Background: Hospitalization is often stressful and confusing for patients and families, and hospitalists play a pivotal role in helping navigate complex treatment plans, integrating multiple consultant and ancillary service recommendations, and providing guidance and reassurance. To achieve this, hospitalists need to quickly develop rapport with patients and families. However, most hospital medicine patients are unable [...]

Background: Recent research highlights that in-hospital communication increasingly is relying on secure electronic messaging with notable unintended consequences, including increasing task switching and the overall burden of communications. This study sought to quantify non-actionable, non-urgent messages to better understand their prevalence and to develop interventions aimed at optimizing communication workflows. Methods: A qualitative content analysis [...]

Background: Rapid recognition of deteriorating patients and efficient physician – nursing communication is essential for patient safety and improved health outcomes (1,2).  We conducted a pilot study at a tertiary care academic hospital in September, 2024 with intervention to improve communication between night physicians (nocturnists) and nurses (RN). Methods: At the study site, night shifts last from 7pm-7am [...]

Background: At our institution, bedside co-rounding with physicians and nurses has been promoted as a mechanism to facilitate care team communication. However, coordinating bedside co-rounding can be logistically challenging and time consuming, especially when patients and care team members are not geographically co-localized. Little is known on how bedside co-rounding impacts patient experience. We aimed [...]

Background: Hospital reimbursement for medical necessity is based on the level of care a patient is receiving. In the electronic medical record (EMR), the level of care, inpatient or observation, is determined by a practitioner order or physician certification. The timeliness of this order is of utmost importance, as medical necessity is a dynamic status. [...]

Background: It has long been established that a critical aspect of high-quality patient care is patient-physician communication.1,2 There can be a variety of potential barriers to this communication, and one such barrier might be the use of contact isolation. Indeed, studies have shown that contact isolation does pose the risk of reducing face-to-face time between [...]

Background: Secure text messaging systems that allow for bidirectional communication between a sender and recipient, instead of relying on unidirectional alphanumeric text or numeric-only messages, have fundamentally changed inpatient communications. At our institution, all clinical team members utilize the same secure messaging platform (Voalte). We aimed to explore physician and nurse overall satisfaction with our [...]

Background: Understanding a patient’s goals of care (GOC) during hospitalization is vital to provide patient centered care. Despite the known importance, little is known about the quality of GOC conversation documentation. The aim of this study is to examine discussion documentation in hospitalized general medicine (GM) patients prior to intensive care unit (ICU) transfer and [...]

Background: Up to 18% of clinic patients are considered difficult by their providers. (1,2) Common characteristics of difficult outpatients are the presence of personality disorders, depression, anxiety, somatization and requesting pain medications. (1,2, 5) Two qualitative studies suggest that inpatient medicine providers also regularly experience hospitalized patients as difficult. (3,4) However, there have been no [...]

Background: Hospitalized patients who are at high-risk for mortality and readmission represent a unique population requiring tailored interventions to improve care outcomes. Advance care planning (ACP) conversations in the inpatient setting can help align care goals with patient preferences, yet their influence on measurable clinical outcomes in this vulnerable population is not well understood. Methods: [...]