#JHMChat Transcript
Healthcare social media transcript of the #JHMChat hashtag.
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See #JHMChat Influencers/Analytics.
| Profile | Tweet |
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 | Society of Hospital Medicine @SocietyHospMed Let tonight's #JHMChat discussion begin! Join the conversation. 🗫 📢 Use #JHMChat on all replies. 📢 Introduce yourself and where you’re from. 📢 Engage with the prompts and each other. 📢 Refresh the latest tweets with the hashtag to stay up to date. |
 | Journal of Hospital Medicine @JHospMedicine 👋 Welcome to tonight's #JHMChat! I'm @SuchitaSata and I'll be your moderator for tonight's #JHMChat on responses to patient safety events. Go ahead and introduce yourselves as we get going! Warm welcome to our authors @NurseNikpour @colleenapogue @matthewdmchugh 👋 |
 | Jen Readlynn, MD, FHM (she/her) @jenreadlynn RT @SocietyHospMed: ⏰🔟 minutes until this month’s #JHMChat! 🩺 Tonight’s facilitator and guests: @SuchitaSata as @JHospMedicine & guests @matthewdmchugh, @ColleenPogue_ , & @NurseNikpour. Don’t forget to use #JHMChat in all tweets! Need a quick refresher 👇 https://t.co/imcMFKWd1M https://t.co/Ibr64eqFmC |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: 👋 Welcome to tonight's #JHMChat! I'm @SuchitaSata and I'll be your moderator for tonight's #JHMChat on responses to patient safety events. Go ahead and introduce yourselves as we get going! Warm welcome to our authors @NurseNikpour @colleenapogue @matthewdmchugh 👋 |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn RT @SuchitaSata: Just a few more minutes! I'm excited for this opportunity to moderate #JHMChat from the journal's account on this important topic of patient safety and how we can (better) handle events as a team |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn RT @JHospMedicine: 👋 Welcome to tonight's #JHMChat! I'm @SuchitaSata and I'll be your moderator for tonight's #JHMChat on responses to patient safety events. Go ahead and introduce yourselves as we get going! Warm welcome to our authors @NurseNikpour @colleenapogue @matthewdmchugh 👋 |
| Journal of Hospital Medicine @JHospMedicine Tonight - how hospitals *should* respond after adverse event happens. Growth mindset, let's crowdsource positive solutions! We are thankful to nursing colleagues & article authors @colleenapogue @NurseNikpour @matthewdmchugh @Penn_CHOPR 🚨 No PHI in #JHMChat 🚨 https://t.co/lHWZX0rUgS |
 | Gopi Astik @gopiastik @SocietyHospMed I’m Gopi - academic Hospitalist and quality researcher with a focus on diagnostic errors joining from chicago! #JHMChat https://t.co/wRhEs8UZnV |
 | Angela Keniston @KenistonAngela RT @JHospMedicine: 👋 Welcome to tonight's #JHMChat! I'm @SuchitaSata and I'll be your moderator for tonight's #JHMChat on responses to patient safety events. Go ahead and introduce yourselves as we get going! Warm welcome to our authors @NurseNikpour @colleenapogue @matthewdmchugh 👋 |
 | Matthew McHugh @matthewdmchugh Excited to be here from @PennNursing @Penn_CHOPR for #JHMChat |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn @JHospMedicine @SuchitaSata @NurseNikpour @colleenapogue @matthewdmchugh @UR_HMD 🤦♀️and I did it already #JHMChat |
 | Annie Massart @Annie_Massart_ Hi everyone! I'm Annie, an academic hospitalist at Emory in Atlanta. Looking forward to chatting with y'all! #JHMChat |
 | Colleen A. Pogue, PhD, RN @colleenapogue @JHospMedicine @SuchitaSata @NurseNikpour @matthewdmchugh Hi all! I’m Colleen Pogue, a 3rd year postdoc fellow at @PennNursing @Penn_CHOPR. Looking forward to this #JHMChat! |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: Tonight - how hospitals *should* respond after adverse event happens. Growth mindset, let's crowdsource positive solutions! We are thankful to nursing colleagues & article authors @colleenapogue @NurseNikpour @matthewdmchugh @Penn_CHOPR 🚨 No PHI in #JHMChat 🚨 https://t.co/lHWZX0rUgS |
| Journal of Hospital Medicine @JHospMedicine @jenreadlynn @SuchitaSata @NurseNikpour @colleenapogue @matthewdmchugh @UR_HMD Thanks for joining Jen! Your Twitter game has been fantastic so we will forgive both of us the #JHMChat reminder :) |
| Journal of Hospital Medicine @JHospMedicine If you're new to #JHMChat, welcome! Tips to follow along 👇 📱 Use #JHMChat on all replies 👋 Introduce yourself and where you’re from. 💬 Engage with the prompts and each other. 🔁 Refresh the "latest" tweets with the hashtag to stay up to date. 🤫 No PHI or case details |
 | Mary Ann @maryannscience1 @JHospMedicine @SuchitaSata @NurseNikpour @colleenapogue @matthewdmchugh Hi! I’m Mary Ann, the senior medical writer at the Emory Division Hospital Medicine. So glad to be here tonight, lol. Happy belated Diwali everyone! 🪔 #JHMChat |
| Journal of Hospital Medicine @JHospMedicine @matthewdmchugh @PennNursing @Penn_CHOPR Thanks for sharing your work with us and your expertise in this conversation! #JHMChat |
 | Anika Kumar, MD (she/her) @freckledpedidoc @JHospMedicine @SuchitaSata @NurseNikpour @colleenapogue @matthewdmchugh 👋 I’m Anika Kumar, Pediatric Hospitalist in Cleveland. 🙏🏽 Thank you #JHMChat family for postponing this chat by 1 day so many of us could celebrate #Diwali with our families. |
 | Charlie M. Wray, DO, MS @WrayCharles @JHospMedicine @SuchitaSata @NurseNikpour @colleenapogue @matthewdmchugh Hi everyone, I'm Charlie Wray - health services researcher and hospitalist at the SFVA/UCSF - tonight I will be multitasking - #JHMChat ing, dinner duty, and taking care of two kiddos (and one feisty cat) |
| Angela Keniston @KenistonAngela Hi! I'm Angela, data & analytics with #CUDHM! Looking forward to the conversation tonight! #JHMChat https://t.co/pEVGBazoQc |
| Society of Hospital Medicine @SocietyHospMed @jenreadlynn @JHospMedicine @SuchitaSata @NurseNikpour @colleenapogue @matthewdmchugh @UR_HMD 😂 it has to happen at least once! #JHMChat |
| Anika Kumar, MD (she/her) @freckledpedidoc RT @JHospMedicine: If you're new to #JHMChat, welcome! Tips to follow along 👇 📱 Use #JHMChat on all replies 👋 Introduce yourself and where you’re from. 💬 Engage with the prompts and each other. 🔁 Refresh the "latest" tweets with the hashtag to stay up to date. 🤫 No PHI or case details |
| Journal of Hospital Medicine @JHospMedicine @Annie_Massart_ Congrats on your promotion Annie! Some good fac dev opportunities with #JHMChat! |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn RT @freckledpedidoc: @JHospMedicine @SuchitaSata @NurseNikpour @colleenapogue @matthewdmchugh 👋 I’m Anika Kumar, Pediatric Hospitalist in Cleveland. 🙏🏽 Thank you #JHMChat family for postponing this chat by 1 day so many of us could celebrate #Diwali with our families. |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: If you're new to #JHMChat, welcome! Tips to follow along 👇 📱 Use #JHMChat on all replies 👋 Introduce yourself and where you’re from. 💬 Engage with the prompts and each other. 🔁 Refresh the "latest" tweets with the hashtag to stay up to date. 🤫 No PHI or case details |
| Charlie M. Wray, DO, MS @WrayCharles @jenreadlynn @JHospMedicine @SuchitaSata @NurseNikpour @colleenapogue @matthewdmchugh @UR_HMD on your first tweet, too! #JHMChat |
| Journal of Hospital Medicine @JHospMedicine 💡 Tonight's #JHMChat is a safe space for discussion, though also a public forum. Please do not share any PHI or specifics of any patient event. We hope this #JHMChat focuses more on the big picture of patient safety and a just culture. 👍Tag all of your Tweets with #JHMChat! |
| Journal of Hospital Medicine @JHospMedicine @colleenapogue @SuchitaSata @NurseNikpour @matthewdmchugh @PennNursing @Penn_CHOPR New twitter handle, we like it :) #JHMChat |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: 💡 Tonight's #JHMChat is a safe space for discussion, though also a public forum. Please do not share any PHI or specifics of any patient event. We hope this #JHMChat focuses more on the big picture of patient safety and a just culture. 👍Tag all of your Tweets with #JHMChat! |
| Journal of Hospital Medicine @JHospMedicine @maryannscience1 @SuchitaSata @NurseNikpour @colleenapogue @matthewdmchugh Oooh you're joining and not just lurking, we love to see it! #JHMChat |
 | Gian Toledanes @ToledanesGian Hello everyone Gian Toledanes, peds hospitalist in Houston, Texas. #JHMChat |
