Background: Co-management across service lines has become increasingly common in hospital medicine. While debate continues over clinical outcomes, some co-management arrangements have led to enhanced provider satisfaction, which may have implications for burnout. We have established successful co-management services with orthopedics, urology (GU), otorhinolaryngology (ENT), trauma and neurosurgery (NS). We are a large urban/suburban academic [...]

Background: Diagnostic errors (DEs), or the failure to accurately identify or provide timely explanations of a patient’s health problem, are a significant source of patient harm. DEs occur in up to 23% of adult inpatients who transfer to intensive care units (ICU) or die. Few studies have examined how clinician team composition impacts DE risk. [...]

Background: Patient experience is increasingly recognized as a measure of healthcare quality and patient-centered care. However, there is insufficient understanding of patient expectations during hospitalization, and of how these are perceived by physicians, nurses, and administrators. The best way to apply the HCAHPS ratings remain elusive due to variability in practice environments, patient and clinician [...]

Background: Co-management across service lines has become increasingly common in hospital medicine. While debate continues over clinical outcomes, some co-management arrangements have led to enhanced provider satisfaction, which may have implications for burnout. We have established successful co-management services with orthopedics, urology (GU), otorhinolaryngology (ENT), trauma and neurosurgery (NS). We are a large urban/suburban academic [...]

Background: Two-thirds of surgical inpatients have at least 2 medical comorbidities, and 14% have six or more. Since 2001, there has been exponential growth of comanagement services, in which hospitalists embedded on surgical services take ownership over medical management. While advanced practice providers (APPs) increasingly manage surgical inpatients, successful comanagement models between hospitalists and APPs [...]

Background: Our hospitalist group has seen a rise in the number of Advanced Practice providers (APP) due to increasing patient workload. The APPs come from varying backgrounds, are within 2 years of graduation and have had little experience in evaluating common emergent and nonemergent presentations on the hospital medicine service. Our current practice is for [...]

Background: Joint leadership- modeled by physician-nurse dyad unit leaders has been a successful leadership structure at our organization for years. Advanced practice providers (APPs) have grown significantly in numbers over the past 10 years and have become critical members of our inpatient healthcare teams. They represent a stable and engaged workforce. In 2016, the nurse-physician [...]

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: 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: From 2016 to 2018, advanced practice provider (APP) utilization in academic hospital medicine groups (HMGs) has increased by 23.6%, with 75.7% of academic HMGs now employing APPs. Due to a lack of standardization around APP utilization, and the frequent use of shared billing models, determination of return on investment for APPs is challenging and [...]