#JHMChat Transcript
Healthcare social media transcript of the #JHMChat hashtag.
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| Profile | Tweet |
|---|---|
 | Society of Hospital Medicine @SocietyHospMed #JHMChat starts NOW! Discuss #meded #ptexp conflicting findings w/ @JHospMedicine @FutureDocs @BradMonash, and don't forget to claim #CME! https://t.co/pGZNfKoFU9 |
 | J Hospital Medicine @JHospMedicine Greetings, I am @FutureDocs your moderator for tonight's #JHMChat. Please introduce yourself. T1 up in a moment... |
| J Hospital Medicine @JHospMedicine Dont forget to register for #CME for participation in tonight's #JHMChat - sign up here! https://t.co/Bhyo5HQ629 |
| J Hospital Medicine @JHospMedicine welcome author @BradMonash author of Standardizing Rounds To Improve #Ptexp #JHMChat https://t.co/ttxPSPwLLp #visualabstract https://t.co/rY7kxuDIKy |
| J Hospital Medicine @JHospMedicine welcome author @BradMonash author of Standardizing Rounds To Improve #Ptexp #JHMChat https://t.co/ttxPSPwLLp... https://t.co/6fMwe6Euil |
| J Hospital Medicine @JHospMedicine Dont forget to register for #CME for participation in tonight's #JHMChat - sign up here! https://t.co/Bhyo5HQ629 https://t.co/PqocRtGvq1 |
| J Hospital Medicine @JHospMedicine Join us now! #JHMChat https://t.co/reXm5w79qO |
 | Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: Greetings, I am @FutureDocs your moderator for tonight's #JHMChat. Please introduce yourself. T1 up in a moment... |
| Vinny Arora MD MAPP @FutureDocs RT @SHMLive: #JHMChat starts NOW! Discuss #meded #ptexp conflicting findings w/ @JHospMedicine @FutureDocs @BradMonash, and don't forget to… |
 | Tony Breu @tony_breu Tony Breu, here from (soon-to-be-snowy) VA Boston. #JHMChat |
 | P. F. Anderson @pfanderson RT @FutureDocs: Interested in patient-centered care? #ptexp #meded #hcldr #pinksocks join us TONIGHT 9p ET #JHMChat see… |
 | Chris Petrilli @PetrilliMD And dont forget to include #JHMChat in all tweets so they are visible! :) https://t.co/WXTQGr02aZ |
| J Hospital Medicine @JHospMedicine . @BradMonash we are honored to have you! don't forget to index all your tweets #JHMChat https://t.co/r1l09uMT6Q |
 | Shoshana Herzig @ShaniHerzig @tony_breu Ditto #JHMChat |
| J Hospital Medicine @JHospMedicine Thanks for reminding everyone Chris! #JHMChat https://t.co/DCbYW9iu88 |
| Chris Petrilli @PetrilliMD Excited to start! #jhmchat |
 | bradley monash @bradmonash @PetrilliMD Take 2: Honored and excited to be here #JHMChat |
| J Hospital Medicine @JHospMedicine RT @BradMonash: @PetrilliMD Take 2: Honored and excited to be here #JHMChat |
 | Charlie M. Wray @WrayCharles Charlie Wray, from sunny (for now) SF #JHMChat |
 | Yaseen Al Lawati @allawatiy RT @AndrewMIbrahim: Should be a great discussion! #Meded https://t.co/Xyrcy3zCWv |
 | ABIM Foundation @ABIMFoundation RT @JHospMedicine: Join us now! #JHMChat https://t.co/reXm5w79qO |
| Vinny Arora MD MAPP @FutureDocs @tony_breu heard it's gonna be hit hard. Stay safe #jhmchat #snowmageddon2017 |
 | Rebecca Jaffe, MD @RJmdphilly Rebecca Jaffe from Philly, where school is cancelled at least 36 hrs b4 the first flake #JHMChat |
| Vinny Arora MD MAPP @FutureDocs RT @BradMonash: @PetrilliMD Take 2: Honored and excited to be here #JHMChat |
| J Hospital Medicine @JHospMedicine RT @RJmdphilly: Rebecca Jaffe from Philly, where school is cancelled at least 36 hrs b4 the first flake #JHMChat |
| Tony Breu @tony_breu @FutureDocs This chat usually is! #JHMChat |
 | Bruce Joy @brucejoy Great topic! Look forward to learning more about the work the team did. #jhmchat |
 | Michelle Brooks, MD, FACP, FHM @michellebr00ks #JHMChat Michelle Brooks here from @VCUHealth in Richmond, VA. Hoping we stay just south of the weather! |
| J Hospital Medicine @JHospMedicine T1: T1 In @BradMonash et al, adherence to patient-centered rounds was variable. How can we improve adherence to practices? #JHMChat |
| J Hospital Medicine @JHospMedicine Special thanks to our partners @SHMLive @CostsofCare @ABIMFoundation for bringing you #JHMChat tonight - #CME #ptexp #meded edition! |
| J Hospital Medicine @JHospMedicine @RJmdphilly great to have you! #beprepared #JHMChat |
 | Shannon K. Martin @shannonmartinmd Hi everyone, Shannon Martin from @UChicagoMed, looking forward to another great #jhmchat tonight! |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: T1: T1 In @BradMonash et al, adherence to patient-centered rounds was variable. How can we improve adherence to pract… |
 | Kelsey Murray @doctorakelso21 Kelsey, m4, future family med doc, curious about topic! Snowing already here in Ohio #JHMChat |
 | Malvinder Parmar @wittykidney Malvinder Parmar, nephtwitron, no COI #JHMChat taking away some time from filling my STANDARIZED #NephMadness brackets https://t.co/ISEYeMkLnp |
| Rebecca Jaffe, MD @RJmdphilly RT @JHospMedicine: T1: T1 In @BradMonash et al, adherence to patient-centered rounds was variable. How can we improve adherence to pract… |
| Society of Hospital Medicine @SocietyHospMed T1 is LIVE! Join #JHMChat on #meded #ptexp conflicting findings now! https://t.co/qxgvIDb1dX |
| Tony Breu @tony_breu I think this has to come from a point “higher” than an individual attending/resident. #JHMChat https://t.co/2owRyWbNN3 |
| J Hospital Medicine @JHospMedicine T1 supplement info- patient-centered rounding practices from are summarized here in this nice #visualabstract from @WrayCharles #jhmchat https://t.co/YRfdHeVrx9 |
| J Hospital Medicine @JHospMedicine T1 supplement info- patient-centered rounding practices from are summarized here in this nice #visualabstract... https://t.co/MoKnA47tMR |
 | Jorge A Rodriguez MD @translatedmed A1 Make it expected and standard, much like we expect the HPI to have certain flow and components. #jhmchat |
| Michelle Brooks, MD, FACP, FHM @michellebr00ks #JHMChat T1 - hard to get people to change from hallway rounds to bedside rounds. emphasize decreased redundancy, increased efficiency. |
| J Hospital Medicine @JHospMedicine @doctorakelso21 thanks for joining and good luck on #MatchDay2017 #jhmchat |
| J Hospital Medicine @JHospMedicine @ShannonMartinMD @UChicagoMed great to have you back #jhmchat |
| bradley monash @bradmonash @JHospMedicine prioritizing making it happen, achieving buy-in, training & preparation, scheduling/geographic cohorting #JHMChat |
| J Hospital Medicine @JHospMedicine RT @BradMonash: @JHospMedicine prioritizing making it happen, achieving buy-in, training & preparation, scheduling/geographic cohorting #JH… |
 | Jamuna Krishnan @jkkrishnanMD T1: aligning incentives, performance feedback, buy-in, making it easy to adhere- setting up the system well #JHMChat |
| Charlie M. Wray @WrayCharles My inner economist says that it has to be incentivized. #CarrotorStick #JHMChat https://t.co/rHtlxPiVw7 |
| Tony Breu @tony_breu @BradMonash @JHospMedicine How essential is geography? Does UCSF (the study site) have geographic admitting? #JHMChat |
| P. F. Anderson @pfanderson RT @AndrewMIbrahim: Great work from @JHospMedicine @FutureDocs integrating #VisualAbstract into the blog post setting up journal club https… |
| J Hospital Medicine @JHospMedicine RT @WrayCharles: My inner economist says that it has to be incentivized. #CarrotorStick #JHMChat https://t.co/rHtlxPiVw7 |
| Chris Petrilli @PetrilliMD T1: I think the key is to have clear expectations set by attending at beg of rotation, adherence is diff to avoid when tone is set #jhmchat |
| Bruce Joy @brucejoy RT @BradMonash: @JHospMedicine prioritizing making it happen, achieving buy-in, training & preparation, scheduling/geographic cohorting #JH… |
| Malvinder Parmar @wittykidney @JHospMedicine @BradMonash what a conundrum- one side talking individualized care on other side standardized rounds! #JHMChat |
| J Hospital Medicine @JHospMedicine RT @PetrilliMD: T1: I think the key is to have clear expectations set by attending at beg of rotation, adherence is diff to avoid when tone… |
| Rebecca Jaffe, MD @RJmdphilly @JHospMedicine @BradMonash #jhmchat system must reinforce practice. Can't just squeeze into otherwise crazy am. Practice must b value added. |
| J Hospital Medicine @JHospMedicine RT @RJmdphilly: @JHospMedicine @BradMonash #jhmchat system must reinforce practice. Can't just squeeze into otherwise crazy am. Practice mu… |