 | Joe Thomas, MD @DocWithBowtie @JHospMedicine @SuchitaSata @NurseNikpour @colleenapogue @matthewdmchugh Hello! Joe Thomas here from Buffalo. Finished a 12-hour shift and a quick (tiny) workout, time to eat some fast food and have a great #JHMChat! Hello everyone! |
| Journal of Hospital Medicine @JHospMedicine @freckledpedidoc @SuchitaSata @NurseNikpour @colleenapogue @matthewdmchugh Thank YOU for holding us to our values of inclusivity, Anika! #JHMChat |
| Journal of Hospital Medicine @JHospMedicine Here's Question 1 for tonight's #JHMCHat: Q1: In your experience, in what situations or circumstances are clinical errors more likely to occur? Remember to respond with A1 and #JHMChat! https://t.co/qHxkxbnNZL |
| Society of Hospital Medicine @SocietyHospMed @gopiastik @JHospMedicine The beauty of #JHMChat — we go where you go! 🛏️ |
 | Jackie Nikpour, PhD, RN @NurseNikpour @colleenapogue @JHospMedicine @SuchitaSata @matthewdmchugh @PennNursing @Penn_CHOPR Thank you for having us at this #JHMChat! I'm Jackie Townley, a second-year postdoctoral fellow in the Center for Health Outcomes & Policy Research (@Penn_CHOPR) at @PennNursing |
| Annie Massart @Annie_Massart_ @JHospMedicine Thank you! And definitely! I'm always on the lookout for opportunities for my colleagues 😃 #JHMChat |
| Journal of Hospital Medicine @JHospMedicine @WrayCharles @SuchitaSata @NurseNikpour @colleenapogue @matthewdmchugh We hear the waffles on your office stove are delicious, by chef baby Wray? #JHMChat |
| Journal of Hospital Medicine @JHospMedicine @KenistonAngela Thanks for joining! Past #JHMChat royalty! |
| Matthew McHugh @matthewdmchugh @JHospMedicine Our @PennNursing @Penn_CHOPR research finds errors occur less in environments where management listens to/acts on clinician safety concerns; safe staffing is prioritized; & complexity is minimized. #JHMChat |
| Mary Ann @maryannscience1 @JHospMedicine @SuchitaSata @NurseNikpour @colleenapogue @matthewdmchugh I’m really never NOT Lurking, though #JHMChat https://t.co/oWRMPuOSVS |
| Journal of Hospital Medicine @JHospMedicine @ToledanesGian King of Visual Abstracts! #JHMChat |
| Journal of Hospital Medicine @JHospMedicine @DocWithBowtie @SuchitaSata @NurseNikpour @colleenapogue @matthewdmchugh Thanks for making us a part of your productive evening! #JHMChat |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn @ToledanesGian Hello my fellow fellow! #JHMChat https://t.co/MhDUKiK4z5 |
| Matthew McHugh @matthewdmchugh RT @matthewdmchugh: @JHospMedicine Our @PennNursing @Penn_CHOPR research finds errors occur less in environments where management listens to/acts on clinician safety concerns; safe staffing is prioritized; & complexity is minimized. #JHMChat |
| Society of Hospital Medicine @SocietyHospMed And we’re off! Have a look at Q1️⃣ for tonight’s #JHMChat! |
| Journal of Hospital Medicine @JHospMedicine @NurseNikpour @colleenapogue @SuchitaSata @matthewdmchugh @PennNursing @Penn_CHOPR Thank you for your powerful perspective piece and inspiring this #JHMChat! |
| Gian Toledanes @ToledanesGian @JHospMedicine #JHMChat https://t.co/Hc30TA6K9O |
| Gopi Astik @gopiastik @JHospMedicine A1: Errors are more likely to occur during periods of high cognitive workload. Especially as hospitalists, we’re constantly multitasking to get through the day. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine Check out our September #JHMChat about hospitalist productivity and we get into the discussion of safe staffing #callback #JHMChat |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn @JHospMedicine A1: Teams don't know each other & don't communicate well, chaotic/stressful environment, multiple distractions, no clear leader. #JHMChat |
| Charlie M. Wray, DO, MS @WrayCharles @matthewdmchugh @JHospMedicine @PennNursing @Penn_CHOPR In my experience, errors will occur in environments where people don't feel psychologically safe and supported. If ppl don't feel comfortable asking for help, bad things will happen #JHMChat |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn RT @WrayCharles: @matthewdmchugh @JHospMedicine @PennNursing @Penn_CHOPR In my experience, errors will occur in environments where people don't feel psychologically safe and supported. If ppl don't feel comfortable asking for help, bad things will happen #JHMChat |
| Matthew McHugh @matthewdmchugh @gopiastik @JHospMedicine Agree @gopiastik -- the 'work' of clinical care is hard enough. Adding the complexity of an often poorly managed environment adds to the cognitive load. #JHMChat |
| Annie Massart @Annie_Massart_ @JHospMedicine A1. Mistakes can be more common when folks are overworked, short-staffed, rushed, or subjected to new/unique/extra stress in the workplace. Like when there's a new confusing EMR. Not that I know what that's like at all 😬 #JHMChat |
| Journal of Hospital Medicine @JHospMedicine @gopiastik Even now we are multitasking, right @WrayCharles ? #JHMChat |
| Angela Keniston @KenistonAngela RT @JHospMedicine: Check out our September #JHMChat about hospitalist productivity and we get into the discussion of safe staffing #callback #JHMChat |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn RT @JHospMedicine: Check out our September #JHMChat about hospitalist productivity and we get into the discussion of safe staffing #callback #JHMChat |
| Colleen A. Pogue, PhD, RN @colleenapogue @JHospMedicine 1A: IME, clinical errors are more likely to occur when there are 🗣️ communication breakdowns b/w nurses &/or healthcare team, esp @ shift change & when the unit is poorly staffed ➡️ rushed care 😮💨 fatigue, stress 😵💫 #JHMChat |
| Matthew McHugh @matthewdmchugh RT @JHospMedicine: @gopiastik Even now we are multitasking, right @WrayCharles ? #JHMChat |
| Gian Toledanes @ToledanesGian A1 when workloads are particularly challenging, compounded by staff (clinical and non-clinical alike) absences from illness or other events #JHMChat |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn RT @Annie_Massart_: @JHospMedicine A1. Mistakes can be more common when folks are overworked, short-staffed, rushed, or subjected to new/unique/extra stress in the workplace. Like when there's a new confusing EMR. Not that I know what that's like at all 😬 #JHMChat |
 | Vinny Arora MD MAPP @FutureDocs @JHospMedicine A1 lack of communication or miscommunication is the root cause of many adverse events. #JHMChat I got the notifications to join! |
| Journal of Hospital Medicine @JHospMedicine @colleenapogue We are already hearing themes of communication, staffing, not knowing each other etc. It's as if high functioning teams need to be a... team? #JHMChat |
 | Maha Sulieman @MahaArhait @JHospMedicine A1 when there are many moving parts in a culture that focus on individual performance rather than system & process #JHMChat |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn RT @Arhait: @JHospMedicine A1 when there are many moving parts in a culture that focus on individual performance rather than system & process #JHMChat |
| Matthew McHugh @matthewdmchugh @JHospMedicine @gopiastik @WrayCharles FOR REAL!!!! Twitter chat has my neurons firing in 10 different directions #JHMChat |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: @colleenapogue We are already hearing themes of communication, staffing, not knowing each other etc. It's as if high functioning teams need to be a... team? #JHMChat |
| Angela Keniston @KenistonAngela My amazing research partner @marishaburden & I believe there is a demonstrable & measurable association between workload and patient safety events! #JHMChat |
| Charlie M. Wray, DO, MS @WrayCharles @JHospMedicine @SuchitaSata @NurseNikpour @colleenapogue @matthewdmchugh I'm just the sous chef, so i can't take any credit for #OfficeWaffles #JHMChat |
| Journal of Hospital Medicine @JHospMedicine @FutureDocs #JHMChat https://t.co/8Rgj0ttUsn |
| Angela Keniston @KenistonAngela And I party-fouled! Forgot to include A1! #JHMChat |
 | Nancy H. Stewart, DO, MS (she/her) @nvhstewart @JHospMedicine #jhmchat A1. care transitions and handoffs! |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn RT @KenistonAngela: My amazing research partner @marishaburden & I believe there is a demonstrable & measurable association between workload and patient safety events! #JHMChat |
