Anton Garazha

 

Editor’s Note: The Society of Hospital Medicine’s (SHM’s) Physician in Training Committee launched a scholarship program in 2015 for medical students to help transform healthcare and revolutionize patient care. The program has been expanded for the 2017-18 year, offering two options for students to receive funding and engage in scholarly work during their first, second and third years of medical school. As a part of the program, recipients are required to write about their experience on a biweekly basis.

This summer, my research project focused on the highly vulnerable patients who are transferred from the medical intensive care unit to the general floor. Patients who are readmitted tend to have worse health outcomes, longer stays, higher mortality rates, and higher health care costs. Previous research shows that higher quality handoffs, where receiving and transferring providers share the same shared mental model, result in better outcomes. We were interested in learning whether these shared mental models are being formed as a result of handoffs between the ward and the MICU.

After surveying providers this summer, and using data from past surveys, we have been able to make headway codifying the level of concordance between providers. We asked ward and MICU providers what they thought was the most important component of care in regards to the care of their patient while they are on the general floor. We focused on two levels of agreement in the handoff: intra-team agreement within the MICU team, and inter-team agreement between the MICU team and the ward. We coded intra-team agreement within the categories of “Complete,” “Strong,” “Weak,” and “No” agreement based on a random sampling of 40 unique patient encounters determined in meetings with Dr. Vineet Arora, Dr. Juan Rojas, Dr. Julie Neborak, and me. Due to a variable number of responses from providers on either side, we also coded the inter-team responses as “Full,” “Partial,” and “No” in order to determine the amount of concordance between teams.

The current results reveal that 18% of MICU teams shared a complete mental model, 25% shared a strong shared mental model, 9% shared a weak mental model, 30% shared no mental model, and 18% of patient encounters did not have a sufficient number of MICU respondents. Regarding inter-team communication, 7% shared a full shared mental model, 49% shared a partial mental model, 30% shared no shared mental model, and 14% of unique patient encounters did not have enough respondents.

With complex patient cases, it can be difficult to identify the most important factor of care for a particular patient. However, I think this information would be very useful in identifying whether these exchanges result in individuals prioritizing the same factor of care for their respective patient. I think this information would be very useful in future quality improvement, and seeing whether this communication results in the formation of shared mental models.

Anton Garazha is a medical student at Chicago Medical School at Rosalind Franklin University in North Chicago. He received his bachelor of science degree in biology from Loyola University in Chicago in 2015 and his master of biomedical science degree from Rosalind Franklin University in 2016. Anton is very interested in community outreach and quality improvement, and in his spare time tutors students in science-based subjects.

 

Editor’s Note: The Society of Hospital Medicine’s (SHM’s) Physician in Training Committee launched a scholarship program in 2015 for medical students to help transform healthcare and revolutionize patient care. The program has been expanded for the 2017-18 year, offering two options for students to receive funding and engage in scholarly work during their first, second and third years of medical school. As a part of the program, recipients are required to write about their experience on a biweekly basis.

This summer, my research project focused on the highly vulnerable patients who are transferred from the medical intensive care unit to the general floor. Patients who are readmitted tend to have worse health outcomes, longer stays, higher mortality rates, and higher health care costs. Previous research shows that higher quality handoffs, where receiving and transferring providers share the same shared mental model, result in better outcomes. We were interested in learning whether these shared mental models are being formed as a result of handoffs between the ward and the MICU.

After surveying providers this summer, and using data from past surveys, we have been able to make headway codifying the level of concordance between providers. We asked ward and MICU providers what they thought was the most important component of care in regards to the care of their patient while they are on the general floor. We focused on two levels of agreement in the handoff: intra-team agreement within the MICU team, and inter-team agreement between the MICU team and the ward. We coded intra-team agreement within the categories of “Complete,” “Strong,” “Weak,” and “No” agreement based on a random sampling of 40 unique patient encounters determined in meetings with Dr. Vineet Arora, Dr. Juan Rojas, Dr. Julie Neborak, and me. Due to a variable number of responses from providers on either side, we also coded the inter-team responses as “Full,” “Partial,” and “No” in order to determine the amount of concordance between teams.

The current results reveal that 18% of MICU teams shared a complete mental model, 25% shared a strong shared mental model, 9% shared a weak mental model, 30% shared no mental model, and 18% of patient encounters did not have a sufficient number of MICU respondents. Regarding inter-team communication, 7% shared a full shared mental model, 49% shared a partial mental model, 30% shared no shared mental model, and 14% of unique patient encounters did not have enough respondents.

With complex patient cases, it can be difficult to identify the most important factor of care for a particular patient. However, I think this information would be very useful in identifying whether these exchanges result in individuals prioritizing the same factor of care for their respective patient. I think this information would be very useful in future quality improvement, and seeing whether this communication results in the formation of shared mental models.

