A novel virtual course to teach medical students high-value decision-making.

Background: Although a clinician's ability to employ high-value decision-making is influenced by training, many undergraduate medical education programmes lack a formal curriculum in high-value, cost-conscious care. We present a curriculum developed through a cross-institutional collaboration that was used to teach students at two institutions about this topic and can serve as a framework for other institutions to develop similar curricula.

Approach: The faculty from the University of Virginia and the Johns Hopkins University School of Medicine created a 2-week-long online course to teach medical students the fundamentals of high-value care.

What strategies are used by clinician champions to reduce low-value care?

Background: Clinician champions are front-line clinicians who advocate for and influence practice change in their local context. The strategies they use when leading efforts to reduce the use of low-value care have not been well described. The purpose of this study is to identify and describe strategies used by six clinician champions who led a low-value care initiative in their clinical setting.

Disseminated Balamuthia mandrillaris Infection.

Balamuthia mandrillaris is a rare cause of human infection, but when infections do occur, they result in high rates of morbidity and mortality. A case of disseminated Balamuthia infection is presented. Early diagnosis and initiation of recommended therapy are essential for increased chances of successful outcomes.

Considering Factors of and Knowledge About Patients in Handover Assessment.

The healthcare system is moving from one primary physician who assumes responsibility for each patient to a more team-based approach. Thus, assessing team communication is critical. This study characterizes and assesses the quality of hospitalist handover communications at shift change using the literature recommended content and language form elements.

Bringing technology to the bedside: using smartphones to improve interprofessional communication.

The purpose of this project was to evaluate the impact of using Smartphones at the bedside on the quality of interprofessional communication and measure the response time between nurses and physicians compared with the usual paging device. Smartphones were provided to nurses and physicians on a 26-bed medical unit during a 2-month study period. Data were collected using Nurse-Physician Communication Questionnaires and Time and Motion data collection tools.

Use of an appreciative inquiry approach to improve resident sign-out in an era of multiple shift changes.

Background: Resident duty hour restrictions have resulted in more frequent patient care handoffs, increasing the need for improved quality of residents' sign-out process.

Objective: To characterize resident sign-out process and identify effective strategies for quality improvement.

Design: Mixed methods analysis of resident sign-out, including a survey of resident views, prospective observation and characterization of 64 consecutive sign-out sessions, and an appreciative-inquiry approach for quality improvement.