Background: Patient experience (PEX) is associated with higher levels of adherence to recommended prevention and treatment processes, better clinical outcomes, improved patient safety within hospitals, and decreased inappropriate health care utilization. (1,2,3) Furthermore, overall patient satisfaction is associated with lower 30-day risk standardized hospital readmission rates after adjusting for clinical quality. (4) Our hospital medicine [...]

Background: Balancing attending supervision with resident autonomy is intended to ensure patient safety while allowing trainees to gain graduated competency and independence upon completion of residency. ACGME work-hour restrictions have increased attending supervision, but its effect on resident education and autonomy is unclear. In order to better understand the underlying tensions and contributing factors to [...]

Background: Duty hour restrictions for resident physicians have led to the ubiquity of night float systems. While this change has positively influenced well-being and supervision, limited studies indicate a negative impact of night float rotations on resident education. Nocturnists have been identified as a key resource for improving the educational value of night float rotations, [...]

Background: Enhanced physician-nurse collaboration improves patient outcomes. Current interprofessional clinical learning environments, however, rarely engage physicians with nurses and are not based on high-performance team frameworks. Therefore, leaders at the University of Chicago Medicine developed the Improving GME Nursing Interprofessional Team Experiences (IGNITE) program to engage interprofessional healthcare teams, with hospitalist coaches, in institutional performance [...]

Background: The relationship between autonomy and supervision (A/S) on general medicine inpatient services requires a balance to ensure patient safety while fostering graduated competency in residents. Previous research at our institution has shown a tension hospitalists feel when balancing these two principles. For example, hospitalists reported that the ideal clinical culture should offer more autonomy [...]

Background: Pediatric hospitalists are responsible for providing high quality care in the hospital setting while teaching learners and maintaining a professional learning environment. This skill is rarely taught during medical training. Peer observation is a collaborative tool with potential for mutual benefit; offering the observer an opportunity to learn new strategies and the individual observed [...]

Background: The American Board of Internal Medicine and the Society of Hospital Medicine have identified routine laboratory testing of stable inpatients as one source of low-value care.1,2 As it is estimated that upwards of 21% of all lab tests represent inappropriate overutilization,3 reducing unnecessary testing could have a significant impact on cost saving, limiting waste, [...]

Background: The tumor microenvironment and its interaction with the tumor are indicative of disease progression but has not been clinically applied due to the lack of objective assessment criteria. Proximity associated effects of the tumor to its microenvironment which can explain the long-term behavior of tumor remains to be developed. In this work, we utilized [...]

Background: The Accreditation Council for Graduate Medical Education’s (ACGME) Clinical Learning Environment Review (CLER) program’s Pathways to Excellence framework includes the expectation that “residents and fellows engage in inter-professional, experiential patient safety event investigations that include analysis” (1, 2). However, as noted by the CLER program national reports, trainee participation in patient safety event analyses [...]

Case Presentation: A healthy 65-year-old male was admitted to the hospital for presumed COPD exacerbation and despite treatment developed hypoxic respiratory failure and shock, transferring to the intensive care unit (ICU) for further management.On arrival, he was tachycardic (120 BPM), BP 74/47 mmHg, febrile (39.0℃) and mechanically ventilated (RR 14) concerning for septic shock. Examination [...]