Anton Garazha is a medical student at Chicago Medical School at Rosalind Franklin University in North Chicago. He received his bachelor of science degree in biology from Loyola University in Chicago in 2015 and his master of biomedical science degree from Rosalind Franklin University in 2016. Anton is very interested in community outreach and quality improvement, and in his spare time tutors students in science-based subjects.

 

Editor’s Note: The Society of Hospital Medicine’s (SHM’s) Physician in Training Committee launched a scholarship program in 2015 for medical students to help transform healthcare and revolutionize patient care. The program has been expanded for the 2017-18 year, offering two options for students to receive funding and engage in scholarly work during their first, second and third years of medical school. As a part of the program, recipients are required to write about their experience on a biweekly basis.

This summer, my research project focused on the highly vulnerable patients who are transferred from the medical intensive care unit to the general floor. Patients who are readmitted tend to have worse health outcomes, longer stays, higher mortality rates, and higher health care costs. Previous research shows that higher quality handoffs, where receiving and transferring providers share the same shared mental model, result in better outcomes. We were interested in learning whether these shared mental models are being formed as a result of handoffs between the ward and the MICU.

After surveying providers this summer, and using data from past surveys, we have been able to make headway codifying the level of concordance between providers. We asked ward and MICU providers what they thought was the most important component of care in regards to the care of their patient while they are on the general floor. We focused on two levels of agreement in the handoff: intra-team agreement within the MICU team, and inter-team agreement between the MICU team and the ward. We coded intra-team agreement within the categories of “Complete,” “Strong,” “Weak,” and “No” agreement based on a random sampling of 40 unique patient encounters determined in meetings with Dr. Vineet Arora, Dr. Juan Rojas, Dr. Julie Neborak, and me. Due to a variable number of responses from providers on either side, we also coded the inter-team responses as “Full,” “Partial,” and “No” in order to determine the amount of concordance between teams.

The current results reveal that 18% of MICU teams shared a complete mental model, 25% shared a strong shared mental model, 9% shared a weak mental model, 30% shared no mental model, and 18% of patient encounters did not have a sufficient number of MICU respondents. Regarding inter-team communication, 7% shared a full shared mental model, 49% shared a partial mental model, 30% shared no shared mental model, and 14% of unique patient encounters did not have enough respondents.

With complex patient cases, it can be difficult to identify the most important factor of care for a particular patient. However, I think this information would be very useful in identifying whether these exchanges result in individuals prioritizing the same factor of care for their respective patient. I think this information would be very useful in future quality improvement, and seeing whether this communication results in the formation of shared mental models.

Anton Garazha is a medical student at Chicago Medical School at Rosalind Franklin University in North Chicago. He received his bachelor of science degree in biology from Loyola University in Chicago in 2015 and his master of biomedical science degree from Rosalind Franklin University in 2016. Anton is very interested in community outreach and quality improvement, and in his spare time tutors students in science-based subjects.

 

Editor’s Note: The Society of Hospital Medicine’s (SHM’s) Physician in Training Committee launched a scholarship program in 2015 for medical students to help transform healthcare and revolutionize patient care. The program has been expanded for the 2017-18 year, offering two options for students to receive funding and engage in scholarly work during their first, second and third years of medical school. As a part of the program, recipients are required to write about their experience on a biweekly basis.

As I wrap up my work for the summer, I am happy to reflect on my wonderful experiences. One of my greatest lessons from my mentors, Dr. Vineet Arora and Dr. Juan Rojas, is the development of a complete methods section and the careful necessity of approaching data and writing the abstract. I now realize the necessity of carefully maintaining a written account of how we approached the data, as it allows us to both communicate it to our audience and to look back on how to further organize it.

I am glad to have learned about how management at University of Chicago Medical Center is handled. I knew that the way handoffs work is based on both written and spoken materials. However, upon interviewing various physicians, I encountered the different ways physicians kept track of their patients. One of the benefits of asking open-ended questions is the ability to glean a large amount of information. Some physicians reveal numerous details regarding both the hierarchy of health factors they wish to manage, as well as details regarding the handoff, as well as the structure, and the different ways each person approaches these details.

Furthermore, my approach towards research significantly shifted in the time I spent this summer. Previously, I would focus primarily on results; however, from having performed a comprehensive literature review, I now focus on the way the data was approached and presented, the way the team kept careful track of methods, and the way they use previous research to establish their project. My previous experience was around quantitative research; the way that research teams approach qualitative research often differs from one another, often requiring a special level of ingenuity in approach and analysis, often due to the highly variable data.