| Michelle Brooks, MD, FACP, FHM @michellebr00ks #JHMchat T1changed to bedside rounds 4 years ago...personally love it. #huddle outside room is key - gives learners chance to confirm plan. |
| J Hospital Medicine @JHospMedicine RT @michellebr00ks: #JHMchat T1changed to bedside rounds 4 years ago...personally love it. #huddle outside room is key - gives learners ch… |
| bradley monash @bradmonash @michellebr00ks agreed. also emphasize that (most) patients prefer exposure to all of the "intellectual capital."#JHMChat |
| Chris Petrilli @PetrilliMD @WrayCharles #JHMChat it is...HCAHPS! |
| Rebecca Jaffe, MD @RJmdphilly RT @michellebr00ks: #JHMChat T1 - hard to get people to change from hallway rounds to bedside rounds. emphasize decreased redundancy, incre… |
| Vinny Arora MD MAPP @FutureDocs Wonder if this has to do with your. #uchicago training ;) #jhmchat https://t.co/8LvffLDNFQ |
| Vinny Arora MD MAPP @FutureDocs RT @jkkrishnanMD: T1: aligning incentives, performance feedback, buy-in, making it easy to adhere- setting up the system well #JHMChat |
| Vinny Arora MD MAPP @FutureDocs RT @BradMonash: @JHospMedicine prioritizing making it happen, achieving buy-in, training & preparation, scheduling/geographic cohorting #JH… |
| Charlie M. Wray @WrayCharles Def agree, Chris. But need larger buy-in. Problem occurs when new attending comes on and doesn't hold people accountable #jhmchat https://t.co/sLWzYg5H5w |
| Michelle Brooks, MD, FACP, FHM @michellebr00ks #jhmchat - T1 - a rounds coordinator might help. also could track adherence to quality practices. |
| J Hospital Medicine @JHospMedicine RT @michellebr00ks: #jhmchat - T1 - a rounds coordinator might help. also could track adherence to quality practices. |
| Rebecca Jaffe, MD @RJmdphilly @michellebr00ks #jhmchat tough to achieve inc efficiency. We changed to PCR now I round on each pt 3x daily |
| Michelle Brooks, MD, FACP, FHM @michellebr00ks RT @BradMonash: @michellebr00ks agreed. also emphasize that (most) patients prefer exposure to all of the "intellectual capital."#JHMChat |
| Tony Breu @tony_breu One incentive is no pre-rounding. This is what gets me some buy-in. #JHMChat https://t.co/X3vYKlRqHs |
| Chris Petrilli @PetrilliMD I think that NOT bedside rounding is inefficient-you talk in hallway -> repeat story intern usually already told pt in prerounds #jhmchat |
| bradley monash @bradmonash @tony_breu @JHospMedicine suspect lack of geographic cohorting negatively impacted adherence. #JHMChat |
 | Ross Morton @signindoc RT @wittykidney: Malvinder Parmar, nephtwitron, no COI #JHMChat taking away some time from filling my STANDARIZED #NephMadness brack… |
| Rebecca Jaffe, MD @RJmdphilly Geo is key. I think necessary not sufficient? #jhmchat https://t.co/9bV4C0PEiz |
| Vinny Arora MD MAPP @FutureDocs Wow how did you get docs to buy in? #jhmchat https://t.co/88NFm6lOvf |
| Michelle Brooks, MD, FACP, FHM @michellebr00ks @WrayCharles - but patients like it better...shouldn't this be an altruistic incentive? #JHMChat |
| Kelsey Murray @doctorakelso21 This is the standard at the children's hospital, but not at the adult hospitals - must have attendings set expectations #JHMChat |
| Vinny Arora MD MAPP @FutureDocs RT @PetrilliMD: I think that NOT bedside rounding is inefficient-you talk in hallway -> repeat story intern usually already told pt in prer… |
| bradley monash @bradmonash @michellebr00ks we have 1 at UCSF Peds. world of difference. #JHMChat |
| Michelle Brooks, MD, FACP, FHM @michellebr00ks @PetrilliMD Agreed - so much more efficient at bedside. #JHMChat |
| Chris Petrilli @PetrilliMD @WrayCharles #JHMChat Absolutely - honestly, I have only done it on select patients but already sent this art out to my April and June teams |
| Tony Breu @tony_breu @RJmdphilly This seems right. When we moved to geography, buy-in seemed to increase. #JHMChat |
| Kelsey Murray @doctorakelso21 It was also helpful to designate roles - senior puts in orders, med student updates white board, etc #JHMChat |
| bradley monash @bradmonash @PetrilliMD #JHMChat https://t.co/iKZ52sJ44D |
| Michelle Brooks, MD, FACP, FHM @michellebr00ks @wittykidney Was doing "hallway" rounds. Talk about the patient outside the room, then go to see them. #JHMChat |
| Rebecca Jaffe, MD @RJmdphilly And follow metric on #QIinrealtime!! #jhmchat https://t.co/kKFSFouVkC |
| J Hospital Medicine @JHospMedicine RT @BradMonash: @tony_breu @JHospMedicine suspect lack of geographic cohorting negatively impacted adherence. #JHMChat |
| Charlie M. Wray @WrayCharles I like this idea. Wonder what CE of this would be. Improved pt satisfaction --> more $$...#jhmchat https://t.co/YaXQOmuCGI |
| Rebecca Jaffe, MD @RJmdphilly RT @tony_breu: One incentive is no pre-rounding. This is what gets me some buy-in. #JHMChat https://t.co/X3vYKlRqHs |
 | Madhu S. MD @thinkalot RT @JHospMedicine: 1h til #JHMchat on patient-centered rounds -good for #ptexp but not #meded? w @BradMonash @FutureDocs… |
| Rebecca Jaffe, MD @RJmdphilly Would love to hear how you do this. We still preround #jhmchat https://t.co/khLwATzq1q |
| J Hospital Medicine @JHospMedicine RT @doctorakelso21: It was also helpful to designate roles - senior puts in orders, med student updates white board, etc #JHMChat |
| Shannon K. Martin @shannonmartinmd Agreed, great time to try out new tips/strategies by putting in expectations at top-no surprises for learners, makes u accountable #jhmchat https://t.co/wS2xg3rnE4 |
| Michelle Brooks, MD, FACP, FHM @michellebr00ks @RJmdphilly YESSSSSS!! #QIinrealtime #JHMChat |
| J Hospital Medicine @JHospMedicine RT @PetrilliMD: I think that NOT bedside rounding is inefficient-you talk in hallway -> repeat story intern usually already told pt in prer… |
| Michelle Brooks, MD, FACP, FHM @michellebr00ks RT @RJmdphilly: And follow metric on #QIinrealtime!! #jhmchat https://t.co/kKFSFouVkC |
| Jamuna Krishnan @jkkrishnanMD White board seems hardest part, rather spend that time making sure patient understands, #JHMChat |
| Tony Breu @tony_breu @RJmdphilly I ask that interns pre-round in (1) sick; (2) potential discharge. Otherwise, they can wait until rounds. #JHMChat |
| Chris Petrilli @PetrilliMD @RJmdphilly #JHMChat step 1 - have them stop ordering daily labs :) |
| Michelle Brooks, MD, FACP, FHM @michellebr00ks RT @ShannonMartinMD: Agreed, great time to try out new tips/strategies by putting in expectations at top-no surprises for learners, make… |
| Vinny Arora MD MAPP @FutureDocs RT @ShannonMartinMD: Agreed, great time to try out new tips/strategies by putting in expectations at top-no surprises for learners, make… |
| Michelle Brooks, MD, FACP, FHM @michellebr00ks RT @WrayCharles: I like this idea. Wonder what CE of this would be. Improved pt satisfaction --> more $$...#jhmchat https://t.co/YaXQOmuCGI |
| Rebecca Jaffe, MD @RJmdphilly @FutureDocs ugghhghhh. Does that answer? (Table round c team, PCR, return to address pt's actual concerns...not sustainable) #jhmchat |
| Vinny Arora MD MAPP @FutureDocs RT @PetrilliMD: @RJmdphilly #JHMChat step 1 - have them stop ordering daily labs :) |
| Michelle Brooks, MD, FACP, FHM @michellebr00ks RT @RJmdphilly: Geo is key. I think necessary not sufficient? #jhmchat https://t.co/9bV4C0PEiz |
| J Hospital Medicine @JHospMedicine RT @PetrilliMD: @RJmdphilly #JHMChat step 1 - have them stop ordering daily labs :) |
| Chris Petrilli @PetrilliMD @jkkrishnanMD #JHMChat We tried ONLY white board on 1 unit- termed "Visual Plan of Care" - it was a success for pts, but adherence was poor |
 | Amy Shaw @amyshawmd T1 practice, repetition, and refining the expectations & training as needed. hard to improve adherence if not perceived as valuable #jhmchat |
| Vinny Arora MD MAPP @FutureDocs I found the lack of adherence to white board interesting too but #ptexp still improved #jhmchat https://t.co/6P4oFSNgW4 |
| Rebecca Jaffe, MD @RJmdphilly @gretchendiemer @estewart2099 YES!!! https://t.co/kGoWaNzq14 |
| Tony Breu @tony_breu @PetrilliMD @jkkrishnanMD Who “owns” the board? MDs? RNs? Other? #JHMChat |
| J Hospital Medicine @JHospMedicine RT @tony_breu: @PetrilliMD @jkkrishnanMD Who “owns” the board? MDs? RNs? Other? #JHMChat |
 | Anika Kumar, MD @freckledpedidoc Very true. We have been doing FCRs for years. It is the "gold standard" since I was a resident. #jhmchat https://t.co/fbvnqKKJ0d |
| Jamuna Krishnan @jkkrishnanMD @tony_breu at our institution pre rounding seen as important to preserve intern autonomy, time/space to come up with own plan- #jhmchat |