| Matthew McHugh @matthewdmchugh @Arhait @JHospMedicine Great point @Arhait -- our research surveying over 10,000 nurses and physicians suggest that productivity targets and quality metrics, if done poorly, distract from good care #JHMChat |
| Joe Thomas, MD @DocWithBowtie @JHospMedicine #JHMChat A1: Others have said, but staffing is so key, in All team aspects. Docs/APPs, nursing, MAs, pharmacy, RTs…when people juggle too many patients, that’s when stuff falls through the cracks. Admin/extramedical burden weighs heavy here, too. |
| Journal of Hospital Medicine @JHospMedicine @Arhait Thanks for being here for this #JHMChat And we love the emphasis on teams and team success! |
| Mary Ann @maryannscience1 @KenistonAngela @marishaburden Do y’all feel like modern day Semmelweises?? #JHMChat |
| Society of Hospital Medicine @SocietyHospMed RT @DocWithBowtie: @JHospMedicine #JHMChat A1: @JHospMedicine #JHMChat A1: Others have said, but staffing is so key, in All team aspects. Docs/APPs, nursing, MAs, pharmacy, RTs…when people juggle too many patients, that’s when stuff falls through the cracks. Admin/extramedical burden weighs heavy here, too. |
| Journal of Hospital Medicine @JHospMedicine @KenistonAngela @marishaburden There's a pub for that... https://t.co/sURhflff19 #JHMChat |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: @KenistonAngela @marishaburden There's a pub for that... https://t.co/sURhflff19 #JHMChat |
| Anika Kumar, MD (she/her) @freckledpedidoc @JHospMedicine A1. Pressure situations. Time stress, ⬆️ patient volumes/acuity, clinician moral distress. There is ⬆️ pressure for clinicians to care for more patients with ⬇️ resources ➡️ moral distress & pressure. We must really put ⏰ & 💴 into supporting & studying moral distress #JHMChat |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn @KenistonAngela I'm sensing that even those of us with experience with #JHMChat are under some high cognitive load where errors are more likely to happen... https://t.co/E66oBcxmn1 |
| Society of Hospital Medicine @SocietyHospMed RT @freckledpedidoc: @JHospMedicine A1. Pressure situations. Time stress, ⬆️ patient volumes/acuity, clinician moral distress. There is ⬆️ pressure for clinicians to care for more patients with ⬇️ resources ➡️ moral distress & pressure. We must really put ⏰ & 💴 into supporting & studying moral distress #JHMChat |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn RT @matthewdmchugh: @Arhait @JHospMedicine Great point @Arhait -- our research surveying over 10,000 nurses and physicians suggest that productivity targets and quality metrics, if done poorly, distract from good care #JHMChat |
| Charlie M. Wray, DO, MS @WrayCharles Just so everyone is aware, having @FutureDocs amble into a #JHMChat is like having Michael Jordan come out of the stands to shoot around with the team |
 | Samir S. Shah @SamirShahMD RT @JHospMedicine: Join us and the authors @NurseNikpour @ColleenAPogue @matthewdmchugh for #JHMChat on this topic tonight! |
| Society of Hospital Medicine @SocietyHospMed RT @WrayCharles: Just so everyone is aware, having @FutureDocs amble into a #JHMChat is like having Michael Jordan come out of the stands to shoot around with the team |
| Journal of Hospital Medicine @JHospMedicine We would love to hear more thoughts about moral distress in constrained enviroments... 🤔 #JHMChat |
| Samir S. Shah @SamirShahMD RT @JHospMedicine: @KenistonAngela @marishaburden There's a pub for that... https://t.co/sURhflff19 #JHMChat |
| Society of Hospital Medicine @SocietyHospMed Our #JHMChat is happening NOW with guests @matthewdmchugh, @ColleenPogue_ , & @NurseNikpour. We’re talking criminal prosecution of clinical errors📑 Don’t miss the chance to learn from colleagues! 💪 @SuchitaSata @JHospMedicine https://t.co/uMPDAtHrDd |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn Just want to really emphasize this one 👇 #JHMChat |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: We would love to hear more thoughts about moral distress in constrained enviroments... 🤔 #JHMChat |
| Charlie M. Wray, DO, MS @WrayCharles @freckledpedidoc @JHospMedicine so you're saying it's not just one thing... #JHMChat |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn RT @JHospMedicine: @KenistonAngela @marishaburden There's a pub for that... https://t.co/sURhflff19 #JHMChat |
| Vinny Arora MD MAPP @FutureDocs @WrayCharles ❤️thanks Charlie! Amazing to just “come” to #jhmchat and not have my notifications on 🔥 from running the account 😂 |
| Journal of Hospital Medicine @JHospMedicine LOVE this. It's not just about how many patients 1 hospitalist has or what the nursing ratio is. It's EVERYBODY. #JHMChat |
| Samir S. Shah @SamirShahMD #JHMChat A bit late but made it 🥳 Samir Shah, @JHospMedicine Editor-in-Chief, joining the chat |
 | 💭 @keeeeeeeeelz RT @DocWithBowtie: @JHospMedicine #JHMChat A1: @JHospMedicine #JHMChat A1: Others have said, but staffing is so key, in All team aspects. Docs/APPs, nursing, MAs, pharmacy, RTs…when people juggle too many patients, that’s when stuff falls through the cracks. Admin/extramedical burden weighs heavy here, too. |
| Matthew McHugh @matthewdmchugh @JHospMedicine A1. Moral distress is a major weight holding back good care and job satisfaction. Constantly knowing what 'should' be done but not always being able to do it because of issues you can't fix as an individual #JHMChat |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn Feeling this so much right now. So. much. moral. distress. #JHMChat @UR_HMD @UR_Med @URMC_DeptMed @URMC_SHWIM |
| Journal of Hospital Medicine @JHospMedicine RT @freckledpedidoc: @JHospMedicine A1. Pressure situations. Time stress, ⬆️ patient volumes/acuity, clinician moral distress. There is ⬆️ pressure for clinicians to care for more patients with ⬇️ resources ➡️ moral distress & pressure. We must really put ⏰ & 💴 into supporting & studying moral distress #JHMChat |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn RT @WrayCharles: Just so everyone is aware, having @FutureDocs amble into a #JHMChat is like having Michael Jordan come out of the stands to shoot around with the team |
| Journal of Hospital Medicine @JHospMedicine RT @matthewdmchugh: @Arhait @JHospMedicine Great point @Arhait -- our research surveying over 10,000 nurses and physicians suggest that productivity targets and quality metrics, if done poorly, distract from good care #JHMChat |
| Charlie M. Wray, DO, MS @WrayCharles @FutureDocs Always good to have you here, MJ #JHMChat |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn RT @matthewdmchugh: @JHospMedicine A1. Moral distress is a major weight holding back good care and job satisfaction. Constantly knowing what 'should' be done but not always being able to do it because of issues you can't fix as an individual #JHMChat |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn RT @JHospMedicine: LOVE this. It's not just about how many patients 1 hospitalist has or what the nursing ratio is. It's EVERYBODY. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine @SamirShahMD Thanks for being here, cap'n! #JHMChat |
| Matthew McHugh @matthewdmchugh @JHospMedicine A1. Indeed. Our research suggests that while have 'enough' people is only the beginning. If not the right complement of all needed perspectives in an environment supporting them -- little benefit #JHMChat |
| Vinny Arora MD MAPP @FutureDocs @WrayCharles Well we are both Chicagoans except one of us is taller 😂 #jhmchat https://t.co/TqlmixKMM6 |
| Journal of Hospital Medicine @JHospMedicine @matthewdmchugh Will add in the burden of professionalism... trying and trying to prevent the distress of not being able to achieve what the goal is... #JHMChat |
 | Seth Trueger @MDaware RT @WrayCharles: Just so everyone is aware, having @FutureDocs amble into a #JHMChat is like having Michael Jordan come out of the stands to shoot around with the team |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn RT @matthewdmchugh: @JHospMedicine A1. Indeed. Our research suggests that while have 'enough' people is only the beginning. If not the right complement of all needed perspectives in an environment supporting them -- little benefit #JHMChat |