After my experience at University of Chicago, I feel significantly more comfortable approaching research. One of my greatest goals regarding my research was to gain a better understanding of the interaction between various departments and the general ward in order to better prepare myself to be an effective physician. By asking the question, “What do you think is the most important factor regarding the management of this patient?”, I fully realized my deep interest in medical management: any research I approach as a physician would be closely intertwined to clinical medicine.

I am very, very thankful for the opportunity to learn from highly experienced physicians and researchers, and I will use this experience going forward with any clinical and research experiences I encounter.

Anton Garazha is a medical student at Chicago Medical School at Rosalind Franklin University in North Chicago. He received his bachelor of science degree in biology from Loyola University in Chicago in 2015 and his master of biomedical science degree from Rosalind Franklin University in 2016. Anton is very interested in community outreach and quality improvement, and in his spare time tutors students in science-based subjects.

 

Editor’s Note: The Society of Hospital Medicine’s (SHM’s) Physician in Training Committee launched a scholarship program in 2015 for medical students to help transform healthcare and revolutionize patient care. The program has been expanded for the 2017-18 year, offering two options for students to receive funding and engage in scholarly work during their first, second and third years of medical school. As a part of the program, recipients are required to write about their experience on a biweekly basis.

As I wrap up my work for the summer, I am happy to reflect on my wonderful experiences. One of my greatest lessons from my mentors, Dr. Vineet Arora and Dr. Juan Rojas, is the development of a complete methods section and the careful necessity of approaching data and writing the abstract. I now realize the necessity of carefully maintaining a written account of how we approached the data, as it allows us to both communicate it to our audience and to look back on how to further organize it.

I am glad to have learned about how management at University of Chicago Medical Center is handled. I knew that the way handoffs work is based on both written and spoken materials. However, upon interviewing various physicians, I encountered the different ways physicians kept track of their patients. One of the benefits of asking open-ended questions is the ability to glean a large amount of information. Some physicians reveal numerous details regarding both the hierarchy of health factors they wish to manage, as well as details regarding the handoff, as well as the structure, and the different ways each person approaches these details.

Furthermore, my approach towards research significantly shifted in the time I spent this summer. Previously, I would focus primarily on results; however, from having performed a comprehensive literature review, I now focus on the way the data was approached and presented, the way the team kept careful track of methods, and the way they use previous research to establish their project. My previous experience was around quantitative research; the way that research teams approach qualitative research often differs from one another, often requiring a special level of ingenuity in approach and analysis, often due to the highly variable data.

After my experience at University of Chicago, I feel significantly more comfortable approaching research. One of my greatest goals regarding my research was to gain a better understanding of the interaction between various departments and the general ward in order to better prepare myself to be an effective physician. By asking the question, “What do you think is the most important factor regarding the management of this patient?”, I fully realized my deep interest in medical management: any research I approach as a physician would be closely intertwined to clinical medicine.

I am very, very thankful for the opportunity to learn from highly experienced physicians and researchers, and I will use this experience going forward with any clinical and research experiences I encounter.

Anton Garazha is a medical student at Chicago Medical School at Rosalind Franklin University in North Chicago. He received his bachelor of science degree in biology from Loyola University in Chicago in 2015 and his master of biomedical science degree from Rosalind Franklin University in 2016. Anton is very interested in community outreach and quality improvement, and in his spare time tutors students in science-based subjects.

 

Editor’s Note: The Society of Hospital Medicine’s (SHM’s) Physician in Training Committee launched a scholarship program in 2015 for medical students to help transform healthcare and revolutionize patient care. The program has been expanded for the 2017-18 year, offering two options for students to receive funding and engage in scholarly work during their first, second and third years of medical school. As a part of the program, recipients are required to write about their experience on a biweekly basis.

As I wrap up my work for the summer, I am happy to reflect on my wonderful experiences. One of my greatest lessons from my mentors, Dr. Vineet Arora and Dr. Juan Rojas, is the development of a complete methods section and the careful necessity of approaching data and writing the abstract. I now realize the necessity of carefully maintaining a written account of how we approached the data, as it allows us to both communicate it to our audience and to look back on how to further organize it.

I am glad to have learned about how management at University of Chicago Medical Center is handled. I knew that the way handoffs work is based on both written and spoken materials. However, upon interviewing various physicians, I encountered the different ways physicians kept track of their patients. One of the benefits of asking open-ended questions is the ability to glean a large amount of information. Some physicians reveal numerous details regarding both the hierarchy of health factors they wish to manage, as well as details regarding the handoff, as well as the structure, and the different ways each person approaches these details.

Furthermore, my approach towards research significantly shifted in the time I spent this summer. Previously, I would focus primarily on results; however, from having performed a comprehensive literature review, I now focus on the way the data was approached and presented, the way the team kept careful track of methods, and the way they use previous research to establish their project. My previous experience was around quantitative research; the way that research teams approach qualitative research often differs from one another, often requiring a special level of ingenuity in approach and analysis, often due to the highly variable data.

