Background: Communication between hospital and outpatient clinicians is a key component to successful care transitions for older adults, yet this communication is frequently lacking. In addition, residents in academic medical centers are not routinely provided with feedback about post-discharge outcomes or opportunities for improvement. Purpose: To implement weekly video conferences that utilize the electronic medical [...]

Background: Multidisciplinary (MDR) team rounds were established at Halifax hospital as daily, dedicated interactions between varying members of the care team on each inpatient floor. Members of the care team include physicians, nurses, physical therapists, pharmacists, and case managers. These multidisciplinary interactions allow for smooth, real-time, and accurate information that facilitate communication and enhance the [...]

Background: At academic centers the work of discharge planning has historically fallen on housestaff. The medical education community’s efforts to improve the trainee experience have led to an iterative process of duty hour reform and re-design. One effect has been “work compression” – each day a trainee is required to complete more tasks in less [...]

Background: Based on the study “Jobs, Careers, Callings: People’s Relations to their Work,” we wanted to see whether how residents intrinsically view their occupation affects their work engagement and burnout. We used the same three categories: “job” defined as viewing your occupation as a means to an end, “career” as focusing on advancement and prestige, [...]

Background: Discharging patients in an efficient manner improves patient satisfaction and hospital throughput. In this project, we sought to improve patient throughput as well as benefit resident education. Prior to our project, 75% of patient discharges were delayed more than two hours after the patient was determined to be medically ready for discharge; 21% were [...]

Background: The practice of routinely ordering daily labs not based on clinical indication on patients in the hospital is a wasteful clinical practice. Routine daily labs can also lead to patient harm by causing pain and iatrogenic anemia, and can burden laboratory staff resulting in increased lab reporting times. Raising awareness about unnecessary lab orders [...]

Background: The Society of Hospital Medicine (SHM) identifies repetitive CBC & chemistry testing as low-value, and they selected this as a Choosing Wisely Recommendation. Overuse of phlebotomy is associated with hospital-acquired anemia, decreased patient satisfaction and increased hospital costs. Process improvement techniques have been utilized to reduce inpatient phlebotomy, but prospectively identifying a cohort of [...]

Background: Cross-cover is defined as caring for hospitalized patients for whom one is not the primary provider. This is a common, daily practice for residents and hospitalists. It has been demonstrated that the primary intern for a patient is available for only 39% of a patient’s hospital stay. Despite this, no guidelines currently exist regarding [...]

Background: Over the past 50 years, observation status patients have been cared for in a variety of settings: in the emergency department, on inpatient floors, and in dedicated observation units. At our medical center, inpatient teams have traditionally cared for observation patients on medical wards. Patients were often unaware of their admission status until they [...]