| Anika Kumar, MD (she/her) @freckledpedidoc @WrayCharles @JHospMedicine It’s Multifactorial… Like all the A1 answers that our amazing community shared. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine @jenreadlynn @SamirShahMD @gradydoctor Did @gradydoctor set an alarm? #JHMChat |
| Gian Toledanes @ToledanesGian RT @matthewdmchugh: @JHospMedicine A1. Indeed. Our research suggests that while have 'enough' people is only the beginning. If not the right complement of all needed perspectives in an environment supporting them -- little benefit #JHMChat |
| Joe Thomas, MD @DocWithBowtie RT @WrayCharles: @matthewdmchugh @JHospMedicine @PennNursing @Penn_CHOPR In my experience, errors will occur in environments where people don't feel psychologically safe and supported. If ppl don't feel comfortable asking for help, bad things will happen #JHMChat |
| Matthew McHugh @matthewdmchugh Hospitals are tremendously complex, interdependent systems. A title from an article many years ago sums it up -- Hospitals must go from “Complex Organizations with Simple Jobs to Simple Organizations with Complex Jobs” #JHMChat #JHMChat |
| Journal of Hospital Medicine @JHospMedicine 2️⃣ It's already time for question 2! Share your experiences and insights! ❓ When a patient safety event occurs, what factors do you consider when reporting it? #JHMChat https://t.co/Iw9bU5LDHh |
| Journal of Hospital Medicine @JHospMedicine RT @matthewdmchugh: Hospitals are tremendously complex, interdependent systems. A title from an article many years ago sums it up -- Hospitals must go from “Complex Organizations with Simple Jobs to Simple Organizations with Complex Jobs” #JHMChat #JHMChat |
| Journal of Hospital Medicine @JHospMedicine This. 👇 #JHMChat |
 | Marisha Burden, MD, MBA @marishaburden RT @JHospMedicine: @KenistonAngela @marishaburden There's a pub for that... https://t.co/sURhflff19 #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @matthewdmchugh: @JHospMedicine A1. Indeed. Our research suggests that while have 'enough' people is only the beginning. If not the right complement of all needed perspectives in an environment supporting them -- little benefit #JHMChat |
| Matthew McHugh @matthewdmchugh @JHospMedicine A2: The right answer or the real answer? It depends on the environment. Will I be taken seriously with attempts to collaboratively understand what happened to prevent reoccurrence? Will I be encouraged to ‘keep it quiet’? Or Will I be ‘thrown under the bus.’ #JHMChat |
| Journal of Hospital Medicine @JHospMedicine @matthewdmchugh Ouch. Saying the quite part out loud... "The right answer or the real answer" The problem with criminal prosecution is just this. #JHMChat |
| Charlie M. Wray, DO, MS @WrayCharles @JHospMedicine This might sound odd - but how hard is it to report? If the bar is high (ie. 10,000 clicks) then my motivation is low. Systems need to make access to these reporting sites easy and seamless #JHMChat |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn A2 #JHMChat (👈saw this done by @aoglasser before so I don't forget): I think the severity of the event and how likely it is to recur and cause harm. I definitely recognize that things are underreported but having the bandwidth and time to report every near miss is tough too. |
| Joe Thomas, MD @DocWithBowtie @JHospMedicine @matthewdmchugh Ooh, you mean ACTUAL professionalism, too! Jokes aside, that definitely weighs on the mind in these situations, especially when we are at our breaking points. #JHMChat |
| Matthew McHugh @matthewdmchugh A2 It should not be underestimated how hard it is, under the best circumstances, to report even near misses. Healthcare is humbling and hard and uncertain even when we get everything right #JHMChat |
| Maha Sulieman @MahaArhait @JHospMedicine A2 try to understand what has led to it rather than focus on pointing fingers. Reporting system is not punitive & the goal is for this not to re- occur. It’s ok to report you missed something yourself because there is a hole in the system that resulted in this. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine @WrayCharles #JHMChat https://t.co/t4sIDW0CW8 |
| Anika Kumar, MD (she/her) @freckledpedidoc @JHospMedicine A2. As @WrayCharles & I were discussing, it’s multifactorial. It’s equally important to share the events that don’t reach the patient as those that do so we can change our systems to prevent future errors. #JHMChat |
| Gian Toledanes @ToledanesGian #JHMChat A2. 1) The people affected, not just the patients, but everyone involved. 2) the circumstances that led to the harm 3) the institution's culture regarding harm and safety events |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: 2️⃣ It's already time for question 2! Share your experiences and insights! ❓ When a patient safety event occurs, what factors do you consider when reporting it? #JHMChat https://t.co/Iw9bU5LDHh |
| Journal of Hospital Medicine @JHospMedicine @jenreadlynn @aoglasser You're absolutely right here ... and also your near miss, my near miss, her near miss, his near miss, etc... all in aggregate could lead to change if we only made the reporting a process that was sustainable. #JHMChat |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn RT @WrayCharles: @JHospMedicine This might sound odd - but how hard is it to report? If the bar is high (ie. 10,000 clicks) then my motivation is low. Systems need to make access to these reporting sites easy and seamless #JHMChat |
| Society of Hospital Medicine @SocietyHospMed RT @Arhait: @JHospMedicine A2 try to understand what has led to it rather than focus on pointing fingers. Reporting system is not punitive & the goal is for this not to re- occur. It’s ok to report you missed something yourself because there is a hole in the system that resulted in this. #JHMChat |
| Samir S. Shah @SamirShahMD @JHospMedicine A2. We have a robust system and a wonderful culture so tend to report and encourage reporting & support those who report. That said, it’s never easy but I’m fortunate to work at a place that recognizes the systems role #jhmchat |
| Society of Hospital Medicine @SocietyHospMed RT @matthewdmchugh: A2 It should not be underestimated how hard it is, under the best circumstances, to report even near misses. Healthcare is humbling and hard and uncertain even when we get everything right #JHMChat |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn RT @matthewdmchugh: @JHospMedicine A2: @JHospMedicine A2: The right answer or the real answer? It depends on the environment. Will I be taken seriously with attempts to collaboratively understand what happened to prevent reoccurrence? Will I be encouraged to ‘keep it quiet’? Or Will I be ‘thrown under the bus.’ #JHMChat |
| Vinny Arora MD MAPP @FutureDocs @JHospMedicine A2 people only think of reporting when real harm occurred but the learning is in all the near miss and no harm events too. #JHMChat I teach patient safety to M2 tomorrow so this is one of the big points! |
| Journal of Hospital Medicine @JHospMedicine RT @matthewdmchugh: A2 It should not be underestimated how hard it is, under the best circumstances, to report even near misses. Healthcare is humbling and hard and uncertain even when we get everything right #JHMChat |
| Annie Massart @Annie_Massart_ @JHospMedicine A2. Who was involved? What happened, in their words? Who (on a system level) needs to be involved to prevent this from happening again? How can I best communicate with all of those parties? #JHMChat |
| Society of Hospital Medicine @SocietyHospMed RT @SamirShahMD: @JHospMedicine A2. We have a robust system and a wonderful culture so tend to report and encourage reporting & support those who report. That said, it’s never easy but I’m fortunate to work at a place that recognizes the systems role #jhmchat |
| Journal of Hospital Medicine @JHospMedicine A just culture is not punitive and not pointing fingers #JHMChat |
| Society of Hospital Medicine @SocietyHospMed RT @FutureDocs: @JHospMedicine A2 people only think of reporting when real harm occurred but the learning is in all the near miss and no harm events too. #JHMChat I teach patient safety to M2 tomorrow so this is one of the big points! |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn RT @FutureDocs: @JHospMedicine A2 people only think of reporting when real harm occurred but the learning is in all the near miss and no harm events too. #JHMChat I teach patient safety to M2 tomorrow so this is one of the big points! |
