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  1. Article ; Online: Bridging the Gap in Competency Assessment During Transition from Undergraduate Medical Education to Graduate Medical Education: A Perspective Piece.

    Anees, Amna / McAlister, Elizabeth G / Garber, Adam M / Calderon, Alvin S / Butler, James / Mallin, Emily / Levine, Diane / Sanders, M Lee / Kwan, Brian / Clewing, J Marietta / Barczi, Steven / Mateja, Candice / Ismail, Nadia

    The American journal of medicine

    2023  Volume 136, Issue 9, Page(s) 941–945.e1

    MeSH term(s) Humans ; Education, Medical, Undergraduate ; Education, Medical, Graduate ; Competency-Based Education ; Clinical Competence ; Curriculum
    Language English
    Publishing date 2023-06-18
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80015-6
    ISSN 1555-7162 ; 1873-2178 ; 0002-9343 ; 1548-2766
    ISSN (online) 1555-7162 ; 1873-2178
    ISSN 0002-9343 ; 1548-2766
    DOI 10.1016/j.amjmed.2023.06.001
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Transforming Ward Rounds Through Rounding-in-Flow.

    Calderon, Alvin S / Blackmore, C Craig / Williams, Barbara L / Chawla, Kavita P / Nelson-Peterson, Dana L / Ingraham, Michael D / Smith, Donna L / Kaplan, Gary S

    Journal of graduate medical education

    2014  Volume 6, Issue 4, Page(s) 750–755

    Abstract: Background: Traditional "batched" bedside clinical care rounds, where rounds for all patients precede clinical tasks, may delay clinical care and reduce resident work efficiency.: Innovation: Using Lean concepts, we developed a novel "Rounding-in- ... ...

    Abstract Background: Traditional "batched" bedside clinical care rounds, where rounds for all patients precede clinical tasks, may delay clinical care and reduce resident work efficiency.
    Innovation: Using Lean concepts, we developed a novel "Rounding-in-Flow" approach, with the patient care team completing all tasks for a single patient before initiating any tasks for the next patient. Outcome measures included timely patient discharge and intern work hours.
    Methods: We performed a retrospective cohort study with historic and contemporaneous control groups, with time series adjustment for underlying temporal trends at a single medical center. Primary outcomes were timely patient discharge orders and resident duty hours. Participants were 17 376 consecutive hospital inpatients between January 1, 2011, and June 30, 2012, and medical ward rounding teams of interns, residents, and attending hospitalists.
    Results: Timely discharge orders, defined as written by 9:00 am, improved from 8.6% to 26.6% (OR, 1.55; 95% CI 1.17-2.06; P  =  .003). Time of actual patient discharge was unchanged. Resident duty hour violations, defined as less than 10 hours between clinical duties, decreased from 2.96 to 0.98 per intern per rotation (difference, 1.98; 95% CI 1.09-2.87; P < .001). Average daily intern work hours decreased from 12.3 to 11.9 hours (difference, 0.4 hours; 95% CI 0.16-0.69; P  =  .002).
    Conclusions: Compared with batched rounding, Lean Rounding-in-Flow using "1-piece flow" principles was associated with more discharge orders written before 9:00 am and fewer violations in the 10-hour break rule, with minimal changes to intern total work hours and actual patient discharge time.
    Language English
    Publishing date 2014-12
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2578612-X
    ISSN 1949-8357 ; 1949-8349
    ISSN (online) 1949-8357
    ISSN 1949-8349
    DOI 10.4300/JGME-D-13-00324.1
    Database MEDical Literature Analysis and Retrieval System OnLINE

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