After my experience at University of Chicago, I feel significantly more comfortable approaching research. One of my greatest goals regarding my research was to gain a better understanding of the interaction between various departments and the general ward in order to better prepare myself to be an effective physician. By asking the question, “What do you think is the most important factor regarding the management of this patient?”, I fully realized my deep interest in medical management: any research I approach as a physician would be closely intertwined to clinical medicine.

I am very, very thankful for the opportunity to learn from highly experienced physicians and researchers, and I will use this experience going forward with any clinical and research experiences I encounter.

Anton Garazha is a medical student at Chicago Medical School at Rosalind Franklin University in North Chicago. He received his bachelor of science degree in biology from Loyola University in Chicago in 2015 and his master of biomedical science degree from Rosalind Franklin University in 2016. Anton is very interested in community outreach and quality improvement, and in his spare time tutors students in science-based subjects.

 

Editor’s Note: The Society of Hospital Medicine’s (SHM’s) Physician in Training Committee launched a scholarship program in 2015 for medical students to help transform healthcare and revolutionize patient care. The program has been expanded for the 2017-18 year, offering two options for students to receive funding and engage in scholarly work during their first, second and third years of medical school. As a part of the program, recipients are required to write about their experience on a biweekly basis.

The transfer of information from floor to the MICU team is a very interesting process: outside of the patient record, the person performing the handoff is highly responsible in the appropriate transfer of information.

During my summer research project, I am exploring the presence of shared mental models between the floor and MICU after patient transfers to the floor in regards to what the most significant factor is in the care of the patient while they are on the floor. One interesting finding during this research project is seeing whether having a shared intra-team model on the transferring side (i.e., MICU side) results in a shared mental model on the receiving side (i.e., the floor). After reviewing many of the free text responses from the various floor and MICU providers, it can become apparent which MICU provider was responsible for the handoff, since it often colors the described responses from the floor providers.

One of the challenges encountered within the project is the way in which we are categorizing agreement between groups. Previously, we created a set of categories based upon recurring themes present within the free-text provider responses, and created categories, such as “cardiac management” and “diabetes management.” Upon creating these categories, I would then group them based upon concordance. However, responses such as “bipap during the night” and “not giving her bipap” would both be coded under “respiratory management,” but those two responses would not show the providers being in concordance. Upon consulting with my mentors Dr. Vineet Arora and Dr. Juan Rojas, we decided that it would be more accurate to categorize concordance based upon the original answers, keeping the breadth of the original data intact.

As I continue to organize the data based on concordance, I have to modify my frame of thought and focus on appropriately representing the responses. There is no such thing as perfect data, and this project is no exception; in this case, not every provider was able to be reached for a response, which requires more nuance as I categorize the degree of concordance within the data and think of appropriate categories. I am very glad to learn the skill of appropriate data representation, as we want it to demonstrate both the potential lack or presence of clarity in handoffs, as well as the represented responding providers.

Anton Garazha is a medical student at Chicago Medical School at Rosalind Franklin University in North Chicago. He received his bachelor of science degree in biology from Loyola University in Chicago in 2015 and his master of biomedical science degree from Rosalind Franklin University in 2016. Anton is very interested in community outreach and quality improvement, and in his spare time tutors students in science-based subjects.

 

Editor’s Note: The Society of Hospital Medicine’s (SHM’s) Physician in Training Committee launched a scholarship program in 2015 for medical students to help transform healthcare and revolutionize patient care. The program has been expanded for the 2017-18 year, offering two options for students to receive funding and engage in scholarly work during their first, second and third years of medical school. As a part of the program, recipients are required to write about their experience on a biweekly basis.

The transfer of information from floor to the MICU team is a very interesting process: outside of the patient record, the person performing the handoff is highly responsible in the appropriate transfer of information.

During my summer research project, I am exploring the presence of shared mental models between the floor and MICU after patient transfers to the floor in regards to what the most significant factor is in the care of the patient while they are on the floor. One interesting finding during this research project is seeing whether having a shared intra-team model on the transferring side (i.e., MICU side) results in a shared mental model on the receiving side (i.e., the floor). After reviewing many of the free text responses from the various floor and MICU providers, it can become apparent which MICU provider was responsible for the handoff, since it often colors the described responses from the floor providers.