| Joe Thomas, MD @DocWithBowtie @JHospMedicine #JHMChat A2: Going back to @WrayCharles’s point, how protected do I feel? Is it going to be obvious that I reported it and will that come back to bite me? I fear it less as a male American attending (even w/brown skin) but for colleagues that don’t fit that entire description… |
| Journal of Hospital Medicine @JHospMedicine We need systems-minded and process-aware folx so they can see the holes in the swiss cheese and report #JHMChat |
| Matthew McHugh @matthewdmchugh @freckledpedidoc @JHospMedicine @WrayCharles YES to this! We find that nurses often identify safety concerns, inefficient processes, and other operational failures but are not taken seriously. So they resort to workarounds #JHMChat |
| Mary Ann @maryannscience1 @JHospMedicine A2 #JHMChat the business literature is really clear that penalizing people for being accountable results in management Chernobyl, basically. It’s insanity to apply the opposite logic to people who’ve devoted their lives to caring for others |
| Anika Kumar, MD (she/her) @freckledpedidoc @WrayCharles @JHospMedicine 💯agree. I often try to assume this task from other members of my team as it can be cumbersome. Many team members are stretched thin (back to my moral distress comment) so this relieves some of their work #JHMChat |
| Journal of Hospital Medicine @JHospMedicine @SamirShahMD How much is the place and how much is the people? #JHMChat |
| Matthew McHugh @matthewdmchugh RT @maryannscience1: @JHospMedicine A2 #JHMChat the business literature is really clear that penalizing people for being accountable results in management Chernobyl, basically. It’s insanity to apply the opposite logic to people who’ve devoted their lives to caring for others |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn @DocWithBowtie @JHospMedicine @WrayCharles So true. There's still a mix in culture too that people think it's punitive or that you're "tattling" on someone when really you're just pointing out a break in the system and that's how we better-care for our patients. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine A whole 'nother layer of underreporting -- the equity lens. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine @matthewdmchugh @freckledpedidoc @WrayCharles We have to make the right thing to do the easy thing #JHMChat |
 | Shikha Jain MD, FACP @ShikhaJainMD RT @WrayCharles: Just so everyone is aware, having @FutureDocs amble into a #JHMChat is like having Michael Jordan come out of the stands to shoot around with the team |
| Journal of Hospital Medicine @JHospMedicine RT @maryannscience1: @JHospMedicine A2 #JHMChat the business literature is really clear that penalizing people for being accountable results in management Chernobyl, basically. It’s insanity to apply the opposite logic to people who’ve devoted their lives to caring for others |
| Vinny Arora MD MAPP @FutureDocs RT @matthewdmchugh: A2 It should not be underestimated how hard it is, under the best circumstances, to report even near misses. Healthcare is humbling and hard and uncertain even when we get everything right #JHMChat |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn @freckledpedidoc @WrayCharles @JHospMedicine I definitely do this as well. I need to remember to report WITH my residents thought, so they can learn and know it's ok to do. #JHMChat |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn RT @matthewdmchugh: @freckledpedidoc @JHospMedicine @WrayCharles YES to this! We find that nurses often identify safety concerns, inefficient processes, and other operational failures but are not taken seriously. So they resort to workarounds #JHMChat |
| Journal of Hospital Medicine @JHospMedicine @freckledpedidoc @WrayCharles Teaching/ coaching learners too to build that culture #JHMChat |
| Society of Hospital Medicine @SocietyHospMed Just about 30 minutes left of tonight's #JHMChat! Join the discussion with @JHospMedicine and your hospitalist peers as we discuss clinical prosecution of clinical errors. ✅ Connect with your hospitalist community ✅ Share advice ✅ Learn tips #HowWeHospitalist |
| Journal of Hospital Medicine @JHospMedicine 💬 🗨️ Great discussion so far! We're already halfway there! Keep the conversation flowing. Question 3 coming in 5 minutes! Here's the article we are referencing, ICYMI: https://t.co/oJsjII1GEx #JHMChat |
| Nancy H. Stewart, DO, MS (she/her) @nvhstewart A2 having a culture of safety and one about educating team members definitely helps when reporting #JHMCHat |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn RT @JHospMedicine: @matthewdmchugh @freckledpedidoc @WrayCharles We have to make the right thing to do the easy thing #JHMChat |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: 💬 🗨️ Great discussion so far! We're already halfway there! Keep the conversation flowing. Question 3 coming in 5 minutes! Here's the article we are referencing, ICYMI: https://t.co/oJsjII1GEx #JHMChat |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn RT @JHospMedicine: A whole 'nother layer of underreporting -- the equity lens. #JHMChat |
 | Jin Sol Lee (이진솔), MD, MPH @JinSolLeeMD RT @SamirShahMD: @JHospMedicine A2. We have a robust system and a wonderful culture so tend to report and encourage reporting & support those who report. That said, it’s never easy but I’m fortunate to work at a place that recognizes the systems role #jhmchat |
| Matthew McHugh @matthewdmchugh @maryannscience1 @JHospMedicine A2 Great point @maryannscience1 ! I would argue that in no other complex industry would such insanity be acceptable to the public or the workers. I also think hospitals are even MORE unpredictable than nuclear plants! Requires constant vigilance, problem solving #JHMChat |
| Journal of Hospital Medicine @JHospMedicine Do people "preempt" the safety report notification, ie "Hey thanks for telling me about this . I know it wasn't your intent. I wanted to let you know I will be entering a safety report to help prevent it from happening again for someone else. Thank you for telling me" #JHMChat |
| Vinny Arora MD MAPP @FutureDocs @freckledpedidoc @WrayCharles Ha ha well she is the GOAT so she can do whatever she wants. Thank you for advocating to move #JHMChat out of Monday of Diwali! I appreciate it :) |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn @nvhstewart As others have pointed out, knowing what happens with the reports can be a good incentive to keep reporting. I you feel like you're just reporting into an abyss that never leads anywhere, you're going to stop. Feedback is helpful! #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @matthewdmchugh: @maryannscience1 @JHospMedicine A2 Great point @maryannscience1 ! I would argue that in no other complex industry would such insanity be acceptable to the public or the workers. I also think hospitals are even MORE unpredictable than nuclear plants! Requires constant vigilance, problem solving #JHMChat |
| Matthew McHugh @matthewdmchugh A2 In the Vaught case, one of the most damaging organizational responses was the lack of reporting juxtaposed with the treatment of the nurse. #JHMChat |
| Anika Kumar, MD (she/her) @freckledpedidoc @jenreadlynn @WrayCharles @JHospMedicine Yes Jen‼️ My last report on teaching service was with the intern. It was her 1️⃣ report. I think if we model & report together perhaps we can ⬆️ reporting at move the needle to safer pt care #JHMChat |
| Jackie Nikpour, PhD, RN @NurseNikpour @SamirShahMD @JHospMedicine What does that look like? What happens when a nurse reports an error in your system? #JHMChat |
| Mary Ann @maryannscience1 @matthewdmchugh @JHospMedicine More unpredictable, higher stakes, and you’re getting yelled at and barfed on all the time! #JHMChat |
| Journal of Hospital Medicine @JHospMedicine @colleenapogue Fantastic response, don't forget the #JHMChat! |
| Joe Thomas, MD @DocWithBowtie @jenreadlynn @nvhstewart “Feedback is helpful” is such a universal sentiment in every aspect of medicine! #JHMChat |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn RT @DocWithBowtie: @jenreadlynn @nvhstewart “Feedback is helpful” is such a universal sentiment in every aspect of medicine! #JHMChat |
