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: 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: 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: Preliminary data from the 2018 Clerkship Directors in Internal Medicine (CDIM) survey showed that in about 50% of both academic and community medical centers, medical students rotate directly with attendings (1). This number has increased by 400% from 2010, the last year for which data is available (2). In our institution, hospital medicine (HM) […]

Background: Regionalization of a provider team’s patients within dedicated nursing units has been shown to allow for improved efficiency and interdisciplinary collaboration. However, the creation of full regionalization is not feasible or appropriate for many medical centers given resource limitations. We hypothesized that we could achieve a significant increase in patient regionalization by modifying admitting […]

Background: Effective teams share common attitudes, behaviors, and cognitions that support teamwork. Within patient safety literature, effective teamwork is a core feature of interventions that reduce adverse events. However, research on teamwork in healthcare has focused on teams of healthcare professionals and has not examined how patients and their family caregivers experience teamwork as part […]

Background: Millions of people are hospitalized in the United States annually and many of those patients are medically complex requiring a team-based approach to care for their medical problems and complex planning for discharge and the transitions thereafter. The process of discharging a patient is multilayered, time-consuming, and arguably one of the most pivotal times […]

Background: There is often little communication across inpatient medicine teams at a busy academic medical center. Although teams comprise trainees across many levels, individual teams often work in parallel without relating shared challenges and experiences. This can be isolating, and practicing in such silos can propagate systems issues and contribute to burn out. Purpose: Create […]