Publications by authors named "Burden M"
Background: Clinician electronic actions within the electronic health record (EHR) are captured seamlessly in real-time during regular work activities in all major EHRs. Analysis of this EHR use metadata, such as audit log data, is increasingly used to understand the impact of work design on critical patient, workforce, and organizational outcomes.
Objective: Understand experiences and perspectives influencing the use and implementation of audit log data into practice.
Background: Academic medical centers are experiencing rapid clinical growth which has outpaced traditional teaching services. Learners such as medical students, advanced practice provider fellows, and residents may be placed onto direct care teaching services (i.e.
View Article and Find Full Text PDFBackground: Various strategies have attempted to address increased patient lengths of stay (LOS), but effectiveness varies. Factors related to work design and workforce experience may also play significant roles.
Objective: Utilizing data from the Discharge in the A.
Article Synopsis
- Effective communication through secure messaging (SM) is vital for hospitals, but there's limited research on how hospitalists are adopting and experiencing this tool.
- A mixed-methods study involving a survey and focus groups revealed that while hospitalists see SM as a beneficial communication method, it also leads to increased multitasking and interruptions.
- Key themes identified include variable adoption of SM, lack of institutional guidance on its use, and changes in work dynamics that affect communication depth and interpersonal relationships; recommendations suggest developing clearer guidelines in collaboration with frontline staff.
Background: Secure electronic messaging is increasingly being utilized for communications in healthcare settings. While it likely increases efficiency, it has also been associated with interruptions, high message volumes, and risk of errors due to multitasking.
Objectives: We aimed to characterize patterns of secure messaging among hospitalists to understand the volume of messages, message patterns, and impact on hospitalist workload.
Background: In the USA, multiple organizations rate hospitals based on quality and patient safety data, but few studies have analyzed and compared the rating results.
Objective: Compare the results of different US hospital-rating organizations.
Design: Observational data analysis of US acute care hospital ratings.
Importance: Administrative harm (AH), defined as the adverse consequences of administrative decisions within health care that impact work structure, processes, and programs, is pervasive in medicine, yet poorly understood and described.
Objective: To explore common AHs experienced by hospitalist clinicians and administrative leaders, understand the challenges that exist in identifying and measuring AH, and identify potential approaches to mitigate AH.
Design, Setting, And Participants: A qualitative study using a mixed-methods approach with a 12-question survey and semistructured virtual focus groups was held on June 13 and August 11, 2023.
Purpose: We performed an exploratory evaluation of gender-specific differences in speakers and their introductions at internal medicine grand rounds.
Method: Internal medicine grand rounds video archives from three sites between December 2013 and September 2020 were manually transcribed and analyzed using natural language processing techniques. Differences in word usage by gender were compared.
Background: The concept of attention can provide insight into the needs of clinicians and how health systems design can impact patient care quality and medical errors.
Purpose: To conduct a scoping review to 1) identify and characterize literature relevant to clinician attention; 2) compile metrics used to measure attention; and 3) create a framework of key concepts.
Data Sources: Cumulated Index to Nursing and Allied Health Literature (CINAHL), Medline (PubMed), and Embase (Ovid) from 2001 to 26 February 2024.
Background: Hospital medicine (HM) continues to be primarily composed of junior hospitalists and research has highlighted a paucity of mentors and academic output. Faculty advancement programs have been identified as a means to support junior hospitalists in their career trajectories and to advance the field. The optimal approach to supporting faculty development (FD) efforts is not known.
View Article and Find Full Text PDFBackground: Virtual hospitalist programs are rapidly growing in popularity due to worsening clinician shortages and increased pressure for flexible work options. These programs also have the potential to establish sustainable staffing models across multiple hospitals optimizing cost. We aimed to explore the current state of virtual hospitalist services at various health systems, challenges and opportunities that exist in providing virtual care, and future opportunities for these types of services.
View Article and Find Full Text PDFBackground: Traditional measures of workload such as wRVUs may not be adequate to understand the impact of workload on key outcomes.
Objective: The objective of this study was to develop a mobile application to assess, in near real time, clinicians' perception of workload and work environment.
Designs, Settings And Participants: We developed the GrittyWork™ application (GW App) using the Chokshi and Mann process model for user-centered digital development.
Background: Medicare previously announced plans for new billing reforms for inpatient visits that are shared by physicians and advanced practice providers (APPs) whereby the clinician spending the most time on the patient visit would bill for the visit.
Objective: To understand how inpatient hospital medicine teams utilize APPs in patient care and how the proposed billing policies might impact future APP utilization.
Design, Setting And Participants: We conducted focus groups with hospitalist physicians, APPs, and other leaders from 21 academic hospitals across the United States.
We assessed how hospitalists frame workplace safety, health, and well-being (SHW); their perception of hospital supports for SHW; and whether and how they are sharing leadership responsibility for each other's SHW. Our findings highlight the important role of local support for hospitalist SHW and reveal the systemic, hospital-wide problems that may impede their SHW. We believe that positioning hospitalists as leaders for SHW will result in systems-wide changes in practices to support the SHW of all care team members.
View Article and Find Full Text PDFBackground: Clinical growth is outpacing the growth of traditional educational opportunities at academic medical centers (AMCs).
Objective: To understand the impact of clinical growth on the educational mission for academic hospitalists.
Design: Qualitative study using semistructured interviews that were analyzed using a mixed inductive and deductive method at the semantic level.
Background: Few hospitals have built surveillance for diagnostic errors into usual care or used comparative quantitative and qualitative data to understand their diagnostic processes and implement interventions designed to reduce these errors.
Objectives: To build surveillance for diagnostic errors into usual care, benchmark diagnostic performance across sites, pilot test interventions, and evaluate the program's impact on diagnostic error rates.
Methods And Analysis: Achieving diagnostic excellence through prevention and teamwork (ADEPT) is a multicenter, real-world quality and safety program utilizing interrupted time-series techniques to evaluate outcomes.
Background: The progression of patients through a hospital from admission to discharge can be slowed by delays in patient discharge, increasing pressure on health care staff. We designed and piloted the Discharge Today tool, with the goal of improving the efficiency of patient discharge; however, adoption remained low.
Purpose: To close this implementation gap, we deployed and evaluated a 4-part implementation strategy bundle.