| Journal of Hospital Medicine @JHospMedicine @NurseNikpour @theNAMedicine To Err is Human... and also common to forget the hashtag ;) #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @nvhstewart: A2 having a culture of safety and one about educating team members definitely helps when reporting #JHMCHat |
| Journal of Hospital Medicine @JHospMedicine 🏥 Now on to Question 3 of the night: How should a hospital optimally support a team or individual after a patient safety event? And how can we as a multidisciplinary team support each other? #JHMChat https://t.co/IXXldZCw8H |
| Journal of Hospital Medicine @JHospMedicine @DocWithBowtie @jenreadlynn @nvhstewart As the #meded community would say, actionable, specific, behavior-based feedback ... #JHMChat |
| Matthew McHugh @matthewdmchugh A2 I think a big problem is many clinicians don't know how their organization would respond. Uncertainty and lack of transparency about what 'could' happen is a disincentive #JHMChat |
| Anika Kumar, MD (she/her) @freckledpedidoc @jenreadlynn @DocWithBowtie @JHospMedicine @WrayCharles I work at 4️⃣ hospitals. At 2️⃣ there is growth mindset in patient safety & reporting. At 1️⃣ the culture is shifting towards the growth mindset model. At the last, we are still working on changing the culture to a growth mindset…. #JHMChat |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn RT @matthewdmchugh: A2 I think a big problem is many clinicians don't know how their organization would respond. Uncertainty and lack of transparency about what 'could' happen is a disincentive #JHMChat |
| Nancy H. Stewart, DO, MS (she/her) @nvhstewart YES!!! #jhmchat |
| Matthew McHugh @matthewdmchugh Unpopular answer but after the event is too late; optimal support means proactively creating the conditions for safe practice. Creating a shared understanding of the “Just Culture” approach is a good start so that hospital response to clinician error is predictable. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine Hey hospitalists -- do your safety leaders at your institutions tell you how they would/do respond to safety event reporting? #JHMChat |
| Joe Thomas, MD @DocWithBowtie @JHospMedicine It would be nice if this was understood, but in many places it probably is helpful to establish that sentiment. Seems like something a lot of us would do out of our own anxiety, haha. #JHMChat |
| Jackie Nikpour, PhD, RN @NurseNikpour @matthewdmchugh @maryannscience1 @JHospMedicine #JHMChat absolutely. We as clinicians can & should be accountable for our individual actions, but we also need systems to be accountable to implement real changes that prevent these errors in the future - not write it off as a one-off incident of a single person. |
| Society of Hospital Medicine @SocietyHospMed Still plenty of time to dive into tonight’s #JHMChat on criminal prosecution of clinical errors, including Q3️⃣: |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: 🏥 Now on to Question 3 of the night: 🏥 Now on to Question 3 of the night: How should a hospital optimally support a team or individual after a patient safety event? And how can we as a multidisciplinary team support each other? #JHMChat https://t.co/IXXldZCw8H |
| Jackie Nikpour, PhD, RN @NurseNikpour RT @matthewdmchugh: A2 I think a big problem is many clinicians don't know how their organization would respond. Uncertainty and lack of transparency about what 'could' happen is a disincentive #JHMChat |
| Matthew McHugh @matthewdmchugh A3 -- forgot the first rule of twitter chat -- label your answer |
| Journal of Hospital Medicine @JHospMedicine RT @NurseNikpour: @matthewdmchugh @maryannscience1 @JHospMedicine #JHMChat absolutely. We as clinicians can & should be accountable for our individual actions, but we also need systems to be accountable to implement real changes that prevent these errors in the future - not write it off as a one-off incident of a single person. |
| Charlie M. Wray, DO, MS @WrayCharles @matthewdmchugh This is a great answer, Matthew #JHMChat |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn @JHospMedicine A3: #JHMChat Recognizing that this may not be possible in every case, but a debrief and action plan. Even if it's early, some transparency about what's being considered and what changes may come can be so valuable. Ensuring someone feels supported & knows their resources. |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: Hey hospitalists -- do your safety leaders at your institutions tell you how they would/do respond to safety event reporting? #JHMChat |
| Colleen A. Pogue, PhD, RN @colleenapogue @JHospMedicine 3A: 1) Don’t assume 👏, 2) Be objective 3) gather ALL info 4) protect clinician 5) show empathy — none of us are immune @theNAMedicine #ToErrIsHuman #JHMChat |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn RT @matthewdmchugh: Unpopular answer but after the event is too late; optimal support means proactively creating the conditions for safe practice. Creating a shared understanding of the “Just Culture” approach is a good start so that hospital response to clinician error is predictable. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine @matthewdmchugh No unpopular answers here, and you point out something powerful. Reactions are not proactive enough to solve the problems #JHMChat |
| Matthew McHugh @matthewdmchugh @WrayCharles Thanks @WrayCharles #JHMChat |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn RT @colleenapogue: @JHospMedicine 3A: @JHospMedicine 3A: 1) Don’t assume 👏, 2) Be objective 3) gather ALL info 4) protect clinician 5) show empathy — none of us are immune @theNAMedicine #ToErrIsHuman #JHMChat |
| Mary Ann @maryannscience1 @JHospMedicine A3 #JHMChat as non-hospitalist support staff who bakes, I’m just gonna sit back and hope someone says “cinnamon rolls”! I know @Annie_Massart_ ‘s carbs keep a lot of folks going through some challenging times over here too |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn RT @NurseNikpour: @matthewdmchugh @maryannscience1 @JHospMedicine #JHMChat absolutely. We as clinicians can & should be accountable for our individual actions, but we also need systems to be accountable to implement real changes that prevent these errors in the future - not write it off as a one-off incident of a single person. |
| Nancy H. Stewart, DO, MS (she/her) @nvhstewart @matthewdmchugh This is so true. I think this is one situation where how leadership would Hanke ‘sets the tone’. I’ve seen instances where trainees were punished for reporting patient safety issues which then makes others silent #jhmchat #safety #cultureofsafety |
| Gian Toledanes @ToledanesGian A3 Address the psychological implications of making a mistake. Offer a safe space to explore safety events. We can always improve but we have to be in a mindset conducive for us to learn to get better. #JHMChat |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: @matthewdmchugh No unpopular answers here, and you point out something powerful. Reactions are not proactive enough to solve the problems #JHMChat |
| Nancy H. Stewart, DO, MS (she/her) @nvhstewart @matthewdmchugh This is so true. I think this is one situation where how leadership would Handle ‘sets the tone’. I’ve seen instances where trainees were punished for reporting patient safety issues which then makes others silent #jhmchat #safety #cultureofsafety |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn RT @JHospMedicine: Hey hospitalists -- do your safety leaders at your institutions tell you how they would/do respond to safety event reporting? #JHMChat |
| Society of Hospital Medicine @SocietyHospMed RT @ToledanesGian: A3 Address the psychological implications of making a mistake. Offer a safe space to explore safety events. We can always improve but we have to be in a mindset conducive for us to learn to get better. #JHMChat |
| Anika Kumar, MD (she/her) @freckledpedidoc @JHospMedicine A3. The best way is by assuring that we follow the data not the human. We know that “To Err is Human.” Each report is usually associated with multiple systems (as @DocWithBowtie pointed out earlier) & we need to go back to the involved systems, not the involved humans. #JHMChat |
