Background: Late afternoon hospital discharges contribute to admission delays, leading to occupancy increase and increased length of stay. However, prominent workplace barriers often exist towards improvement initiatives that target early discharge. Team members cite timing of rounds, absence of early discharge support resources, communication breakdowns, and increased daytime admission volume as barriers to change. Furthermore, [...]

Background: There is often little communication across inpatient medicine teams at a busy academic medical center. Although teams comprise trainees across many levels, individual teams often work in parallel without relating shared challenges and experiences. This can be isolating, and practicing in such silos can propagate systems issues and contribute to burn out. Purpose: Create [...]

Background: Choroidal melanoma, the most common primary intraocular malignancy in adults, is a dangerous cancer which can lead to blindness. Diagnosed at an average age of 65 & lacking identifiable environmental or genetic factors, melanoma of the eye can affect anyone. Commonly found on routine ophthalmological screening, patients are sent to quaternary hospitals for further [...]

Background: Procedures, both inpatient and outpatient, are an essential part of the training for family medicine residents. Several residency programs struggle to provide the minimum number of procedures for residents to develop competency and comfort with the said procedures. Hospitalists do offer increased experience with procedures, although more recently, hospitalists are also referring most procedures [...]

Background: Medical Assistance in Dying (MAiD) was legalized in Canada in 2016. Health authorities across the country have grappled with how to ensure equitable access for patients. In Victoria, British Columbia, a small group of pioneering community physicians were responding to all community and hospital MAiD requests. The lack of a coordinated system, coupled with [...]

Background: More than 30 million children and adolescents participate in organized sports in the United States every year. Participation has numerous benefits including improved physical fitness and better school performance, however, it is not without risk. According to the Centers for Disease Control and Prevention, children sustain more than 3.1 million sports and recreation-related injuries [...]

Background: Successful hospitalist co-management programs address provider knowledge base as well as ongoing faculty skill development and education (1). With a growing liver transplant program, our institution has seen increased patient volume on the hospitalist liver service. Hospitalists and hepatologists co-manage this expanding population of high acuity patients with complex pathologies. In the past year, [...]

Background: The essential elements of physicians’ daily practice occur within the clinical learning and working environment (LWE), the crossroads where medical education and lifelong learning intersect with direct patient care. The LWE, therefore, is the keystone for academic hospitalists interacting with learners across the medical education continuum. It is of equal significance for direct-care hospitalists [...]

Background: Onboarding for new hospitalist attendings tends to focus heavily on local systems practices, such as the electronic health record, how to engage consultants, and billing in order to ensure clinical functionality. This orientation tends to be impersonal and deficient in the essential skills for a long and fulfilling career in hospital medicine. The importance [...]

Background: Teaching trainees clinical reasoning is a critical skill for clinical teachers. Advances in the fields of cognitive science and educational theory have provided a conceptual framework of core concepts in clinical reasoning: problem representation, illness scripts, treatment thresholds, and test-treatment thresholds. Purpose: We designed a one-hour workshop to teach interns core concepts in clinical [...]