Background: Secure text messaging systems that allow for bidirectional communication between a sender and recipient, instead of relying on unidirectional alphanumeric text or numeric-only messages, have fundamentally changed inpatient communications. At our institution, all clinical team members utilize the same secure messaging platform (Voalte). We aimed to explore physician and nurse overall satisfaction with our [...]

Background: Understanding a patient’s goals of care (GOC) during hospitalization is vital to provide patient centered care. Despite the known importance, little is known about the quality of GOC conversation documentation. The aim of this study is to examine discussion documentation in hospitalized general medicine (GM) patients prior to intensive care unit (ICU) transfer and [...]

Background: Up to 18% of clinic patients are considered difficult by their providers. (1,2) Common characteristics of difficult outpatients are the presence of personality disorders, depression, anxiety, somatization and requesting pain medications. (1,2, 5) Two qualitative studies suggest that inpatient medicine providers also regularly experience hospitalized patients as difficult. (3,4) However, there have been no [...]

Background: Hospitalized patients who are at high-risk for mortality and readmission represent a unique population requiring tailored interventions to improve care outcomes. Advance care planning (ACP) conversations in the inpatient setting can help align care goals with patient preferences, yet their influence on measurable clinical outcomes in this vulnerable population is not well understood. Methods: [...]

Background: Patient experience is critical in the quality of care delivered in hospitals and is closely linked to better clinical outcomes and patient satisfaction. Hospitalized patients under the care of hospitalists often face challenges related to communication, understanding their plan of care, and feeling connected to their healthcare team. Enhancing patient experience in this setting [...]

Background: As a strategy to improve throughput and efficiency, Vanderbilt University Hospital implemented geographic localization across several Hospital Medicine (HM) teams and units. This large-scale structural change presents an opportunity to not only improve efficiency and quality metrics, but to improve other patient-centered outcomes including patient experience. Purpose: To assess the impact of a hospital [...]

Background: Patient experience is a key indicator of healthcare quality, influencing both satisfaction and outcomes. Despite ongoing efforts to improve care, many patients continue to report unmet needs or concerns, particularly in the late afternoon and evening hours. Addressing these concerns before the end of the day is essential to enhancing overall patient experience. Purpose: [...]

Background: Hospitalized patients often report that they lack the opportunity to share their priorities, and currently there is no standard protocol for hospitalists to elicit their patients’ priorities. Additionally, changes in 2025 to CMS reimbursement rules will require hospitals to have protocols for eliciting what matters to admitted patients, further necessitating the development of an [...]

Background: International medical graduates (IMGs) are vital members of the United States (US) healthcare landscape, making up 24.7% of physicians nationally.[1] Despite this, IMGs face numerous challenges in matching and transitioning to US residencies. One hurdle is adapting to the Western value of relationship-centered care (RCC), which emphasizes patient autonomy, shared decision-making, and interpersonal communication [...]

Background: Length of stay is an ongoing challenge for hospitals across USA. Large number of medically stable patients continue to remain in the hospital. There are multiple barriers including social, financial, and poor communication between team members. This delays discharge leading to poor patient care, burnout of team members, reduced bed capacity and access. Purpose: [...]