 | Kimberly D. Manning, MD @gradydoctor @JHospMedicine Waaaaaah!!! A3 We need a structured way to process that doesn’t shame people. #JHMChat |
| Gopi Astik @gopiastik @JHospMedicine A3: we have a great peer-2-peer program where we connect folks adverse events/unanticipated outcomes with trained faculty who can be a friendly ear and provide support. @AngChaudhariMD is the brains behind it. #JHMChat |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn RT @ToledanesGian: A3 Address the psychological implications of making a mistake. Offer a safe space to explore safety events. We can always improve but we have to be in a mindset conducive for us to learn to get better. #JHMChat |
| Society of Hospital Medicine @SocietyHospMed RT @gradydoctor: @JHospMedicine Waaaaaah!!! A3 We need a structured way to process that doesn’t shame people. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine @jenreadlynn The debrief in the moment helps with the moral distress mentioned earlier in #JHMChat |
| Jackie Nikpour, PhD, RN @NurseNikpour @JHospMedicine A3. Do not rush to judgement. Gather the facts in a manner that does not assign blame to an individual or team. Most of all - acknowledge that medical errors rarely are the result of one person alone. @WrayCharles & others alluded to this - it's multifactorial. #JHMChat |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn @maryannscience1 @JHospMedicine @Annie_Massart_ Cinnamon rolls would definitely help. #JHMChat https://t.co/Enc6yExz82 |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn RT @NurseNikpour: @JHospMedicine A3. Do not rush to judgement. Gather the facts in a manner that does not assign blame to an individual or team. Most of all - acknowledge that medical errors rarely are the result of one person alone. @WrayCharles & others alluded to this - it's multifactorial. #JHMChat |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn RT @gopiastik: @JHospMedicine A3: @JHospMedicine A3: we have a great peer-2-peer program where we connect folks adverse events/unanticipated outcomes with trained faculty who can be a friendly ear and provide support. @AngChaudhariMD is the brains behind it. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine @ToledanesGian The Second Victim paradigm is important to remember #JHMChat |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn @gopiastik @JHospMedicine @AngChaudhariMD That's amazing! How powerful! Trust and psychological safety built into the team. #JHMChat |
| Jackie Nikpour, PhD, RN @NurseNikpour A3. Clear communication & transparency about what led up to the med. error & what hapepned as a result. Acknowledge that we are human - none of us are immune. We can support the clinician AND support the patient who was on the receiving end - not mutually exclusive #JHMChat |
| Journal of Hospital Medicine @JHospMedicine Word of the night: "MULTIFACTORIAL." notice, *not* individual https://t.co/4Nco1nkq8r |
| Mary Ann @maryannscience1 RT @gopiastik: @JHospMedicine A3: @JHospMedicine A3: we have a great peer-2-peer program where we connect folks adverse events/unanticipated outcomes with trained faculty who can be a friendly ear and provide support. @AngChaudhariMD is the brains behind it. #JHMChat |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn RT @NurseNikpour: A3. Clear communication & transparency about what led up to the med. error & what hapepned as a result. Acknowledge that we are human - none of us are immune. We can support the clinician AND support the patient who was on the receiving end - not mutually exclusive #JHMChat |
| Nancy H. Stewart, DO, MS (she/her) @nvhstewart RT @NurseNikpour: A3. Clear communication & transparency about what led up to the med. error & what hapepned as a result. Acknowledge that we are human - none of us are immune. We can support the clinician AND support the patient who was on the receiving end - not mutually exclusive #JHMChat |
| Journal of Hospital Medicine @JHospMedicine anyone have a good debriefing program or second-victim support system they want to share? #JHMChat |
| Nancy H. Stewart, DO, MS (she/her) @nvhstewart RT @gopiastik: @JHospMedicine A3: @JHospMedicine A3: we have a great peer-2-peer program where we connect folks adverse events/unanticipated outcomes with trained faculty who can be a friendly ear and provide support. @AngChaudhariMD is the brains behind it. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine ⏩ Well that went fast! We're at the final question of tonight's #JHMChat! Q4: What are examples of "good catches" or "near misses" turning into system changes? https://t.co/rFbv4m3TX0 |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn @NurseNikpour Thank you for the reminder that we cannot forget about the patient in these scenarios. They need support and guidance as well. #JHMChat |
| Jackie Nikpour, PhD, RN @NurseNikpour This is so important. Be proactive in system-level prevention. All frontline clinicians should know well before an error occurs that they will be safe in reporting to admin. #JHMChat |
| Kimberly D. Manning, MD @gradydoctor @JHospMedicine A3 I was looking for this thread. It’s a place to start with patient safety events from the human side. #JHMChat #humanismalways |
| Journal of Hospital Medicine @JHospMedicine It's as if we like to know that what we do matters... #JHMChat |
| Nancy H. Stewart, DO, MS (she/her) @nvhstewart RT @freckledpedidoc: @JHospMedicine A3. The best way is by assuring that we follow the data not the human. We know that “To Err is Human.” Each report is usually associated with multiple systems (as @DocWithBowtie pointed out earlier) & we need to go back to the involved systems, not the involved humans. #JHMChat |
| Nancy H. Stewart, DO, MS (she/her) @nvhstewart RT @gradydoctor: @JHospMedicine Waaaaaah!!! A3 We need a structured way to process that doesn’t shame people. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine Masterful thread as always by @gradydoctor #JHMChat |
| Matthew McHugh @matthewdmchugh A3 - A hard thing to reconcile is that there are instances where the clinician is one of the pieces of swiss cheese. The Vaught case illustrates-she made clear mistakes requiring accountability but she acknowledged immediately. But little focus on other pieces of cheese #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @jenreadlynn: @NurseNikpour Thank you for the reminder that we cannot forget about the patient in these scenarios. They need support and guidance as well. #JHMChat |
| Society of Hospital Medicine @SocietyHospMed RT @NurseNikpour: A3. Clear communication & transparency about what led up to the med. error & what hapepned as a result. Acknowledge that we are human - none of us are immune. We can support the clinician AND support the patient who was on the receiving end - not mutually exclusive #JHMChat |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: anyone have a good debriefing program or second-victim support system they want to share? #JHMChat |
| Jackie Nikpour, PhD, RN @NurseNikpour At the end of the day, clinicians & patients are on the same side. We all want the best outcomes. We BOTH benefit from having safe working environments, adequate resources, and transparent reporting process. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine Q4 is live! #JHMChat |
| Society of Hospital Medicine @SocietyHospMed 🚨Last question alert!🚨 Sliding right into Q4️⃣ of tonight’s #JHMChat! |
| Society of Hospital Medicine @SocietyHospMed RT @gradydoctor: @JHospMedicine A3 I was looking for this thread. It’s a place to start with patient safety events from the human side. #JHMChat #humanismalways |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn @JHospMedicine Our team has been trying to vaccinate all patients who are gridlocked in the hospital for COVID and flu. There was some confusing language in the orders about "paper consent" and one of our pharmacists did her research and helped to simplify the process! #JHMChat |
