Background: The COVID-19 crisis has put an unprecedented strain on the US healthcare system (1). Hospital Medicine (HM) has been on the front lines of the crisis response (2). Multiple surges and troughs are expected before the pandemic subsides with a very large surge predicted for the winter of 2020-2021 (3). As the HM service [...]

Background: Previous studies demonstrate patient readmissions to the Medical Intensive Care unit (MICU) from the ward are potentially associated with worse outcomes due to breakdowns in communication during ICU-ward transfer. Though previous work highlights the importance of shared mental models (whether clinicians have a mutual understanding) during handoffs, no studies examined the prevalence of a [...]

Background: Interprofessional teamwork in healthcare organizations is crucial to the delivery of quality patient care. Efforts to improve teamwork on hospital medicine units commonly fail due to clinicians and other care team members (case managers and pharmacists) are responsible for patients scattered across numerous floors and units. UK HealthCare developed and implemented the Interprofessional Teamwork [...]

Background: Interprofessional education (IPE) has been shown to enhance knowledge, skills, and collaborative attitudes among healthcare providers, while also improving patient outcomes. While IPE is becoming more common in undergraduate medical education, many graduate medical education (GME) programs currently lack formal curricula. Those GME curricula that involve experiential learning have focused largely on the nursing [...]

Background: The 2001 Institute of Medicine Report Crossing the Quality Chasm cited a lack of care coordination as a contributing factor to the “chasm” between evidence-based and delivered care and suggests team-based models of care delivery. Hospitalists are tasked with increasing efficiency in inpatient care. LOS is designated as a measure of care coordination and [...]

Background: The hospitalist role has traditionally been within the hospital setting where a dedicated Rapid Response Team (RRT) and critical care support are available to respond to acute clinical events. While hospitalist involvement in RRT/Codes can vary by institution, the academic hospitalist is infrequently the RRT/Code team leader. As the hospitalist’s scope expands to new [...]

Background: Effective patient handoffs during care transitions are crucial in the skilled nursing home setting where physician providers may not round on a daily basis, and the healthcare facility staff has shift changes on a daily basis. Currently, many critical communications regarding patients are shared via private phone calls, text messages, emails and log books. [...]

Background: Sepsis is a leading cause of death in US hospitals, and is a major contributor to hospital mortality and length of stay. Much has been done in hospitals nationwide to identify and treat sepsis early. Similarly, at Bridgeport Hospital, a clinical redesign was initiated to identify and act on patients with signs of sepsis [...]

Background: Due to the complexity of patient discharge needs leading to increased length of stay within a large academic medical center, a specialized inpatient unit became a priority. Purpose: The University of Kentucky Healthcare created the Complex Discharge team to identify and manage patients who may have a long length of stay, a challenging placement [...]

Background: Hospital discharges before noon have become a common institutional goal in order to improve hospital throughput, reduce emergency department boarding time, and enhance patient satisfaction. Evaluation of baseline rates at Brigham and Women’s Faulkner Hospital (BWFH), a 100-bed academically-affiliated community hospital, demonstrated <10% of patients were discharged before noon. Purpose: To improve rates of [...]