| J Hospital Medicine @JHospMedicine Great convo tonight on patient-centered rounds. T2 up in a moment #JHMChat welcome to #ptexp #meded community |
| Tony Breu @tony_breu @jkkrishnanMD Fair point, but I’m not certain the interns glean that much from pre-rounds. The time saved allows for #AMreport #JHMChat |
| Michelle Brooks, MD, FACP, FHM @michellebr00ks RT @BradMonash: @JHospMedicine prioritizing making it happen, achieving buy-in, training & preparation, scheduling/geographic cohorting #JH… |
| Rebecca Jaffe, MD @RJmdphilly @jkkrishnanMD we delegate to RN coordinator. They do a great job. #jhmchat |
| Malvinder Parmar @wittykidney T1 - most challenging would be to correct the intern/resident presenting the history, if issues, in front of patient & others #JHMChat |
| Jorge A Rodriguez MD @translatedmed Wonder if "Digital Whiteboards" pulling info from EMR would facilitate keeping pts informed and inc. adherence. #jhmchat |
| Tony Breu @tony_breu This sounds like a good idea. At least someone is tasked with the the job. #JHMChat https://t.co/TSxiJWKiGo |
| Kelsey Murray @doctorakelso21 How do we show value if residents perceive it as lasting longer even if it is in fact shorter? Providers must value pt experience #JHMChat |
| Chris Petrilli @PetrilliMD @tony_breu @jkkrishnanMD #JHMChat The MDs were supposed to and the RNs would "score" adherence (erase board qAM) |
 | Jason Stein MD SFHM @1jasonstein #JHMChat interested in any insights into why residents seemed less satisfied while patients more so |
| Shannon K. Martin @shannonmartinmd @jkkrishnanMD @tony_breu same here, proud part of housestaff culture, balance bt using rounds wisely when busy & respecting process #jhmchat |
| bradley monash @bradmonash @tony_breu @jkkrishnanMD we also recommended "selective" pre-rounds (sick/active, poss d/c). #JHMChat |
| J Hospital Medicine @JHospMedicine T2 In @BradMonash et al, patient-centered rounds assoc w inc patient satisfaction but dec resident satisfaction. Why? #JHMChat |
 | Robert J. Mahoney, MD @mahoneyr Jumping into #JHMChat a bit lately. Evening, everyone. |
| Tony Breu @tony_breu @doctorakelso21 Is it residents or interns who perceive it as longer?, @BradMonash #JHMChat |
| Anika Kumar, MD @freckledpedidoc At my hospital, intern leads discussion & presents to pt/family, senior res & intern answer qs, 2nd intern orders & I supervise. #jhmchat https://t.co/axiACxuNiq |
| J Hospital Medicine @JHospMedicine Related to white boards, @jhospmedicine survey of practices @ucsfdhm #JHMChat https://t.co/2BnTaG62d7 |
| J Hospital Medicine @JHospMedicine RT @freckledpedidoc: At my hospital, intern leads discussion & presents to pt/family, senior res & intern answer qs, 2nd intern orders &… |
| Rebecca Jaffe, MD @RJmdphilly Why can we accomplish 4 kids not adults? I think this is key! Something visceral re involving fam & achieving understanding 4 kids #jhmchat https://t.co/iqgSfHrVob |
| J Hospital Medicine @JHospMedicine Related to white boards, @jhospmedicine survey of practices @ucsfdhm #JHMChat https://t.co/2BnTaG62d7 https://t.co/nXOmnRaT8L |
 | Alex Auseon @ajauseon Catching up to conv as someone who struggles mightily w conflicting needs during rounds #jhmchat |
| bradley monash @bradmonash @wittykidney this is definitely an art (like aikido). #JHMChat |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: Related to white boards, @jhospmedicine survey of practices @ucsfdhm #JHMChat https://t.co/2BnTaG62d7 https://t.co/nXOmn… |
| Michelle Brooks, MD, FACP, FHM @michellebr00ks @wittykidney huddle outside room just prior to going into the room is KEY. Gives learners a chance to confirm story/plan. #jhmchat |
| Rebecca Jaffe, MD @RJmdphilly RT @translatedmed: Wonder if "Digital Whiteboards" pulling info from EMR would facilitate keeping pts informed and inc. adherence. #jhmchat |
| Vinny Arora MD MAPP @FutureDocs RT @RJmdphilly: Why can we accomplish 4 kids not adults? I think this is key! Something visceral re involving fam & achieving under… |
| bradley monash @bradmonash @tony_breu @doctorakelso21 for analyses learners were lumped #JHMChat |
| Shoshana Herzig @ShaniHerzig Where is @Jed_Gonzalo15 when you need him? #jhmchat |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: T2 In @BradMonash et al, patient-centered rounds assoc w inc patient satisfaction but dec resident satisfaction. Why? #… |
 | Nancy H Stewart DO, MS @nvhstewart Had to get kids to bed! Jumping on #jhmchat a bit late tonight- sorry! |
| Kelsey Murray @doctorakelso21 @tony_breu @BradMonash article says 'trainees'. Attendings had high satisfaction #jhmchat |
| Tony Breu @tony_breu @ShaniHerzig @Jed_Gonzalo15 Probably rounding at the bedside. Extremely well. #JHMChat |
| Jorge A Rodriguez MD @translatedmed T2 wonder if dissatisfaction comes from effort to tailor presentation with more patient friendly language . #jhmchat |
| bradley monash @bradmonash @1JasonStein included perceived decreased autonomy and decreased efficiency #JHMChat |
| J Hospital Medicine @JHospMedicine Thanks for coming! dont forget to tag your tweets #JHMChat https://t.co/l8mwTdE3EH |
| Michelle Brooks, MD, FACP, FHM @michellebr00ks #JHMChat T2 - may be about different expectations of rounds - residents = #meded; patients = take care of me please. |
| Chris Petrilli @PetrilliMD @translatedmed #JHMChat that was my idea for our "Innovation Challenge" (#dominos) but ?offense taken to being compared to Pizza Company :) https://t.co/7Lcad1hOlZ |
| Rebecca Jaffe, MD @RJmdphilly RT @JHospMedicine: T2 In @BradMonash et al, patient-centered rounds assoc w inc patient satisfaction but dec resident satisfaction. Why? #… |
| Vinny Arora MD MAPP @FutureDocs RT @ShannonMartinMD: @jkkrishnanMD @tony_breu same here, proud part of housestaff culture, balance bt using rounds wisely when busy & respe… |
| bradley monash @bradmonash @RJmdphilly mission in pediatrics is crystal clear. more diluted in medicine. #JHMChat |
| Anika Kumar, MD @freckledpedidoc Can't speak for adults, in peds residents feel they can't present full story bc they have to speak in laymen terms with families #jhmchat https://t.co/zYEdDXXHGx |
| Tony Breu @tony_breu Resident = decreased autonomy; Interns = having to participate in rounds on co-intern patients #JHMChat https://t.co/GREsZAyPvZ |
| Charlie M. Wray @WrayCharles resident usually want 1 thing: autonomy, autonomy, and autonomy... standardization takes this from them #jhmchat https://t.co/x9ApYpLrEm |
| Chris Petrilli @PetrilliMD @mahoneyr #JHMChat Welcome! |
| Robert J. Mahoney, MD @mahoneyr About to pilot a similar program on our medicine floors. So far everyone's found something to be dissatisfied about #JHMChat |
| Rebecca Jaffe, MD @RJmdphilly @BradMonash how can you transfer this to medicine? Surgery? Humans? #jhmchat |
| Jason Stein MD SFHM @1jasonstein @BradMonash @JHospMedicine #JHMChat Brad thoughts on MD sat possibly dependent on quality of RN prep and contributions, i.e. value add? |
| J Hospital Medicine @JHospMedicine @mahoneyr Great to have you back as a participant! #JHMChat |
| Tony Breu @tony_breu @WrayCharles Unless the attending keeps their mouth shut. #JHMChat |
| bradley monash @bradmonash @tony_breu yes. decreased autonomy, perceived decreased efficiency. control arm = rounding the resident's way #JHMChat |
| Jorge A Rodriguez MD @translatedmed @PetrilliMD haha. It's really a great idea. Providing pts directly from the source. Did you need up building it ? #jhmchat |
| J Hospital Medicine @JHospMedicine RT @doctorakelso21: This is the standard at the children's hospital, but not at the adult hospitals - must have attendings set expectations… |
| Rebecca Jaffe, MD @RJmdphilly RT @BradMonash: @1JasonStein included perceived decreased autonomy and decreased efficiency #JHMChat |
 | Jigar Contractor @jigsymd @tony_breu @WrayCharles Probably the hardest part of rounds? #jhmchat |
| Chris Petrilli @PetrilliMD @WrayCharles #JHMChat I think this can be reframed if they lead rounds and attending makes focus teaching > direct pt care at bedside |
| Michelle Brooks, MD, FACP, FHM @michellebr00ks #JHMChat T2 - classic rounds to resident = their chance to shine/look smart. PCR takes the focus off of the resident or student. |
| bradley monash @bradmonash @1JasonStein @JHospMedicine great question. only universally lauded aspect of intervention was RN engagement #JHMChat |
