Background: Most academic general medical services cover patients across several different care units in the hospital. Studies have shown that de-regionalized care leads to a lack of team cohesion and poor communication between healthcare providers. Prior studies have shown that teamwork improves patient outcomes and increases health care worker satisfaction. However, little information using validated [...]

Background: Effective and timely communication among caregivers is one of the 2016 Hospital National Patient Safety Goals set forth by the Joint Commission. The pager messaging system remains predominant in the U.S health care system, but is this one-way pager device falling out of favor over smart phones in the health care setting? There is [...]

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: 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: 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 [...]

Background: Communicating with patients with limited English proficiency (LEP) can be a challenge. Despite laws and studies reinforcing the need to use appropriate interpretation services, many fail to do so. Impressing upon learners the importance of effective communication with LEP patients poses another barrier. We created an innovated immersive experience to help learners understand the [...]

Background: Hospitalization of the patient with advanced cancer can be a pivotal moment and opportunity to explore patient goals of care in order to deliver high value, patient-centered care that emphasizes quality of life. Part of this discussion should define patient preferences regarding code status as it is known that prognosis is extremely poor and [...]

Background: Interprofessional rounds have the potential to improve patient safety, quality, and experience.  Although increasingly implemented, significant variation in rounding practice patterns exist and few data are available to evaluate impact on patients’ experiences. We implemented a novel inpatient collaborative care (CC) model, which includes interprofessional rounds, and also purposely integrates patients and families into [...]