Background: Hospitals around the country are facing patient flow issues. Late discharges on the inpatient floors are thought to contribute to overcrowding in the emergency department and increased evening admissions (Wertheimer, 2014). This can lead to decreased quality of care, patient satisfaction, and increased length of stay. Some hospitals have attempted to promote early discharges [...]

Background: One target for improvement of effective patient centered care on the inpatient medical ward is the mechanism for communication among the multidisciplinary care team (MCT).  The medical service at Stanford Hospital and Clinics recently implemented morning “team care rounds” (TCRs) that provided space for the MCT members, including the physician (MD), nurse (RN), case [...]

Background: Joint physician-nurse rounding is an important best practice that facilitates communication and patient participation in their care while improving outcomes and satisfaction. Interdisciplinary bedside rounding has been shown to reduce mortality, lengths of stay, medication errors, and readmissions while improving staff engagement, teamwork, and patient experience (1, 2, 3). In 2018, our hospital added [...]

Background: Rising inpatient census, limited physical space and unpredictable admission rates introduce communication inefficiencies among doctors, nurses and patients. Purpose: At UC San Diego Health System, we aimed to streamline communication among physicians, patients and other care team members. Description: Two operational changes were made: 1) establishment of team-based geographic cohorting and 2) segregation of [...]

Background: Multidisciplinary team-based care is a novel concept in hospital medicine where, healthcare team members representing multiple disciplines collaborate to develop patient care plans. Multiple published studies have shown that team-based care is associated with improved length of stay (LOS) and increased staff satisfaction but the data on patient safety and patient satisfaction is conflicting. [...]

Background: Teaching during bedside rounds is necessary to educate students and housestaff, but attendings rarely receive structured feedback on their teaching and rounding practices. We aimed to evaluate a Peer Observation Program and a structured bedside rounds observation tool. We hypothesized that participants would value observing their colleagues, report more effective preparation of the team [...]

Background: Research using the inpatient setting for interprofessional education (IPE) is sparse. At Duke Regional Hospital, the interprofessional team caring for general medicine teaching service patients includes residents, interns, medical students, physician assistant (PA) students, pharmacy students and residents, pharmacists, nurses, case managers and attending physicians. Purpose: To determine the educational and operational measures needed [...]

Background: Historical studies suggest that bedside (BS) rounding is optimal for learners. More recent studies report variable results with BS rounding viewed unfavorably among learners. Nonetheless, some academic institutions are moving toward widespread adoption of BS rounding as the preferred rounding style. On the Internal Medicine (IM) inpatient teaching services at the University of Kentucky [...]

Background: Effective communication between the inpatient care team, patients and their families is an integral part of high quality, safe care while inpatient and during transitions of care. Collaborative, highly functioning interdisciplinary teams can impact the perception of that care by the patient and family. A multidisciplinary team at Utah Valley Hospital piloted an accountable [...]

Background: For the academic hospitalist, rounds are the cornerstone of teaching, learning, and patient care. At our institution, a study found that internal medicine residents on the inpatient wards spent an average of 3.4 hours rounding daily. However, most residents and attendings described rounds as “inefficient” and “low value.” With the importance of ACGME work [...]