| J Hospital Medicine @JHospMedicine RT @BradMonash: @1JasonStein @JHospMedicine great question. only universally lauded aspect of intervention was RN engagement #JHMChat |
| J Hospital Medicine @JHospMedicine RT @michellebr00ks: #JHMChat T2 - classic rounds to resident = their chance to shine/look smart. PCR takes the focus off of the resident o… |
| Robert J. Mahoney, MD @mahoneyr During development we would be asked "why can't MDs keep appointment times for rounds on floors?" #JHMChat |
| Vinny Arora MD MAPP @FutureDocs RT @michellebr00ks: #JHMChat T2 - classic rounds to resident = their chance to shine/look smart. PCR takes the focus off of the resident o… |
| Malvinder Parmar @wittykidney @tony_breu @WrayCharles then no teaching, pseudo-confidence in learners, poor education & its consequences later #JHMChat |
| Vinny Arora MD MAPP @FutureDocs RT @PetrilliMD: @WrayCharles #JHMChat I think this can be reframed if they lead rounds and attending makes focus teaching > direct pt care… |
| Chris Petrilli @PetrilliMD @translatedmed #JHMChat MOST of the data is avail in EPIC under "scheduled"/"Unscheduled" test...but needed a solid HIPAA compliant GUI |
| Tony Breu @tony_breu @WrayCharles But it is hard. So many “teaching points” to be made. #JHMChat |
| Charlie M. Wray @WrayCharles RT @michellebr00ks: #JHMChat T2 - classic rounds to resident = their chance to shine/look smart. PCR takes the focus off of the resident o… |
 | Jason A. Wolf @jasonawolf RT @JHospMedicine: welcome author @BradMonash author of Standardizing Rounds To Improve #Ptexp #JHMChat https://t.co/ttxPSPwLLp… |
| Vinny Arora MD MAPP @FutureDocs RT @BradMonash: @tony_breu yes. decreased autonomy, perceived decreased efficiency. control arm = rounding the resident's way #JHMChat |
| Vinny Arora MD MAPP @FutureDocs RT @WrayCharles: resident usually want 1 thing: autonomy, autonomy, and autonomy... standardization takes this from them #jhmchat https://t… |
| bradley monash @bradmonash @RJmdphilly great question. https://t.co/K0uVyKhEcx. #JHMChat |
| Vinny Arora MD MAPP @FutureDocs I feel your pain #jhmchat https://t.co/nuvuhngAu2 |
| Jorge A Rodriguez MD @translatedmed @PetrilliMD definitely doable, would have to make decisions regarding what information to push to screens. #jhmchat |
| Rebecca Jaffe, MD @RJmdphilly Interesting idea here. If RN involvement is novel for housestaff, it needs to be high quality to seem worth the change #jhmchat https://t.co/NfSMOT5IVi |
 | Marcia de la Cuadra @marciadelacuadr Watching B. Monash play shortstop for our JHM study on #jhmchat |
| bradley monash @bradmonash @wittykidney @tony_breu @WrayCharles lots to be said for coaching #JHMChat https://t.co/euttZTqTwb |
| Kelsey Murray @doctorakelso21 T2 imo great attendings involved learners in teaching team and patient and it was ok to discuss topics in front of family #JHMChat |
| Vinny Arora MD MAPP @FutureDocs #MicDrop by our author @BradMonash tonight on #jhmchat https://t.co/w652Z1txYg |
| Rebecca Jaffe, MD @RJmdphilly @tony_breu @WrayCharles omg the tension is aweful! #jhmchat I just can't help contributing!!! |
| Alex Auseon @ajauseon As adult cardiologist - want to get work done, educ pts, teach mult levels, give HS room to practice = 2much #jhmchat |
| J Hospital Medicine @JHospMedicine RT @FutureDocs: #MicDrop by our author @BradMonash tonight on #jhmchat https://t.co/w652Z1txYg |
| Rebecca Jaffe, MD @RJmdphilly RT @BradMonash: @RJmdphilly great question. https://t.co/K0uVyKhEcx. #JHMChat |
| Jamuna Krishnan @jkkrishnanMD T2: difficult to multi-task when entire team in front of patient leading to perceived decreased efficiency = lower satisfaction #JHMChat |
| Michelle Brooks, MD, FACP, FHM @michellebr00ks #jhmchat T2 as an attending, PCR (#SIBR), gives me an idea of level of synthesis of learner and ability to communicate to pt @1JasonStein |
| Anika Kumar, MD @freckledpedidoc @michellebr00ks maybe not. Shining to pt more important than shining to attending. Families recognize intern as primary doc. #jhmchat |
| Chris Petrilli @PetrilliMD @translatedmed #JHMChat #IntellectualPropertyAgreement? :) Let's get started on that! |
| Chris Petrilli @PetrilliMD RT @FutureDocs: #MicDrop by our author @BradMonash tonight on #jhmchat https://t.co/w652Z1txYg |
| Shannon K. Martin @shannonmartinmd impt to remember/acknowledge/name this, even tho they are "adult learners", can be hard for trainees to lose educational spotlight #jhmchat https://t.co/bI69xB5yEa |
| Jason Stein MD SFHM @1jasonstein @BradMonash @JHospMedicine #JHMChat thanks and any insights into how to improve resident perception of efficiency and/or autonomy? |
| J Hospital Medicine @JHospMedicine @marciadelacuadr welcome to the discussion - feel free to jump in as a discussant! #JHMchat |
| Michelle Brooks, MD, FACP, FHM @michellebr00ks RT @BradMonash: @RJmdphilly great question. https://t.co/K0uVyKhEcx. #JHMChat |
| Tony Breu @tony_breu @RJmdphilly @WrayCharles or… (internal dialog): “Wait, did we decide to start IVF or not???” #JHMChat |
| Anika Kumar, MD @freckledpedidoc Great article!! #jhmchat https://t.co/dpCEM2w0y6 |
| Nancy H Stewart DO, MS @nvhstewart "High quality" means different things for different interprofessional team members-- interprofessional care = more pt centered -> time https://t.co/d1Vh4H9vyL |
| Jason Stein MD SFHM @1jasonstein RT @RJmdphilly: Interesting idea here. If RN involvement is novel for housestaff, it needs to be high quality to seem worth the cha… |
| J Hospital Medicine @JHospMedicine RT @nvhs0401: "High quality" means different things for different interprofessional team members-- interprofessional care = more… |
| bradley monash @bradmonash @1JasonStein @JHospMedicine as in EBM, show them the data. we have rounding coordinators feeding back pt experience to teams #JHMChat |
| Tony Breu @tony_breu Related to T2: Is trainee “satisfaction” what we’re aiming for? #JHMChat |
| Shannon K. Martin @shannonmartinmd RT @FutureDocs: #MicDrop by our author @BradMonash tonight on #jhmchat https://t.co/w652Z1txYg |
 | Sean Molloy @SeanJMolloy RT @JHospMedicine: welcome author @BradMonash author of Standardizing Rounds To Improve #Ptexp #JHMChat https://t.co/ttxPSPwLLp… |
| Anika Kumar, MD @freckledpedidoc Yes!! The job of the attending is empower the team to engage pt & answer questions. #jhmchat https://t.co/AZGRsCrlX7 |
| Rebecca Jaffe, MD @RJmdphilly RT @FutureDocs: #MicDrop by our author @BradMonash tonight on #jhmchat https://t.co/w652Z1txYg |
| Charlie M. Wray @WrayCharles RT @tony_breu: Related to T2: Is trainee “satisfaction” what we’re aiming for? #JHMChat |
| Chris Petrilli @PetrilliMD @1JasonStein @JHospMedicine #JHMChat my old attending and mentor @sanjaysaint always made it clear to pt that the intern was "their doc" |
 | Poonam Sharma @PoonamSS RT @tony_breu: Related to T2: Is trainee “satisfaction” what we’re aiming for? #JHMChat |
| bradley monash @bradmonash @tony_breu good ?. "teaching" often underestimated by learners https://t.co/f9Z83oKjZQ. #JHMChat |
| Nancy H Stewart DO, MS @nvhstewart Trainees certainly think so, esp. when they eval rotation #jhmchat https://t.co/1lMkP112mU |
 | Benji Mathews, MD @MDbenji Just joining in after a teaching service week. Discussion provoking article in our teaching faculty group here @bradmonash #jhmchat |
| Jigar Contractor @jigsymd @tony_breu @WrayCharles Teaching points are always available to be made; real question is the value outweigh pt satisfaction #jhmchat |
| Poonam Sharma @PoonamSS Great question. #JHMchat https://t.co/PesuRXGj6H |
| Robert J. Mahoney, MD @mahoneyr T2 in general, anything that changes resident behavior leads to resident dissatisfaction #JHMChat |
| Tony Breu @tony_breu @PetrilliMD So so important. This isn’t your “intern” or your “resident”. This is your DOCTOR. #JHMChat |
| Michelle Brooks, MD, FACP, FHM @michellebr00ks @freckledpedidoc I hope to encourage this in learners! My eval is not nearly as important as their patients' perceptions! #JHMChat |
| Nancy H Stewart DO, MS @nvhstewart Yes!!! I often have to remind trainees "I'm going to teach you something now" 🙈 #jhmchat https://t.co/BiZaMw4twY |
| J Hospital Medicine @JHospMedicine T3 What should the purposes of attending rounds be? #ptexp #meded #JHMChat |
| Society of Hospital Medicine @SocietyHospMed Don't forget to claim #CME after tonight's #JHMChat by clicking here: https://t.co/6DBtoNyhHk |