| Joe Thomas, MD @DocWithBowtie @JHospMedicine #JHMChat A3: others have mentioned hospital leadership being transparent about the process and outcome. Had to do reappointment training recently. Was a nice little slide show, but words on a screen don’t mean much when I see how staff actually feel the hospital treats them. |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn RT @gradydoctor: @JHospMedicine A3 I was looking for this thread. It’s a place to start with patient safety events from the human side. #JHMChat #humanismalways |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn RT @JHospMedicine: It's as if we like to know that what we do matters... #JHMChat |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn RT @NurseNikpour: At the end of the day, clinicians & patients are on the same side. We all want the best outcomes. We BOTH benefit from having safe working environments, adequate resources, and transparent reporting process. #JHMChat |
| Joe Thomas, MD @DocWithBowtie BIG FAN OF THIS |
| Jackie Nikpour, PhD, RN @NurseNikpour A3. I have little doubt that everyone here on tonight's Twitter chat has made a medical error of some sort, and/or will make one in the future. It's one of the few universal truths in healthcare. If you expect perfection, you'll fail every time. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine So many #qualityimprovement initiatives stem from these good catches/ near misses We here at the Journal publish many research papers on these efforts. We would love to hear from you! Just gonna leave the author guidelines here... https://t.co/4Nco1n3n6r #JHMChat |
| Maha Sulieman @MahaArhait @ToledanesGian Consoling & coaching should equally be considered as a response to a mistake. #JHMChat |
| Angela Keniston @KenistonAngela RT @JHospMedicine: So many #qualityimprovement initiatives stem from these good catches/ near misses We here at the Journal publish many research papers on these efforts. We would love to hear from you! Just gonna leave the author guidelines here... https://t.co/4Nco1n3n6r #JHMChat |
| Mary Ann @maryannscience1 RT @JHospMedicine: So many #qualityimprovement initiatives stem from these good catches/ near misses We here at the Journal publish many research papers on these efforts. We would love to hear from you! Just gonna leave the author guidelines here... https://t.co/4Nco1n3n6r #JHMChat |
| Matthew McHugh @matthewdmchugh A4.Not many - it usually takes a tragic/grievous error. True for safety issues generally (e.g, drug & consumer product safety).I would bet the 1 thing reported less often than errors is near misses.Moving up the chain of causation even one link though that would be big! #JHMChat |
| Colleen A. Pogue, PhD, RN @colleenapogue @JHospMedicine @matthewdmchugh #JHMChat !!! 🤦🏻♀️ |
| Jackie Nikpour, PhD, RN @NurseNikpour A4. What is the process of turning a "good catch" into systems change? Whose responsibility is it to lead those changes? This is why we need nurses w/ QI & #ImpSci training. Recognizing a patient care issue --> identifying solutions --> implementing & evaluating. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @NurseNikpour: A3. I have little doubt that everyone here on tonight's Twitter chat has made a medical error of some sort, and/or will make one in the future. It's one of the few universal truths in healthcare. If you expect perfection, you'll fail every time. #JHMChat |
| Society of Hospital Medicine @SocietyHospMed Don’t miss a chance to get your work published in @JHospMedicine! Who knows? Maybe your paper will be the topic of a #JHMChat! |
| Journal of Hospital Medicine @JHospMedicine RT @NurseNikpour: A4. What is the process of turning a "good catch" into systems change? Whose responsibility is it to lead those changes? This is why we need nurses w/ QI & #ImpSci training. Recognizing a patient care issue --> identifying solutions --> implementing & evaluating. #JHMChat |
| Mary Ann @maryannscience1 Pretty much true in every human endeavor! Great insight by @Arhait #JHMChat |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn RT @NurseNikpour: A3. I have little doubt that everyone here on tonight's Twitter chat has made a medical error of some sort, and/or will make one in the future. It's one of the few universal truths in healthcare. If you expect perfection, you'll fail every time. #JHMChat |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn RT @JHospMedicine: So many #qualityimprovement initiatives stem from these good catches/ near misses We here at the Journal publish many research papers on these efforts. We would love to hear from you! Just gonna leave the author guidelines here... https://t.co/4Nco1n3n6r #JHMChat |
| Society of Hospital Medicine @SocietyHospMed Thank you for being a part of this #JHMChat. As we wind down, please take some time to fill out our brief feedback form. 📝 We want to 👂 from you on what you want to see from #JHMChat! 👀 https://t.co/k9nukavP9F |
| Journal of Hospital Medicine @JHospMedicine ⌛ Last few minutes left in tonight's #JHMChat. Any additional insights or final thoughts to share? |
| Matthew McHugh @matthewdmchugh @Arhait @ToledanesGian Great point @Arhait -- And I think we can lower the threshold for doing this. Shouldnt only occur with 'big' things --Normalize #JHMChat |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: ⌛ Last few minutes left in tonight's #JHMChat. Any additional insights or final thoughts to share? |
| Kimberly D. Manning, MD @gradydoctor @JHospMedicine A4 We now have a special questionnaire that has to be answered before we enter orders for MRI. I think that process alone has stopped many unnecessary images, which then opens space for the people who really need them. #JHMChat |
| Jackie Nikpour, PhD, RN @NurseNikpour A4. Are there examples of med. errors where the clinician(s) involved are PART of the team designing & implementing solutions? No doubt, clinicians feel guilty about errors. Maybe leveraging their lessons learned is a way to support clinicians & prevent similar errors. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine Now also wondering if systems need to do a better job of publicizing all the little changes that happen upstream, changes because someone noticed the *potential* for badness, before that badness happened... #JHMChat |
| Journal of Hospital Medicine @JHospMedicine @gradydoctor High value care and patient safety intertwined, we love to see it. #JHMChat |
| Matthew McHugh @matthewdmchugh A4 It shouldn’t even take an error or near miss -- simply asking clinicians about all of the workarounds they need to engage to get care accomplished would be a great start. We all can probably name 10 things right now that get in the way of good safe care #JHMChat |
| Society of Hospital Medicine @SocietyHospMed RT @gradydoctor: @JHospMedicine A4 We now have a special questionnaire that has to be answered before we enter orders for MRI. I think that process alone has stopped many unnecessary images, which then opens space for the people who really need them. #JHMChat |
| Jackie Nikpour, PhD, RN @NurseNikpour @matthewdmchugh Great point. Near misses happen all the time & are VASTLY underreported. Why expose yourself to retaliation when an error didn't actually occur? Encouraging/incentivizing these reports is a key first step. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine @NurseNikpour Some hospitals have RCAs or "swarms" after an event and incorporate the frontline teams, turning that moral distress into action! #JHMChat |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn RT @NurseNikpour: A4. Are there examples of med. errors where the clinician(s) involved are PART of the team designing & implementing solutions? No doubt, clinicians feel guilty about errors. Maybe leveraging their lessons learned is a way to support clinicians & prevent similar errors. #JHMChat |
| Jackie Nikpour, PhD, RN @NurseNikpour @JHospMedicine This should be standard practice. Are there any qual studies exploring clinicians responses to these? #JHMChat |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn RT @gradydoctor: @JHospMedicine A4 We now have a special questionnaire that has to be answered before we enter orders for MRI. I think that process alone has stopped many unnecessary images, which then opens space for the people who really need them. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine This is a good action item to take back to your hospitalists from this #JHMChat. Crowdsource the "pebbles in the shoes" -- and use it as the basis of QI projects! |
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