Background: Improving hospital throughput is a barrier facing medical facilities.  Poor throughput leads to prolonged patient wait times for beds, a cause of patient complaints.  Often these wait times are the result of late discharge times for admitted patients.  One focus of multidisciplinary rounds is early discharge, hoping to get admitted patients to their beds […]

Background: Substantial portions of hospitalized patients in the United States do not understand their plan of care. Hospitalized patients’ knowledge of their plan of care affects their ability to provide truly informed consent and assent to inpatient treatment, and to assume their medical care after discharge. There is a need for further study of the […]

Background:  The rapidly changing and increasingly complex hospitalist work environment has placed new focus on provider burnout and resilience. As hospitalist leaders seek tools to address these issues, the design thinking process offers a novel user-centered approach. Initially developed in the tech industry, design thinking moves quickly and iteratively through five stages: Empathize, Define, Ideate, Prototype, and […]

Background: Due to low cost, dependability, and familiarity, one-way alphanumeric paging continues to be a commonly used method of in-hospital communication. However, lack of urgency indicators has been cited as a key limitation. To address this issue, an Interdisciplinary Communication Improvement Taskforce (In-CITe) at an academic medical institution adopted a Priority Structured Paging (PSP) system […]

Background: Lack of urgency indicators and receipt confirmation are two of several known alphanumeric paging limitations. To address absence of urgency indicators, a Priority Structured Paging (PSP) system that allowed nurses to communicate priority was adopted at an academic medical institution across multiple nursing units caring for a mixed patient type and acuity. Data recorded […]

Background: Residents are frequently the first physicians notified when acute changes occur in patient conditions.   Delays in appropriate diagnostic testing or treatment can adversely affect patients if residents are unfamiliar with certain clinical situations and fail to escalate to an attending physician.  Our hospital had no written guidelines on when internal medicine residents should escalate […]

Background: Effective communication between health-care providers, patients and their families is a key aspect of the discussion surrounding a patient’s goals of care.  One crucial part of this process is reaching a shared understanding of how the patient views their own quality of life.   The objective of this study was to characterize factors patients and […]

Background: Patient evaluation of satisfaction with their physician has been utilized for several years and is now being included as a parameter utilized to calculate reimbursement. Despite the routine use of these evaluations by most hospitals and agencies, little research has been done to evaluate the metrics of patient evaluations. We sought to assess whether […]

Background: Patient evaluation of satisfaction with their physician has been utilized for several years and is now being included as a parameter utilized to calculate reimbursement. Despite the routine use of these evaluations by most hospitals and agencies, little research has been done to evaluate the metrics of patient evaluations. We sought to assess whether […]

Background: Advance care planning is nationally recognized as important for honoring patient wishes at the end of life. Despite this widespread recognition, many patients lack advance care planning and spend their last days in ways not concordant with their values. Moreover, traditional advance directives may provide only a partial context for patients’ belief systems relevant […]