| Tony Breu @tony_breu @BradMonash And the best learning often isn’t easy (or particularly enjoyable). #JHMChat |
| Vinny Arora MD MAPP @FutureDocs RT @tony_breu: @PetrilliMD So so important. This isn’t your “intern” or your “resident”. This is your DOCTOR. #JHMChat |
| Nancy H Stewart DO, MS @nvhstewart RT @tony_breu: @PetrilliMD So so important. This isn’t your “intern” or your “resident”. This is your DOCTOR. #JHMChat |
| Robert J. Mahoney, MD @mahoneyr I would remind them "when you call me for low BP at 8am, then that's what I'm doing for the next hour." @screamingmd #jhmchat |
| Rebecca Jaffe, MD @RJmdphilly Hard to do with #pcr. Intern seems like bottom rung, in our model anyway. #jhmchat https://t.co/t1QuUYdrDA |
| Nancy H Stewart DO, MS @nvhstewart RT @JHospMedicine: T3 What should the purposes of attending rounds be? #ptexp #meded #JHMChat |
| Michelle Brooks, MD, FACP, FHM @michellebr00ks RT @BradMonash: @tony_breu good ?. "teaching" often underestimated by learners https://t.co/f9Z83oKjZQ. #JHMChat |
| Tony Breu @tony_breu @nvhs0401 And then tell them, “I just taught you something”. #JHMChat |
| Society of Hospital Medicine @SocietyHospMed #JHMChat T3 is live! https://t.co/Djtw3nsFBx |
| Michelle Brooks, MD, FACP, FHM @michellebr00ks RT @freckledpedidoc: Yes!! The job of the attending is empower the team to engage pt & answer questions. #jhmchat https://t.co/AZGRsCrlX7 |
| Anika Kumar, MD @freckledpedidoc @JigsyMD @tony_breu @WrayCharles can learn 1 thing from every encounter. I highlight that in hallway huddle AFTER bedside round #jhmchat |
| Chris Petrilli @PetrilliMD @nvhs0401 #JHMChat https://t.co/POHKv3kfcE improved satisfaction = less burnout |
| Rebecca Jaffe, MD @RJmdphilly RT @JHospMedicine: T3 What should the purposes of attending rounds be? #ptexp #meded #JHMChat |
| Tony Breu @tony_breu @FutureDocs Asks this question. Not sure there is one answer. I tell the team it’s (1) advance pt care; (2) learn. In that order. #JHMChat https://t.co/HfcLzpqM1r |
 | S. Lane 📎 @sulane7 RT @PetrilliMD: I think that NOT bedside rounding is inefficient-you talk in hallway -> repeat story intern usually already told pt in prer… |
| Vinny Arora MD MAPP @FutureDocs Status quo bias -any change from baseline is perceived as a loss #jhmchat learned from @CassSunstein @RichardThaler book Nudge https://t.co/q7VjHuzjpS |
| Amy Shaw @amyshawmd @doctorakelso21 also sheds light on another skill for learners to build! provides opportunity to observe communication. #jhmchat T2 |
| Jorge A Rodriguez MD @translatedmed @RJmdphilly brings up question of pt ability to ID doctor and differentiate between different levels. #jhmchat |
| Vinny Arora MD MAPP @FutureDocs RT @tony_breu: @FutureDocs Asks this question. Not sure there is one answer. I tell the team it’s (1) advance pt care; (2) learn.… |
| bradley monash @bradmonash @tony_breu @PetrilliMD favorite slide when teaching about patient-engaged rounds. #JHMChat https://t.co/28tsWqzFiE |
| Vinny Arora MD MAPP @FutureDocs RT @BradMonash: @tony_breu @PetrilliMD favorite slide when teaching about patient-engaged rounds. #JHMChat https://t.co/28tsWqzFiE |
| Robert J. Mahoney, MD @mahoneyr T3 #JHMChat Not sure if there is any single purpose, but it is often the only time when everyone who makes decisions is all together. |
| J Hospital Medicine @JHospMedicine RT @BradMonash: @tony_breu @PetrilliMD favorite slide when teaching about patient-engaged rounds. #JHMChat https://t.co/28tsWqzFiE |
| Anika Kumar, MD @freckledpedidoc @nvhs0401 I start off wk telling team my responsibility is to share 1 teaching pearl for every pt every day. Team holds me to it #jhmchat |
| Shannon K. Martin @shannonmartinmd @JHospMedicine T3 is there 1 answer!? purpose for me keeps shifting over first 5+ yrs as attdg, likely to be diff for diff members #jhmchat |
| J Hospital Medicine @JHospMedicine RT @ShannonMartinMD: @JHospMedicine T3 is there 1 answer!? purpose for me keeps shifting over first 5+ yrs as attdg, likely to be diff for… |
| Rebecca Jaffe, MD @RJmdphilly @nvhs0401 meaning if RNs bring data/insights team is lacking or can accomplish tasks team would ow do...then value added to res #jhmchat |
| Michelle Brooks, MD, FACP, FHM @michellebr00ks RT @PetrilliMD: @nvhs0401 #JHMChat https://t.co/POHKv3kfcE improved satisfaction = less burnout |
| Robert J. Mahoney, MD @mahoneyr @FutureDocs @CassSunstein @RichardThaler At least until current housestaff leave. Then we can't picture how it was any other way #JHMchat |
 | QA Ninja @qualityninja RT @PetrilliMD: @translatedmed #JHMChat MOST of the data is avail in EPIC under "scheduled"/"Unscheduled" test...but needed a solid HIPAA c… |
| QA Ninja @qualityninja RT @translatedmed: @PetrilliMD definitely doable, would have to make decisions regarding what information to push to screens. #jhmchat |
| Chris Petrilli @PetrilliMD #JHMChat @sanjaysaint 1) provide excellent patient care 2) make sure res/studs learn "a ton of medicine" 3) Have fun (in that order) |
| Rebecca Jaffe, MD @RJmdphilly @tony_breu @FutureDocs and how is that received? #jhmchat |
| J Hospital Medicine @JHospMedicine Glad you're made it Ryan! Moderator of #Meded chat on #jhmchat tonight https://t.co/THJmxizfpY |
| Marcia de la Cuadra @marciadelacuadr @translatedmed @RJmdphilly this is a huge issue! #jhmchat |
| Nancy H Stewart DO, MS @nvhstewart RT @PetrilliMD: @nvhs0401 #JHMChat https://t.co/POHKv3kfcE improved satisfaction = less burnout |
| J Hospital Medicine @JHospMedicine RT @PetrilliMD: #JHMChat @sanjaysaint 1) provide excellent patient care 2) make sure res/studs learn "a ton of medicine" 3) Have fun (in th… |
| Chris Petrilli @PetrilliMD RT @BradMonash: @tony_breu @PetrilliMD favorite slide when teaching about patient-engaged rounds. #JHMChat https://t.co/28tsWqzFiE |
| Jigar Contractor @jigsymd T3 caring for THE patient as a team and ensuring learners gain something along the way. #jhmchat |
| Vinny Arora MD MAPP @FutureDocs RT @michellebr00ks: #JHMChat T1 - hard to get people to change from hallway rounds to bedside rounds. emphasize decreased redundancy, incre… |
| Tony Breu @tony_breu @RJmdphilly @FutureDocs You know, I’m not sure anyone has specifically commented on this prioritziation. I should ask. #JHMChat |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: Glad you're made it Ryan! Moderator of #Meded chat on #jhmchat tonight https://t.co/THJmxizfpY |
| Kelsey Murray @doctorakelso21 @PetrilliMD @1JasonStein @JHospMedicine @sanjaysaint on pcr, felt like pt trusted me more even as med stu when you present to team #JHMChat |
| Rebecca Jaffe, MD @RJmdphilly I answer that need to understand - is "attending rounds" same as "pt centered rounds"? Does this need rethinking? #jhmchat https://t.co/3VhNzYNoFC |
| bradley monash @bradmonash @JHospMedicine hmmm. advance knowledge, skills, attitudes, and patient care? #JHMChat |
| Robert J. Mahoney, MD @mahoneyr As attending, I judge the success of rounds by the degree to which I was mostly spectating @PetrilliMD @sanjaysaint #jhmchat |
 | Linda Hunter @lhunter1310 RT @JHospMedicine: welcome author @BradMonash author of Standardizing Rounds To Improve #Ptexp #JHMChat https://t.co/ttxPSPwLLp… |
| Michelle Brooks, MD, FACP, FHM @michellebr00ks #JHMChat T3 - multiple competing interests - 6 core competencies - PC, SBP, PBLI, ICS, PROF, MK...right? |
| Michelle Brooks, MD, FACP, FHM @michellebr00ks RT @RJmdphilly: I answer that need to understand - is "attending rounds" same as "pt centered rounds"? Does this need rethinking?… |
| Jigar Contractor @jigsymd @PetrilliMD @sanjaysaint I'm pretty sure this sums up attending rounds. No one would be there w/o the patient! #jhmchat |
| Charlie M. Wray @WrayCharles My favorite answer so far... #jhmchat https://t.co/3nMjatsUvc |
| Tony Breu @tony_breu @mahoneyr @PetrilliMD @sanjaysaint I initially saw “spectating” as “speculating” - to which I said “yup, that’s me”. #JHMChat |
| Vinny Arora MD MAPP @FutureDocs One of my personal favorite questions #jhmchat after duty hours 2x patients identified attending as doctor most involved in case https://t.co/cnrcG1Qpqd |
 | Steve Delisi @avidus_piscator RT @tony_breu: @PetrilliMD So so important. This isn’t your “intern” or your “resident”. This is your DOCTOR. #JHMChat |