One of the challenges encountered within the project is the way in which we are categorizing agreement between groups. Previously, we created a set of categories based upon recurring themes present within the free-text provider responses, and created categories, such as “cardiac management” and “diabetes management.” Upon creating these categories, I would then group them based upon concordance. However, responses such as “bipap during the night” and “not giving her bipap” would both be coded under “respiratory management,” but those two responses would not show the providers being in concordance. Upon consulting with my mentors Dr. Vineet Arora and Dr. Juan Rojas, we decided that it would be more accurate to categorize concordance based upon the original answers, keeping the breadth of the original data intact.

As I continue to organize the data based on concordance, I have to modify my frame of thought and focus on appropriately representing the responses. There is no such thing as perfect data, and this project is no exception; in this case, not every provider was able to be reached for a response, which requires more nuance as I categorize the degree of concordance within the data and think of appropriate categories. I am very glad to learn the skill of appropriate data representation, as we want it to demonstrate both the potential lack or presence of clarity in handoffs, as well as the represented responding providers.

Anton Garazha is a medical student at Chicago Medical School at Rosalind Franklin University in North Chicago. He received his bachelor of science degree in biology from Loyola University in Chicago in 2015 and his master of biomedical science degree from Rosalind Franklin University in 2016. Anton is very interested in community outreach and quality improvement, and in his spare time tutors students in science-based subjects.

 

Editor’s Note: The Society of Hospital Medicine’s (SHM’s) Physician in Training Committee launched a scholarship program in 2015 for medical students to help transform healthcare and revolutionize patient care. The program has been expanded for the 2017-18 year, offering two options for students to receive funding and engage in scholarly work during their first, second and third years of medical school. As a part of the program, recipients are required to write about their experience on a biweekly basis.

The transfer of information from floor to the MICU team is a very interesting process: outside of the patient record, the person performing the handoff is highly responsible in the appropriate transfer of information.

During my summer research project, I am exploring the presence of shared mental models between the floor and MICU after patient transfers to the floor in regards to what the most significant factor is in the care of the patient while they are on the floor. One interesting finding during this research project is seeing whether having a shared intra-team model on the transferring side (i.e., MICU side) results in a shared mental model on the receiving side (i.e., the floor). After reviewing many of the free text responses from the various floor and MICU providers, it can become apparent which MICU provider was responsible for the handoff, since it often colors the described responses from the floor providers.

One of the challenges encountered within the project is the way in which we are categorizing agreement between groups. Previously, we created a set of categories based upon recurring themes present within the free-text provider responses, and created categories, such as “cardiac management” and “diabetes management.” Upon creating these categories, I would then group them based upon concordance. However, responses such as “bipap during the night” and “not giving her bipap” would both be coded under “respiratory management,” but those two responses would not show the providers being in concordance. Upon consulting with my mentors Dr. Vineet Arora and Dr. Juan Rojas, we decided that it would be more accurate to categorize concordance based upon the original answers, keeping the breadth of the original data intact.

As I continue to organize the data based on concordance, I have to modify my frame of thought and focus on appropriately representing the responses. There is no such thing as perfect data, and this project is no exception; in this case, not every provider was able to be reached for a response, which requires more nuance as I categorize the degree of concordance within the data and think of appropriate categories. I am very glad to learn the skill of appropriate data representation, as we want it to demonstrate both the potential lack or presence of clarity in handoffs, as well as the represented responding providers.

Anton Garazha is a medical student at Chicago Medical School at Rosalind Franklin University in North Chicago. He received his bachelor of science degree in biology from Loyola University in Chicago in 2015 and his master of biomedical science degree from Rosalind Franklin University in 2016. Anton is very interested in community outreach and quality improvement, and in his spare time tutors students in science-based subjects.

 

Editor’s Note: The Society of Hospital Medicine’s (SHM’s) Physician in Training Committee launched a scholarship program in 2015 for medical students to help transform healthcare and revolutionize patient care. The program has been expanded for the 2017-18 year, offering two options for students to receive funding and engage in scholarly work during their first, second and third years of medical school. As a part of the program, recipients are required to write about their experience on a biweekly basis.

As I walk the University of Chicago Hospital observing various health care practitioners, I am continually impressed with the businesslike approach and productivity of each individual. The hospital staff is composed of highly intelligent, experienced, and talented physicians, but I have come to understand that in this large system it can be difficult to maintain quality patient care with both increased census and increased handoffs.

The research project I am working on focuses on shared mental models between the MICU and the general floor on what the most important factor of care is while they are on the floor, and to identify how prominent it is for shared mental models to be present between the transferring and receiving teams. After reading various papers, I am beginning to understand the various complexities present in translating information when transferring patients from any department onto the floor.

When looking through the current data showing each individual’s responses on an interprofessional team, I start to recognize trends and see key phrases or words that represent whether the two groups are, or are not, in agreement with one another. When comparing agreement between teams, certain factors continually come up in regards to patient care, such as respiratory, hemodynamic, or infection management, and I start to see whether there is both inter-team and intra-team concordance.

