Journal of general internal medicine
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Editorial
Closer to or Farther away from an Ideal Model of Care? Lessons Learned from Geographic Cohorting.
Geographic "cohorting," "co-location," "regionalization," or "localization" refers to the assignation of a hospitalist team to a specific inpatient unit. Its benefits may be related to the formation of a team and the additional interventions like interdisciplinary rounding that the enhanced proximity facilitates. However, cohorting is often adopted in isolation of the bundled approach within which it has proven beneficial. ⋯ Institutions and inpatient units should work in synergy to shape the day-to-day work which directly affects patient and clinician outcomes-and ultimately culminates in the success or failure of the parent organization. Such synergy can manifest in workflow design and metric selection. Attention to workloads and adopting the principles of continuous quality improvement are also crucial to developing models of care that deliver excellent care.
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Telehealth visits have become an integral model of healthcare delivery since the COVID-19 pandemic. This rapid expansion of telehealthcare delivery has forced faculty development and trainee education in telehealth to occur simultaneously. In response, academic medical institutions have quickly implemented clinical training to teach digital health skills to providers across the medical education continuum. ⋯ It proposes strategies for the successful integration of the AAMC telehealth competencies and ACGME milestones into medical education, including skills in communication, data gathering, and patient safety with appropriate telehealth use. Direct observation tools in the paper offer educators novel instruments to assess telehealth competencies in medical students, residents, and peer faculty. The integration of AAMC and ACGME telehealth competencies and the new assessment tools in this paper provide a unique perspective to advance clinical practice and teaching skills in telehealthcare delivery.
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Physician burnout is increasingly recognized as a crisis across health care systems, with Wellness committees and Wellness officers becoming commonplace in large institutions. Unfortunately, these well-intended bodies often propagate the message that individuals are responsible for solving their own burnout, minimizing the importance of institutional responsibility in the problem. This essay explores the parallels between current Wellness initiatives and the petrochemical industry, specifically focusing on their messaging efforts and the role of implied blame and subsequent felt shame. It then explores how systematic efforts to push back against the petrochemical industry might serve as a model upon which to base future Wellness efforts.