 | Chris Carroll MD MS @ChrisCarrollMD This is often overlooked & so important! If you don't label it as "teaching", often learners don't remember that you've taught! https://t.co/PSlvT4bGC0 |
| Nancy H Stewart DO, MS @nvhstewart RT @ChrisCarrollMD: This is often overlooked & so important! If you don't label it as "teaching", often learners don't remember that yo… |
| bradley monash @bradmonash @RJmdphilly agreed. "attg rounds" does not = "pt-centered rounds." nor does "bedside rounds." pt-centered not necessarily best. #JHMChat |
| Rebecca Jaffe, MD @RJmdphilly I wish. I think I judge in terms of degree to which we have moved pt care plan forward effectively as team. Can't be perfect #jhmchat https://t.co/M0J0NMvnie |
| Vinny Arora MD MAPP @FutureDocs RT @RJmdphilly: I answer that need to understand - is "attending rounds" same as "pt centered rounds"? Does this need rethinking?… |
 | Sapna Kudchadkar, MD, PhD 👩🏽⚕️ @SapnaKmd RT @ChrisCarrollMD: This is often overlooked & so important! If you don't label it as "teaching", often learners don't remember that yo… |
| Jorge A Rodriguez MD @translatedmed RT @FutureDocs: One of my personal favorite questions #jhmchat after duty hours 2x patients identified attending as doctor most inv… |
| Robert J. Mahoney, MD @mahoneyr @tony_breu @PetrilliMD @sanjaysaint Idle speculation is the chief currency of the medicine attending #JHMchat |
| Michelle Brooks, MD, FACP, FHM @michellebr00ks #JHMChat T3 - Rounds are where the core competencies become evident to learners. |
| Alex Auseon @ajauseon Pt care yes, but trainees need chance to practice/get feedback - this is why we're all still working on it post-GME https://t.co/dOvUXst0Rk |
| Nancy H Stewart DO, MS @nvhstewart @ChrisCarrollMD this just happened last week on rounds-- "this is teaching"... "I am teaching you something now" 🙈#jhmchat |
| Jamuna Krishnan @jkkrishnanMD I feel the same way about morning rounds as inpatient notes, everyone feels differently about purpose, but agreed pts most impt #JHMChat |
| Rebecca Jaffe, MD @RJmdphilly RT @ShannonMartinMD: @JHospMedicine T3 is there 1 answer!? purpose for me keeps shifting over first 5+ yrs as attdg, likely to be diff for… |
| Tony Breu @tony_breu @mahoneyr @PetrilliMD @sanjaysaint Without it, I’d be useless (still might be). #JHMChat |
| J Hospital Medicine @JHospMedicine T4 How can we improve patient-centered rounds so it’s a win-win for #ptexp & #meded ? #JHMChat |
| Anika Kumar, MD @freckledpedidoc @nvhs0401 thanks. It puts everyone on the same page & team feels attending invested in teaching learners #jhmchat |
| Marcia de la Cuadra @marciadelacuadr @RJmdphilly my advice to new attendings: the less you say, the smarter you look! #JHMchat |
| Michelle Brooks, MD, FACP, FHM @michellebr00ks RT @mahoneyr: As attending, I judge the success of rounds by the degree to which I was mostly spectating @PetrilliMD @sanjaysaint #jhmchat |
| Rebecca Jaffe, MD @RJmdphilly 😕 https://t.co/cpqsrxyebU |
| Chris Petrilli @PetrilliMD @nvhs0401 @ChrisCarrollMD #JHMChat #CheckingTheBox |
| Michelle Brooks, MD, FACP, FHM @michellebr00ks RT @FutureDocs: One of my personal favorite questions #jhmchat after duty hours 2x patients identified attending as doctor most inv… |
| Steve Delisi @avidus_piscator Don't think this is simply bias against change, but likely related to not being included in the process that lead to the change #leadership https://t.co/UQzLm2aB3x |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: T4 How can we improve patient-centered rounds so it’s a win-win for #ptexp & #meded ? #JHMChat |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: T4 How can we improve patient-centered rounds so it’s a win-win for #ptexp & #meded ? #JHMChat |
| Tony Breu @tony_breu Do it more. Practice makes perfect (or at least better). #JHMChat https://t.co/bvLxthk4T5 |
 | Tom Varghese Jr. MD @TomVargheseJr RT @ChrisCarrollMD: This is often overlooked & so important! If you don't label it as "teaching", often learners don't remember that yo… |
| Chris Petrilli @PetrilliMD T4: @JHospMedicine #JHMChat It's a win-win for all as-is...more efficient and better communication among staff/patient = less pages |
| Robert J. Mahoney, MD @mahoneyr @RJmdphilly Some house staff need more prompting than others to move the plan forward. The needs change with each team. #jhmchat |
| Tom Varghese Jr. MD @TomVargheseJr RT @FutureDocs: One of my personal favorite questions #jhmchat after duty hours 2x patients identified attending as doctor most inv… |
| Benji Mathews, MD @MDbenji Agreed @michellebr00ks! There are exceptions, but hallway rounds are least efficient - repeat self if going back in. #jhmchat https://t.co/f5Nov4kLge |
| Anika Kumar, MD @freckledpedidoc In peds attending Rounds = pt centered Rounds (or family centered Rounds as we call it). https://t.co/8nbVcLgCPe |
| bradley monash @bradmonash @JHospMedicine #JHMChat https://t.co/NkmrGj3j4T |
| Malvinder Parmar @wittykidney @marciadelacuadr @RJmdphilly and then wonder why so many unnecessary tests are being done. #jhmchat |
| Charlie M. Wray @WrayCharles It needs to be normalized. Then it will be accepted & practiced--no matter who is attending or what the "goal" of attending rounds #jhmchat https://t.co/yxBIPvbik9 |
 | Dr. Martha Gulati @DrMarthaGulati RT @ChrisCarrollMD: This is often overlooked & so important! If you don't label it as "teaching", often learners don't remember that yo… |
| Steve Delisi @avidus_piscator More likely to have residents engaged if more meaningfully included in the process leading to the change. #JHMChat https://t.co/i09QMTGCfF |
| Vinny Arora MD MAPP @FutureDocs I guess tell the residents so they feel like it is. Curious what they think of data #jhmchat https://t.co/aZlCVX5dT0 |
| Jigar Contractor @jigsymd T4 reduce redundancy, model ideal behavior - how to doctor, observe learners then provide consistent feedback #jhmchat |
 | Jay Bhatt @bhangrajay RT @JHospMedicine: T4 How can we improve patient-centered rounds so it’s a win-win for #ptexp & #meded ? #JHMChat |
| Rebecca Jaffe, MD @RJmdphilly Let a few more classes of residents graduate 😉 https://t.co/8MWBy6OoG1 |
| Vinny Arora MD MAPP @FutureDocs RT @benjikmathews: Agreed @michellebr00ks! There are exceptions, but hallway rounds are least efficient - repeat self if going back i… |
| Robert J. Mahoney, MD @mahoneyr @FutureDocs On days when I round solo on the teaching service, I reintroduce myself to patients. Some recognize me. #JHMchat |
| Vinny Arora MD MAPP @FutureDocs RT @avidus_piscator: More likely to have residents engaged if more meaningfully included in the process leading to the change. #JHMChat htt… |
| Alex Auseon @ajauseon Have someone you aspire to emulate watch u round and provide coaching https://t.co/7geh0yyftR |
| Michelle Brooks, MD, FACP, FHM @michellebr00ks T4 - psychological safety is important. Learners don't want to be wrong in front of patients. #JHMChat |
| J Hospital Medicine @JHospMedicine Thx for joining - indexing #jhmchat https://t.co/MkKyu2fVCi |
| Chris Petrilli @PetrilliMD @FutureDocs #JHMChat for my April/June teams, they've sounded positive - and residents are always honest with their attending :) |
| Rebecca Jaffe, MD @RJmdphilly @wittykidney @marciadelacuadr not sure I get connection? #jhmchat |
| Nancy H Stewart DO, MS @nvhstewart RT @ShannonMartinMD: Agreed, great time to try out new tips/strategies by putting in expectations at top-no surprises for learners, make… |
| J Hospital Medicine @JHospMedicine RT @avidus_piscator: More likely to have residents engaged if more meaningfully included in the process leading to the change. #JHMChat htt… |
| Benji Mathews, MD @MDbenji Great thoughts. Article is a reminder to pull bits & pieces into own rounding style - white board usage is key @frekledpedidoc #jhmchat https://t.co/9BpVcw4qPX |
| J Hospital Medicine @JHospMedicine RT @WrayCharles: It needs to be normalized. Then it will be accepted & practiced--no matter who is attending or what the "goal" of a… |
| Anika Kumar, MD @freckledpedidoc Can't agree more. Peds studies have shown this. #jhmchat https://t.co/Z33e1HVyn9 |
| J Hospital Medicine @JHospMedicine RT @benjikmathews: Agreed @michellebr00ks! There are exceptions, but hallway rounds are least efficient - repeat self if going back i… |
| Rebecca Jaffe, MD @RJmdphilly RT @JigsyMD: T4 reduce redundancy, model ideal behavior - how to doctor, observe learners then provide consistent feedback #jhmchat |