I continue to discuss these topics with my mentors, Dr. Vineet Arora and Dr. Juan Rojas, in order to appropriately categorize all survey responses and identify whether there is concordance between teams. I am glad to be able to rely on their insight concerning methods of coding the data, as well as what type of medical care each responding individual receives, and remaining on track with my estimated timeline of completion.

Past research supports the idea that increased times, distractions, and workloads in regard to handoffs result in potential errors, decreasing the quality of patient care and potentially resulting in worse patient outcomes. MICU patients are at a particular risk, since ineffective communication could lead to readmission, which could result in worsened health outcomes.

I believe that this current research project is highly significant since it highlights whether effective communication is occurring in the first place, and whether teams are appropriately communicating patient plans for this group of higher-acuity patients. As I continue my research at the university, I hope to further identify whether effective communication is taking place for this at-risk group of floor patients.
 

Anton Garazha is a medical student at Chicago Medical School at Rosalind Franklin University in North Chicago. He received his bachelor of science degree in biology from Loyola University in Chicago in 2015 and his master of biomedical science degree from Rosalind Franklin University in 2016. Anton is very interested in community outreach and quality improvement, and in his spare time tutors students in science-based subjects.

 

Editor’s Note: The Society of Hospital Medicine’s (SHM’s) Physician in Training Committee launched a scholarship program in 2015 for medical students to help transform healthcare and revolutionize patient care. The program has been expanded for the 2017-18 year, offering two options for students to receive funding and engage in scholarly work during their first, second and third years of medical school. As a part of the program, recipients are required to write about their experience on a biweekly basis.

As I walk the University of Chicago Hospital observing various health care practitioners, I am continually impressed with the businesslike approach and productivity of each individual. The hospital staff is composed of highly intelligent, experienced, and talented physicians, but I have come to understand that in this large system it can be difficult to maintain quality patient care with both increased census and increased handoffs.

The research project I am working on focuses on shared mental models between the MICU and the general floor on what the most important factor of care is while they are on the floor, and to identify how prominent it is for shared mental models to be present between the transferring and receiving teams. After reading various papers, I am beginning to understand the various complexities present in translating information when transferring patients from any department onto the floor.

When looking through the current data showing each individual’s responses on an interprofessional team, I start to recognize trends and see key phrases or words that represent whether the two groups are, or are not, in agreement with one another. When comparing agreement between teams, certain factors continually come up in regards to patient care, such as respiratory, hemodynamic, or infection management, and I start to see whether there is both inter-team and intra-team concordance.

I continue to discuss these topics with my mentors, Dr. Vineet Arora and Dr. Juan Rojas, in order to appropriately categorize all survey responses and identify whether there is concordance between teams. I am glad to be able to rely on their insight concerning methods of coding the data, as well as what type of medical care each responding individual receives, and remaining on track with my estimated timeline of completion.

Past research supports the idea that increased times, distractions, and workloads in regard to handoffs result in potential errors, decreasing the quality of patient care and potentially resulting in worse patient outcomes. MICU patients are at a particular risk, since ineffective communication could lead to readmission, which could result in worsened health outcomes.

I believe that this current research project is highly significant since it highlights whether effective communication is occurring in the first place, and whether teams are appropriately communicating patient plans for this group of higher-acuity patients. As I continue my research at the university, I hope to further identify whether effective communication is taking place for this at-risk group of floor patients.
 

Anton Garazha is a medical student at Chicago Medical School at Rosalind Franklin University in North Chicago. He received his bachelor of science degree in biology from Loyola University in Chicago in 2015 and his master of biomedical science degree from Rosalind Franklin University in 2016. Anton is very interested in community outreach and quality improvement, and in his spare time tutors students in science-based subjects.

 

Editor’s Note: The Society of Hospital Medicine’s (SHM’s) Physician in Training Committee launched a scholarship program in 2015 for medical students to help transform healthcare and revolutionize patient care. The program has been expanded for the 2017-18 year, offering two options for students to receive funding and engage in scholarly work during their first, second and third years of medical school. As a part of the program, recipients are required to write about their experience on a biweekly basis.

As I walk the University of Chicago Hospital observing various health care practitioners, I am continually impressed with the businesslike approach and productivity of each individual. The hospital staff is composed of highly intelligent, experienced, and talented physicians, but I have come to understand that in this large system it can be difficult to maintain quality patient care with both increased census and increased handoffs.

The research project I am working on focuses on shared mental models between the MICU and the general floor on what the most important factor of care is while they are on the floor, and to identify how prominent it is for shared mental models to be present between the transferring and receiving teams. After reading various papers, I am beginning to understand the various complexities present in translating information when transferring patients from any department onto the floor.

