes. Despite the demonstrated value of SDM across disciplines, little is known about how to increase SDM in general inpatient settings. We sought to evaluate the effectiveness of an educational bundle on inpatient resident teams’ abilities […]

Background The goal of the Accreditation Council for Graduate Medical Education (ACGME) CLER program is to optimize the clinical learning environment for trainees, including improving interprofessional practice.  It is unclear how to best prepare interns for interprofessional practice.  A prior needs assessment of residents and staff nurses at the University of Chicago on this topic […]