| J Hospital Medicine @JHospMedicine RT @PetrilliMD: T4: @JHospMedicine #JHMChat It's a win-win for all as-is...more efficient and better communication among staff/patient = le… |
| J Hospital Medicine @JHospMedicine RT @tony_breu: Do it more. Practice makes perfect (or at least better). #JHMChat https://t.co/bvLxthk4T5 |
| Robert J. Mahoney, MD @mahoneyr @FutureDocs Sometimes residents introduce me as "the boss". I usually correct them - the one in the bed is the boss. #jhmchat |
| bradley monash @bradmonash @michellebr00ks T4. huddle outside room can ask, "what are you worried about or struggling with?" #JHMChat |
| J Hospital Medicine @JHospMedicine RT @michellebr00ks: #JHMChat T3 - Rounds are where the core competencies become evident to learners. |
| J Hospital Medicine @JHospMedicine RT @WrayCharles: My favorite answer so far... #jhmchat https://t.co/3nMjatsUvc |
| J Hospital Medicine @JHospMedicine RT @JigsyMD: @PetrilliMD @sanjaysaint I'm pretty sure this sums up attending rounds. No one would be there w/o the patient! #jhmchat |
| Michelle Brooks, MD, FACP, FHM @michellebr00ks @BradMonash EXACTLY. I've been stressing that the HUDDLE is KEY!!! #JHMChat |
| Vinny Arora MD MAPP @FutureDocs RT @mahoneyr: @FutureDocs On days when I round solo on the teaching service, I reintroduce myself to patients. Some recognize me. #JHMchat |
| Shannon K. Martin @shannonmartinmd bittersweet moment when presenting finding at GR and heard equal groans from resident & faculty sides, can agree on some things :) #jhmchat https://t.co/tUgElTGwQv |
| Anika Kumar, MD @freckledpedidoc @benjikmathews the MS who isn't presenting fills out the white board at my institution. #jhmchat |
| Vinny Arora MD MAPP @FutureDocs the simple truth all doctors need to abide by #ptexp #pinksocks #jhmchat https://t.co/0TeABCklnh |
| Rebecca Jaffe, MD @RJmdphilly T4 - realize we are in a time of flux. Current model likely an iteration of what will work best. Keeps me sane, at least #JHMchat |
| Jorge A Rodriguez MD @translatedmed @mahoneyr @FutureDocs some more data on the subject https://t.co/gh3StjyqPH #jhmchat |
| bradley monash @bradmonash similar #ptsat seen in pediatrics at our institution #jhmchat https://t.co/aHjblBk1dq |
 | Lolli @__lollipopland RT @nvhs0401: Yes!!! I often have to remind trainees "I'm going to teach you something now" 🙈 #jhmchat https://t.co/BiZaMw4twY |
 | hscott61 @hscott61 RT @FutureDocs: the simple truth all doctors need to abide by #ptexp #pinksocks #jhmchat https://t.co/0TeABCklnh |
 | Niles Schools @ncsviklngs RT @ChrisCarrollMD: This is often overlooked & so important! If you don't label it as "teaching", often learners don't remember that yo… |
| Nancy H Stewart DO, MS @nvhstewart RT @FutureDocs: the simple truth all doctors need to abide by #ptexp #pinksocks #jhmchat https://t.co/0TeABCklnh |
 | Sonia Behal @soniabehal RT @FutureDocs: the simple truth all doctors need to abide by #ptexp #pinksocks #jhmchat https://t.co/0TeABCklnh |
| Rebecca Jaffe, MD @RJmdphilly @michellebr00ks @BradMonash this is why we table round first. try to work teaching there. Rounds on unit very brief! #jhmchat |
 | Betty M. Chung @bettymchung RT @JHospMedicine: T4 How can we improve patient-centered rounds so it’s a win-win for #ptexp & #meded ? #JHMChat |
| Chris Petrilli @PetrilliMD RT @FutureDocs: the simple truth all doctors need to abide by #ptexp #pinksocks #jhmchat https://t.co/0TeABCklnh |
| Jigar Contractor @jigsymd Pts like it when MDs spend time w/ them, residents have little time -> find more time by improving #service over education tasks #jhmchat |
| Kelsey Murray @doctorakelso21 T4 defined roles, getting learners involved, and takeaways or teaching points from every pt. Set expectations early #JHMChat |
 | Ali Khaki @arkhaki @PetrilliMD T1 I don't think enough attending a are good at helping house staff with this, we need to teach them first! #JHMChat |
| Jorge A Rodriguez MD @translatedmed Wonder if resident dissatisfaction tracked with burnout? #jhmchat |
| J Hospital Medicine @JHospMedicine Special thanks to author @BradMonash who joined us to discuss patient-centered rounds on tonight's #JHMChat |
| Tony Breu @tony_breu @JigsyMD The currency of interns are progress notes. If they can be folded into rounds, then there may be more buy-in. #JHMChat |
| Society of Hospital Medicine @SocietyHospMed Mark your calendar! The next #JHMChat will be Monday, 4/10 at 9PM ET discussing safety & value of VIP #patient services w/ @DrJoshuaAD! |
| bradley monash @bradmonash @RJmdphilly @michellebr00ks so much material at bedside, however #JHMChat |
| Michelle Brooks, MD, FACP, FHM @michellebr00ks @RJmdphilly @BradMonash I think more time on the unit improves #interprofessional collaboration - we spend 2-2.5 hours on unit. #JHMChat |
| J Hospital Medicine @JHospMedicine RT @SHMLive: Mark your calendar! The next #JHMChat will be Monday, 4/10 at 9PM ET discussing safety & value of VIP #patient services w/ @Dr… |
| J Hospital Medicine @JHospMedicine RT @tony_breu: @JigsyMD The currency of interns are progress notes. If they can be folded into rounds, then there may be more buy-in. #JHMC… |
 | champ @rileyreyes__ RT @ChrisCarrollMD: This is often overlooked & so important! If you don't label it as "teaching", often learners don't remember that yo… |
| J Hospital Medicine @JHospMedicine RT @JigsyMD: Pts like it when MDs spend time w/ them, residents have little time -> find more time by improving #service over education tas… |
| bradley monash @bradmonash T4. it takes a village. #jhmchat |
| J Hospital Medicine @JHospMedicine RT @FutureDocs: the simple truth all doctors need to abide by #ptexp #pinksocks #jhmchat https://t.co/0TeABCklnh |
| Rebecca Jaffe, MD @RJmdphilly @BradMonash so we always have bad PG in Jan to April - volume up, etc. is that winter dip artifact? #jhmchat |
| Amy Shaw @amyshawmd @JigsyMD and residents like spending time with patients! #jhmchat |
| J Hospital Medicine @JHospMedicine RT @mahoneyr: @FutureDocs Sometimes residents introduce me as "the boss". I usually correct them - the one in the bed is the boss. #jhmchat |
| Robert J. Mahoney, MD @mahoneyr T4 #JHMChat I think we will learn during our rollout that we cannot let multidisciplinary rounds be taken over by one discipline. |
| Malvinder Parmar @wittykidney @RJmdphilly @marciadelacuadr if attending is going to be quite, then who is going to correct learners #jhmchat |
| Nancy H Stewart DO, MS @nvhstewart RT @avidus_piscator: More likely to have residents engaged if more meaningfully included in the process leading to the change. #JHMChat htt… |
| Charlie M. Wray @WrayCharles @tony_breu @JigsyMD Here's the hidden carrot I was referring to earlier #jhmchat |
| J Hospital Medicine @JHospMedicine RT @BradMonash: T4. it takes a village. #jhmchat |
| Chris Petrilli @PetrilliMD @translatedmed #JHMChat Not in Greece :) https://t.co/3gpTvFnTAz |
| bradley monash @bradmonash @tony_breu @JigsyMD high-functioning teams involve co-interns updating notes for each other on portable workstations. #JHMChat |
| Chris Petrilli @PetrilliMD RT @JHospMedicine: Special thanks to author @BradMonash who joined us to discuss patient-centered rounds on tonight's #JHMChat |
| Tony Breu @tony_breu @BradMonash @JigsyMD Which is why practice is so important. #JHMChat |
| bradley monash @bradmonash @RJmdphilly results sustained. #JHMChat |
| Benji Mathews, MD @MDbenji @WrayCharles Think #pocus was similar. Took years for culture to build, now slightly more normalized to have #ultrasound rounds with pts. https://t.co/PXL1lscJZ4 |
| Vinny Arora MD MAPP @FutureDocs Back up behavior #jhmchat #teamwork https://t.co/RMDOZozWCY |
| Nancy H Stewart DO, MS @nvhstewart RT @SHMLive: Mark your calendar! The next #JHMChat will be Monday, 4/10 at 9PM ET discussing safety & value of VIP #patient services w/ @Dr… |
| Benji Mathews, MD @MDbenji Agreed. In experimenting done patient centered rounds primarily with holdovers, very sick or family present #jhmchat https://t.co/lqbgvNaW2d |
 | End Well @endwellsf RT @FutureDocs: the simple truth all doctors need to abide by #ptexp #pinksocks #jhmchat https://t.co/0TeABCklnh |
| Marcia de la Cuadra @marciadelacuadr @wittykidney @RJmdphilly I don't think the majority of what most attendings are saying is correcting learners. #JHMchat |