When looking through the current data showing each individual’s responses on an interprofessional team, I start to recognize trends and see key phrases or words that represent whether the two groups are, or are not, in agreement with one another. When comparing agreement between teams, certain factors continually come up in regards to patient care, such as respiratory, hemodynamic, or infection management, and I start to see whether there is both inter-team and intra-team concordance.

I continue to discuss these topics with my mentors, Dr. Vineet Arora and Dr. Juan Rojas, in order to appropriately categorize all survey responses and identify whether there is concordance between teams. I am glad to be able to rely on their insight concerning methods of coding the data, as well as what type of medical care each responding individual receives, and remaining on track with my estimated timeline of completion.

Past research supports the idea that increased times, distractions, and workloads in regard to handoffs result in potential errors, decreasing the quality of patient care and potentially resulting in worse patient outcomes. MICU patients are at a particular risk, since ineffective communication could lead to readmission, which could result in worsened health outcomes.

I believe that this current research project is highly significant since it highlights whether effective communication is occurring in the first place, and whether teams are appropriately communicating patient plans for this group of higher-acuity patients. As I continue my research at the university, I hope to further identify whether effective communication is taking place for this at-risk group of floor patients.
 

Anton Garazha is a medical student at Chicago Medical School at Rosalind Franklin University in North Chicago. He received his bachelor of science degree in biology from Loyola University in Chicago in 2015 and his master of biomedical science degree from Rosalind Franklin University in 2016. Anton is very interested in community outreach and quality improvement, and in his spare time tutors students in science-based subjects.

 

Editor’s Note: The Society of Hospital Medicine’s (SHM’s) Physician in Training Committee launched a scholarship program in 2015 for medical students to help transform healthcare and revolutionize patient care. The program has been expanded for the 2017-18 year, offering two options for students to receive funding and engage in scholarly work during their 1st, 2nd, and 3rd years of medical school. As a part of the program, recipients are required to write about their experience on a biweekly basis.

Quality improvement in clinical practice has recently become very important to me. What use is clinical knowledge if it cannot be appropriately used to benefit patients in a clinical setting?

Having volunteered at various hospitals since middle school, I became profoundly aware from a young age of the level of clinical knowledge that physicians must possess in order to safely treat their patients. When taking English and psychology classes in college, I became fascinated with the process of communication and common misunderstandings that take place due to different frames of mind.

Throughout my 1st year at medical school, my interest in communication continued to grow. In one of my classes, Essentials of Clinical Reasoning, we were taught to continually consider how to effectively translate our thought processes and potential diagnoses to our patients. To begin crafting effective HPIs, we created complete, whole histories from visit to visit.

At this time, I discovered the subfield of research concerning strategies surrounding handoffs as transition of care changes, with patients often suffering due to breakdowns in communication.

With my interest in handoffs, and with direction from the Society of Hospital Medicine, I reached out to Dr. Vineet Arora, a leading academic hospitalist at the University of Chicago with a highly impressive history of research concerning quality of care toward hospitalized adults. Under the supervision of Dr. Arora and Dr. Juan Rojas, a pulmonary critical care fellow, I will help investigate whether receiving floor physicians and intensive care unit physicians possess similar shared mental models in regards to the most pertinent point of care – when patients are transferred out of the ICU.

We seek to identify if there are any associations present between readmission from the general floor, the providers’ rated likelihood of the patient returning to the ICU, and whether floor and ICU physicians are on the same page concerning condition management while on the floor.

I believe the experience I gain at the University of Chicago Medical Center will be invaluable to my future as a physician. I am very excited to get to know the various clinicians at UChicago, to gain clinical experience by observing the management of the general ward, and to identify how effective physicians communicate.

Above all, I hope to use any knowledge I gain this summer to become an efficient, knowledgeable, and compassionate physician capable of providing the highest quality of care to my future patients.

Anton Garazha is a medical student at Chicago Medical School at Rosalind Franklin University in North Chicago, Ill. He received his B.S. in Biology from Loyola University in Chicago in 2015 and his Master of Biomedical Science from Rosalind Franklin University in 2016. Anton is very interested in community outreach and quality improvement, and in his spare time tutors students in science-based subjects.

 

Editor’s Note: The Society of Hospital Medicine’s (SHM’s) Physician in Training Committee launched a scholarship program in 2015 for medical students to help transform healthcare and revolutionize patient care. The program has been expanded for the 2017-18 year, offering two options for students to receive funding and engage in scholarly work during their 1st, 2nd, and 3rd years of medical school. As a part of the program, recipients are required to write about their experience on a biweekly basis.

Quality improvement in clinical practice has recently become very important to me. What use is clinical knowledge if it cannot be appropriately used to benefit patients in a clinical setting?

