Background: The transfer of patients between hospitals (interhospital transfer, IHT), exposes patients to risks of discontinuity of care, such as errors in communication and gaps in information transfer. In this study, we aim to quantify clinician-reported medical errors attributable to incomplete communication/information transfer during IHT to a tertiary referral hospital. Methods: We included all patients [...]

Background: Clinicians are not always effective communicators. Communication skill training provided to students, fellows, and faculty is inconsistent.1 However, system-wide relationship-centered communication skills training can improve patient satisfaction scores, reduce burnout, and improve physician empathy.2 Thus, our study’s objective was to determine if a voluntary one-day skills-based communication course could improve provider knowledge, confidence, and [...]

Background: Patient-physician communication is essential to medical care. Simple physician behaviors, such as sitting at the bedside, may bolster patient-physician communication.1-3 Yet despite the potential benefit of sitting, prior work suggests that inpatient physicians do not sit frequently.1,4 Methods: Trained staff performed in-person surveys of patients admitted to seven general internal medicine teaching services from [...]

Background: Uncertainty of viral transmission and PPE availability early in the SARS-CoV-2 pandemic created unique infection control challenges for hospitals. Prior to masking recommendations and widespread testing availability, the hospital medicine service at an academic hospital system published “medical distancing” guidelines to reduce the frequency and proximity of physician-patient interactions to minimize transmission. While previous [...]

Background: Hospitalists commonly discuss advance care planning (ACP), which supports patients in understanding and expressing their values for medical care during serious illness. The coronavirus disease of 2019 (COVID-19) pandemic has increased the urgency of these conversations, especially for patients with older age, comorbidities, or an otherwise high risk for complications such as ICU admission, [...]

Background: Electronic messages represent a growing proportion of inter-professional team communication in the inpatient setting. Poor communication hinders team collaboration, increases patient readmissions, and may facilitate burnout. Descriptions of inter-provider communications have largely utilized survey data in specialized settings at a single time-point. We sought to characterize in-patient hospital-wide inter-provider communication patterns over a year. [...]

Background: Rounds are critical for facilitating patient care, supporting interprofessional communication and providing education for trainees (1,2). Social distancing requirements in the era of COVID led to significant changes to the traditional rounding structure (3). The impact of these changes on patient care, interprofessional communication and education remain unknown. Methods: An interprofessional needs assessment was [...]

Background: Discharge planning should begin at the time of admission and involve preparing patients for the transition out of the hospital. Unfortunately, many hospitalized patients disagree with their provider about their discharge plan, including what needs to be accomplished in the hospital or the dismissal’s timing and location. When patients and their providers do not [...]

Background: Over the last few decades, medicine has seen increasing specialization and a proliferation of roles, trends which can complicate patient care in the hospital setting. Inpatient care teams are comprised of many types of members, and the boundaries between roles can change and at times be ambiguous, e.g., between hospitalist and subspecialist consultants. In [...]

Background: Many institutions rely on informal training for internal medicine (IM) residents about how to provide effective discharge communication to patients and their caregivers. Complete instructions are essential to safe transitions of care. At our institution, we evaluated baseline knowledge of these topics among IM residents, and assessed how an educational module impacted residents’ knowledge, [...]