| Rebecca Jaffe, MD @RJmdphilly RT @BradMonash: @tony_breu @JigsyMD high-functioning teams involve co-interns updating notes for each other on portable workstations. #JHMC… |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: Special thanks to author @BradMonash who joined us to discuss patient-centered rounds on tonight's #JHMChat |
| Tony Breu @tony_breu Thank you! @BradMonash @FutureDocs @JHospMedicine for another great chat! Looking forward to @DrJoshuaAD next month. #JHMChat |
| bradley monash @bradmonash @benjikmathews key is to cultivate autonomy beyond rounding structure... #JHMChat |
| J Hospital Medicine @JHospMedicine RT @tony_breu: Thank you! @BradMonash @FutureDocs @JHospMedicine for another great chat! Looking forward to @DrJoshuaAD next month. #JHMChat |
| Society of Hospital Medicine @SocietyHospMed Thank you @JHospMedicine @FutureDocs @BradMonash for another engaging #JHMChat! |
| Society of Hospital Medicine @SocietyHospMed #JHMChat #CME evaluation will be open for 1 hour! Find it here: https://t.co/9REKuO09lJ |
| Malvinder Parmar @wittykidney The bottom line #jhmchat, https://t.co/6EqXATbwFQ |
| J Hospital Medicine @JHospMedicine RT @SHMLive: Thank you @JHospMedicine @FutureDocs @BradMonash for another engaging #JHMChat! |
| J Hospital Medicine @JHospMedicine Special thanks to our partners @SHMLive @CostsofCare @ABIMFoundation for bringing you #JHMChat tonight - dont forget to get #CME |
| J Hospital Medicine @JHospMedicine Join next #JHMChat Mon Apr 10th 9p ET unnecessary care for #VIPpatients? #choosingwisely w @WrayCharles @DrJoshuaAD #visualabstract https://t.co/QbT9bd0Oyj |
| Rebecca Jaffe, MD @RJmdphilly @marciadelacuadr @wittykidney perhaps not most. Hopefully good ones are modeling good practice/behaviors. #jhmchat |
| Michelle Brooks, MD, FACP, FHM @michellebr00ks RT @tony_breu: Thank you! @BradMonash @FutureDocs @JHospMedicine for another great chat! Looking forward to @DrJoshuaAD next month. #JHMChat |
| J Hospital Medicine @JHospMedicine Join next #JHMChat Mon Apr 10th 9p ET unnecessary care for #VIPpatients? #choosingwisely w @WrayCharles... https://t.co/yVbaaMhLve |
| bradley monash @bradmonash RT @tony_breu: Thank you! @BradMonash @FutureDocs @JHospMedicine for another great chat! Looking forward to @DrJoshuaAD next month. #JHMChat |
| Michelle Brooks, MD, FACP, FHM @michellebr00ks RT @BradMonash: @benjikmathews key is to cultivate autonomy beyond rounding structure... #JHMChat |
| Marcia de la Cuadra @marciadelacuadr @wittykidney @RJmdphilly But maybe if we all monitored each other's rounds more, we'd know for sure! #JHMchat |
| Jigar Contractor @jigsymd RT @amyshawmd: @JigsyMD and residents like spending time with patients! #jhmchat |
| Michelle Brooks, MD, FACP, FHM @michellebr00ks RT @SHMLive: Thank you @JHospMedicine @FutureDocs @BradMonash for another engaging #JHMChat! |
| Benji Mathews, MD @MDbenji Agreed @RJmdphilly. With large census I pick ~3 holdovers/very ill/any with bedside #pocus per day to do patient centered rounds #jhmchat https://t.co/BMKxsTKI92 |
| Vinny Arora MD MAPP @FutureDocs RT @SHMLive: Thank you @JHospMedicine @FutureDocs @BradMonash for another engaging #JHMChat! |
| Malvinder Parmar @wittykidney @marciadelacuadr @RJmdphilly but that should be the most important goal #JHMChat otherwise "blind leading the blind!" |
| Amy Shaw @amyshawmd @RJmdphilly nice to keep some perspective -- very few new ideas/practices are permanent & unchanging #jhmchat |
 | Satyen Nichani @snichanimd RT @benjikmathews: Awesome infographic! Twitter 4 educators. Thanks @TChanMD via @tech4teachers19. #FOAMed #JHMchat #meded #education https… |
 | Carl Seashore @carlseashore RT @BradMonash: @RJmdphilly great question. https://t.co/K0uVyKhEcx. #JHMChat |
| Charlie M. Wray @WrayCharles RT @JHospMedicine: Join next #JHMChat Mon Apr 10th 9p ET unnecessary care for #VIPpatients? #choosingwisely w @WrayCharles @DrJoshuaAD… |
| Shannon K. Martin @shannonmartinmd RT @SHMLive: Thank you @JHospMedicine @FutureDocs @BradMonash for another engaging #JHMChat! |
| Jigar Contractor @jigsymd The key to learning and improving! https://t.co/Si4gJJmFP7 |
| Carl Seashore @carlseashore RT @FutureDocs: #MicDrop by our author @BradMonash tonight on #jhmchat https://t.co/w652Z1txYg |
| Robert J. Mahoney, MD @mahoneyr Thanks @JHospMedicine @FutureDocs @BradMonash for great #JHMchat |
| Michelle Brooks, MD, FACP, FHM @michellebr00ks RT @JHospMedicine: Join next #JHMChat Mon Apr 10th 9p ET unnecessary care for #VIPpatients? #choosingwisely w @WrayCharles... https://t.co/… |
 | Joannie Yeh MD FAAP @BetaMomma RT @freckledpedidoc: @nvhs0401 I start off wk telling team my responsibility is to share 1 teaching pearl for every pt every day. Team hold… |
| Joannie Yeh MD FAAP @BetaMomma RT @freckledpedidoc: @nvhs0401 thanks. It puts everyone on the same page & team feels attending invested in teaching learners #jhmchat |
| Nancy H Stewart DO, MS @nvhstewart RT @tony_breu: Thank you! @BradMonash @FutureDocs @JHospMedicine for another great chat! Looking forward to @DrJoshuaAD next month. #JHMChat |
| Rebecca Jaffe, MD @RJmdphilly Missed opportunity for tonight's take homes cause 2 busy catching up to all the good stuff! So: #JHMChat |
| Vinny Arora MD MAPP @FutureDocs Special thx @WrayCharles for suggest @hootsuite scheduling -my wifi cut out in middle bc snow but kept #jhmchat on phone! #backupplan |
| Society of Hospital Medicine @SocietyHospMed Thanks to our partners @ABIMFoundation & @CostsofCare for your continued support! #JHMChat |
| Benji Mathews, MD @MDbenji Thanks @bradmonash @JHospMedicine! Great reminders, bits & pieces to improve teaching practice (involving nursing, white boards!) #jhmchat |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: Join next #JHMChat Mon Apr 10th 9p ET unnecessary care for #VIPpatients? #choosingwisely w @WrayCharles @DrJoshuaAD… |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: Special thanks to our partners @SHMLive @CostsofCare @ABIMFoundation for bringing you #JHMChat tonight - dont forget to… |
| Vinny Arora MD MAPP @FutureDocs RT @SHMLive: #JHMChat #CME evaluation will be open for 1 hour! Find it here: https://t.co/9REKuO09lJ |
| J Hospital Medicine @JHospMedicine RT @SHMLive: #JHMChat #CME evaluation will be open for 1 hour! Find it here: https://t.co/9REKuO09lJ |
| Rebecca Jaffe, MD @RJmdphilly 1) make it standard & value added 2) win res over by protecting autonomy & model pt first 3) find a partner & compare models! #jhmchat |
| Carl Seashore @carlseashore RT @FutureDocs: the simple truth all doctors need to abide by #ptexp #pinksocks #jhmchat https://t.co/0TeABCklnh |
 | Edward Bender, MD @ebender001 GIF what a great addition to #VisualAbstract https://t.co/vNkrFEXWhr |
 | Armand Krikorian @endouno #meded https://t.co/QJIxuE3Dsp |
| Benji Mathews, MD @MDbenji Looking forward to the next #jhmchat with @DrJoshuaAD on 4/10 |
| Jigar Contractor @jigsymd Looking forward to the next! #jhmchat https://t.co/v3bFQ0LkH3 |
 | DON the MUA @makeupbyd0n RT @ChrisCarrollMD: This is often overlooked & so important! If you don't label it as "teaching", often learners don't remember that yo… |
| Bruce Joy @brucejoy RT @benjikmathews: Agreed @michellebr00ks! There are exceptions, but hallway rounds are least efficient - repeat self if going back i… |
 | Dr Fatma @bastakif RT @JHospMedicine: Join next #JHMChat Mon Apr 10th 9p ET unnecessary care for #VIPpatients? #choosingwisely w @WrayCharles @DrJoshuaAD… |
| Jigar Contractor @jigsymd RT @tony_breu: @JigsyMD The currency of interns are progress notes. If they can be folded into rounds, then there may be more buy-in. #JHMC… |
 | Robert Hopkins @aradultimmdoc RT @JHospMedicine: Join next #JHMChat Mon Apr 10th 9p ET unnecessary care for #VIPpatients? #choosingwisely w @WrayCharles @DrJoshuaAD… |
| Bruce Joy @brucejoy This is at the core of #SIBR and the #ACU care model now in use in a growing number of hospitals. #JHMChat. https://t.co/pRA7T9REOC https://t.co/uDpWKkynDM |
 | Sascha Baldry @SLBaldry RT @mahoneyr: T3 #JHMChat Not sure if there is any single purpose, but it is often the only time when everyone who makes decisions is all t… |
| Sascha Baldry @SLBaldry RT @mahoneyr: About to pilot a similar program on our medicine floors. So far everyone's found something to be dissatisfied about #JHMChat |
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