Having volunteered at various hospitals since middle school, I became profoundly aware from a young age of the level of clinical knowledge that physicians must possess in order to safely treat their patients. When taking English and psychology classes in college, I became fascinated with the process of communication and common misunderstandings that take place due to different frames of mind.

Throughout my 1st year at medical school, my interest in communication continued to grow. In one of my classes, Essentials of Clinical Reasoning, we were taught to continually consider how to effectively translate our thought processes and potential diagnoses to our patients. To begin crafting effective HPIs, we created complete, whole histories from visit to visit.

At this time, I discovered the subfield of research concerning strategies surrounding handoffs as transition of care changes, with patients often suffering due to breakdowns in communication.

With my interest in handoffs, and with direction from the Society of Hospital Medicine, I reached out to Dr. Vineet Arora, a leading academic hospitalist at the University of Chicago with a highly impressive history of research concerning quality of care toward hospitalized adults. Under the supervision of Dr. Arora and Dr. Juan Rojas, a pulmonary critical care fellow, I will help investigate whether receiving floor physicians and intensive care unit physicians possess similar shared mental models in regards to the most pertinent point of care – when patients are transferred out of the ICU.

We seek to identify if there are any associations present between readmission from the general floor, the providers’ rated likelihood of the patient returning to the ICU, and whether floor and ICU physicians are on the same page concerning condition management while on the floor.

I believe the experience I gain at the University of Chicago Medical Center will be invaluable to my future as a physician. I am very excited to get to know the various clinicians at UChicago, to gain clinical experience by observing the management of the general ward, and to identify how effective physicians communicate.

Above all, I hope to use any knowledge I gain this summer to become an efficient, knowledgeable, and compassionate physician capable of providing the highest quality of care to my future patients.

Anton Garazha is a medical student at Chicago Medical School at Rosalind Franklin University in North Chicago, Ill. He received his B.S. in Biology from Loyola University in Chicago in 2015 and his Master of Biomedical Science from Rosalind Franklin University in 2016. Anton is very interested in community outreach and quality improvement, and in his spare time tutors students in science-based subjects.

 

Editor’s Note: The Society of Hospital Medicine’s (SHM’s) Physician in Training Committee launched a scholarship program in 2015 for medical students to help transform healthcare and revolutionize patient care. The program has been expanded for the 2017-18 year, offering two options for students to receive funding and engage in scholarly work during their 1st, 2nd, and 3rd years of medical school. As a part of the program, recipients are required to write about their experience on a biweekly basis.

Quality improvement in clinical practice has recently become very important to me. What use is clinical knowledge if it cannot be appropriately used to benefit patients in a clinical setting?

Having volunteered at various hospitals since middle school, I became profoundly aware from a young age of the level of clinical knowledge that physicians must possess in order to safely treat their patients. When taking English and psychology classes in college, I became fascinated with the process of communication and common misunderstandings that take place due to different frames of mind.

Throughout my 1st year at medical school, my interest in communication continued to grow. In one of my classes, Essentials of Clinical Reasoning, we were taught to continually consider how to effectively translate our thought processes and potential diagnoses to our patients. To begin crafting effective HPIs, we created complete, whole histories from visit to visit.

At this time, I discovered the subfield of research concerning strategies surrounding handoffs as transition of care changes, with patients often suffering due to breakdowns in communication.

With my interest in handoffs, and with direction from the Society of Hospital Medicine, I reached out to Dr. Vineet Arora, a leading academic hospitalist at the University of Chicago with a highly impressive history of research concerning quality of care toward hospitalized adults. Under the supervision of Dr. Arora and Dr. Juan Rojas, a pulmonary critical care fellow, I will help investigate whether receiving floor physicians and intensive care unit physicians possess similar shared mental models in regards to the most pertinent point of care – when patients are transferred out of the ICU.

We seek to identify if there are any associations present between readmission from the general floor, the providers’ rated likelihood of the patient returning to the ICU, and whether floor and ICU physicians are on the same page concerning condition management while on the floor.

I believe the experience I gain at the University of Chicago Medical Center will be invaluable to my future as a physician. I am very excited to get to know the various clinicians at UChicago, to gain clinical experience by observing the management of the general ward, and to identify how effective physicians communicate.

Above all, I hope to use any knowledge I gain this summer to become an efficient, knowledgeable, and compassionate physician capable of providing the highest quality of care to my future patients.

Anton Garazha is a medical student at Chicago Medical School at Rosalind Franklin University in North Chicago, Ill. He received his B.S. in Biology from Loyola University in Chicago in 2015 and his Master of Biomedical Science from Rosalind Franklin University in 2016. Anton is very interested in community outreach and quality improvement, and in his spare time tutors students in science-based subjects.