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: Rapid response teams play an important role in the care of clinically deteriorating patients. Variability in team members, setting, and activation criteria creates unique challenges to studying these teams. The complexities and inefficiencies of rapid responses due to their heterogeneity are poorly understood. Here, we explore opportunities for improved rapid response team efficiency using […]

Background: As the racial/ethnic diversity of the US population continues to increase, the proportion of patients with limited English proficiency (LEP) expands. Language barriers can pose as a significant obstacle to receiving high-quality health care and adversely affect the patient experience. Residents commonly encounter patients with LEP in the hospital setting and to a lesser […]

Background: Press–Ganey survey data suggest that low self‐assessment of discharge preparedness is associated with hospital readmission. However, Press–Ganey data are collected after hospitalization, limiting the ability to respond to concerns. The intent of this project was to implement a predischarge patient satisfaction survey to determine if there was an association between low self‐assessed discharge readiness […]

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: Teamwork is essential to providing safe, effective, patient-centered care. Prior research documented discrepancies in perceptions of teamwork and collaboration among nurses and physicians. However, prior studies have been limited to single sites and academic medical centers. Methods: We conducted surveys of healthcare professionals in 4 hospitals participating in the REdesigning SystEms to Improve Teamwork […]

Background: Observational studies suggest unanticipated ICU admissions or cardiac arrests are preceded by hours of unstable clinical signs and symptoms. Medical Emergency Teams (METs) are intended to treat these patients earlier, by identifying them through use of standardized clinical criteria. However, the prevalence of clinically unstable patients on general wards meeting these criteria is not […]

Background: Nurse-physician teamwork is a critical determinant of outcomes among hospitalized patients. Although improvement interventions have been designed for specific settings (eg, intensive care units and operating rooms), less attention has been given to nurse-physician teamwork in hospital medicine. Therefore, our goal was to assess the quality and effectiveness of interventions for improving nurse-physician teamwork […]

Background: Hospitalizations are disruptive, stressful, and costly for patients and families. Readmissions are costly for payers. Readmissions within 30 days occur in 13% of pediatric hospitalizations; prior studies estimate 30-day unplanned readmission rates to children’s hospitals at 6.5%.  However, estimates of unplanned readmission are based on non-validated algorithms developed by expert opinion to exclude planned […]

Background: Appendicitis is the most common surgical condition of childhood. Although guidelines exist for diagnostic imaging, there is lack of consensus about pre‐ and postoperative medical management. Our objective was to examine the effects of variations in pre‐ and postoperative care of appendicitis on outcomes. Methods: As part of a PI project we examined the […]