Background: Assessing vitals at regular intervals can be disruptive to a patient’s rest and unnecessary if the patient is clinically stable. These interruptions may lead to impaired sleep, parental fatigue and anxiety, delayed discharge, and increased cost of care. Moreover, alarm fatigue has been described with over-monitoring of patients, as has the overuse of staff […]

Background: One of the challenges in hospital medicine is the care of patients overnight, when the primary team is unavailable, and care is being provided by those who are not as familiar with the patient. This is compounded by the high volume of pages at night. At UNC Rex Hospital, these factors resulted in delays […]

Background: Family-centered rounds on our pediatric hospital medicine teaching service, which cares for patients in multiple units throughout the hospital, are often prolonged with unpredictable progression. This contributes to inconsistent nursing participation, inefficiencies in patient care, and variable end times. Through the implementation of scheduled-based rounding, our aims were to: 1) start 90% of rounds […]

Background: Effective nurse-physician communication is imperative to safe, patient-centered care. Poor communication can lead to adverse events, ranging from near misses to patient deaths. It is important for information to be accurate and timely. In addition to patient safety, there are financial implications to poor communication. According to a 2015 study, communication failures in the […]