Background: Microaggressions (adapted from Sue et al. 2007) are “brief and commonplace verbal, behavioral, or environmental indignities, whether intentional or unintentional, that communicate hostile, derogatory, or negative slights and insults with regards to race, gender, religion, or sexual orientation that target a person or group”. In healthcare, studies have examined microaggressions’ effect on trainee experience, [...]

Background: Communication failures amongst interdisciplinary internal medicine (IM) teams occur often in the inpatient setting, which can inhibit mutual understanding of care plans, increase the potential for medical error, and contribute to patient dissatisfaction. Efforts to enhance interdisciplinary collaborative teamwork within inpatient IM teams highlighted a critical need to address concerns related to communication. Methods: [...]

Background: Multidisciplinary rounding (MDR) is a necessary component to safe and effective patient care and discharge during hospitalization. However, there are many barriers to daily MDR that can limit the effectiveness of the team. An interdisciplinary needs assessment of MDR at our institution revealed poor communication on plan of care and limited understanding of interdisciplinary [...]

Background: There is a paucity of literature examining length of stay for medical patients requiring discharge to subacute rehabilitation facilities (SAR). At our institution, this subset of patients had an average length of stay (ALOS) of 8.2 days while medical patients being discharged to home had ALOS of 4.2 days during the first half of [...]

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: VTE is associated with considerable morbidity and mortality, in fact, as many as 10% of deaths of hospitalized patients have been contributed to pulmonary embolism.1 The ACP and AACP in their 2011 and 2012 guidelines, respectively, recommend that all hospitalized patients be evaluated for risk of VTE, and subsequent prophylaxis be initiated if benefits [...]

Background: Hospitals emphasize early discharge to improve throughput. Interdisciplinary team members often report feeling rushed in the 24 hours before discharge, which may increase the likelihood of discharge errors and burnout for the team. Purpose: To identify obstacles preventing timely completion of discharge activities, improve reliability of the discharge process, improve staff experience, and decrease [...]