#JHMChat Transcript

Healthcare social media transcript of the #JHMChat hashtag.
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Society of Hospital Medicine @SHMLive
#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 @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 @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 @SHMLive
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 @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 @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 @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 @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 @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 @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 @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 @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 @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 @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 @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 @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 @SHMLive
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 @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 @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 @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 @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 @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 @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 @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 @benjikmathews
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 @SHMLive
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 @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 @SHMLive
#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 @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 @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 @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 @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 @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 @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 @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 @SHMLive
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 @benjikmathews
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 @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 @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 @benjikmathews
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 @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 @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 @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 @SHMLive
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 @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
Clinical Pearl @clinicalpearl
Inpatient teaching services are most effective when this dynamic is created by attendings, IMO. https://t.co/0j7YQMFCkn
Benji Mathews @benjikmathews
@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 @benjikmathews
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 @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 @SHMLive
Thank you @JHospMedicine @FutureDocs @BradMonash for another engaging #JHMChat!
Society of Hospital Medicine @SHMLive
#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 @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 @benjikmathews
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 @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 @SHMLive
Thanks to our partners @ABIMFoundation & @CostsofCare for your continued support! #JHMChat
Benji Mathews @benjikmathews
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 @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 @benjikmathews
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
#JHMChat content from Twitter.