Background: The Hospitalist Division at Washington University in St. Louis provides coverage for multiple different services at Barnes-Jewish Hospital. At the present time, there are a total of 68 MDs and 6 NPs caring for greater than 100 patients on a daily basis. Our main Hospital Medicine service is comprised of 11 different Hospitalist attending […]

Background: Dedicated hospitalists are associated with improvements in healthcare quality and patient outcomes, but are not feasible for small-volume critical access hospitals (CAHs). A telemedicine “virtual hospitalist” model may expand the capabilities of a CAH at a fraction of the cost of an on-site provider. Purpose: Our purpose was to provide hospitalist coverage to remote […]

Background: Inter-hospital transfer (IHT, the transfer of patients between hospitals) exposes patients to risks of discontinuity of care. To identify aspects of the transfer process that increase risk, we examined the impact of select transfer process factors on clinical outcomes among patients undergoing IHT. Methods: We performed a retrospective analysis of patients ≥ age 18 […]

Background: There are approximately 7,000 Physician Assistants (PAs) and 10,000 Nurse Practitioners (NPs) working as hospitalists nationally. About 63% of hospitalist groups utilize NPs/PAs. The demand for hospitalists continues to exceed the supply and has led to increased utilization of NPs/PAs in hospital medicine. NP/PAs receive very limited inpatient training and there is wide variation […]

Background: Communication between patients, nurses and physicians is vital to patient care. Prior studies have shown that a substantial number of hospitalized patients do not understand their care plan and that physician-nurse co-location or time spent communicating have little impact on physician-nurse concordance of plan of care. To our knowledge, there have been no prior […]

Background: High volume communications to physicians for non-emergent issues can disrupt workflows and cause delays and inefficiencies. The frustration caused by unnecessary communication can also affect the job satisfaction of the Care Team. Physicians at Mercy North Iowa received an average of 140 pages for call back on medical cases every day from January 2015 […]

Background: Elderly inpatients often require the support of family and informal caregivers at transitions and yet adequacy of communication between hospital physicians and members of the patient’s social support is poorly studied. Methods: Mixed methodology survey of patients, their preferred social support member, and physicians as part of a communication quality improvement initiative on the […]

Background: Family members often play a significant role in the care of geriatric patients during and after hospitalization. Both patients and families have expectations for communication with the provider team in the acute setting, but navigating the flow of medical information across the family unit is challenging with current care models. Pediatric medicine recognizes that […]

Background: Multiple recent studies have demonstrated a link between effective clinician communication and patient experience of care in the hospital. Additionally, at a time of unprecedented rates of clinician burnout, communication challenges can negatively impact hospitalist job satisfaction. Despite this, there are limited proven interventions for improving communication in hospital medicine. A low-cost, high-yield, and […]

Background: Research suggests that ambulation in hospital settings can help prevent functional decline in patients. Early ambulation also contributes to better patient outcomes and decreased length of stay. The purpose of this study is to investigate patient perspectives to learn about factors that influence early ambulation and recommended amount of ambulation while in the hospital. […]