is Chief Resident in Quality and Safety, Oregon Health & Science University and Portland Veterans Administration, Portland, Oregon, USA.
is Assistant Professor, Oregon Health & Science University and Portland Veterans Administration, Portland, Oregon, USA.
J Grad Med Educ. 2024 Aug;16(4):479-483. doi: 10.4300/JGME-D-23-00924.1. Epub 2024 Aug 15.
Orienting medical trainees to new practice environments is essential. Huddles have been shown to improve communication and safety outcomes. However, their use in orienting trainees to systems processes and changes on inpatient general medicine (GM) wards remains unexplored. Implement a weekly inpatient huddle between residents and hospital leaders to improve dissemination of information around health system operations. In 2019, we established "Resident Huddle," a weekly 20-minute huddle for senior internal medicine residents rotating on GM wards at a US Department of Veterans Affairs Hospital led by the site leads. Resident Huddle content included system updates, rotation updates, process reminders, performance feedback, and systems and patient safety concerns raised by trainees. Reactions to the huddle were assessed via survey. Behavioral change was assessed by rates of complete trainee admission medication reconciliation documentation before and after huddle implementation. Resident Huddle started in October 2019 and continues to this day. Between October 2019 and June 2022, 136 of 205 participants completed surveys (66% response rate). Respondents agreed or strongly agreed that the huddle provided useful information for care delivery (94%, 128 of 136), improved work engagement (73%, 99 of 136), provided feedback on practice patterns (90%, 121 of 135), and that issues they experienced were acknowledged and acted upon (86%, 114 of 133). Retrospective medical record analysis demonstrated improvement in admission medication reconciliation completion rate by trainees from pre-intervention (32%, 19 of 60) to post-intervention (73%, 44 of 60). A weekly huddle between hospital leaders and residents strengthened communication and equipped trainees with operational health systems knowledge to enhance patient care outcomes while fostering a greater sense of engagement with their work environment.
培训医学实习生适应新的实践环境至关重要。群体讨论已被证明可以改善沟通和安全结果。然而，它们在将实习生引入住院内科（GM）病房的系统流程和变更方面的应用仍未得到探索。
实施住院医每周例会，在住院医和医院领导之间进行，以改善围绕卫生系统运作的信息传播。
2019 年，我们在美国退伍军人事务部医院建立了“住院医例会”，由站点负责人领导，每周进行 20 分钟的 GM 病房轮转的高级内科住院医参加。住院医例会的内容包括系统更新、轮转更新、流程提醒、绩效反馈以及住院医提出的系统和患者安全问题。通过调查评估对例会的反应。通过例会实施前后住院医完全完成入院药物重整记录的比例来评估行为改变。
住院医例会始于 2019 年 10 月，至今仍在继续。在 2019 年 10 月至 2022 年 6 月期间，136 名 205 名参与者完成了调查（66%的回复率）。受访者同意或强烈同意例会为医疗服务提供了有用的信息（94%，136 人中有 128 人），提高了工作投入度（73%，136 人中有 99 人），提供了对实践模式的反馈（90%，135 人中有 121 人），他们遇到的问题得到了承认并得到了解决（86%，133 人中有 114 人）。回顾性病历分析显示，住院医的入院药物重整完成率从干预前的 32%（60 人中的 19 人）提高到干预后的 73%（60 人中的 44 人）。
医院领导和住院医之间的每周例会加强了沟通，并为住院医提供了运营卫生系统知识，以提高患者护理结果，同时培养他们对工作环境的更大投入感。
