From the Society

Student Hospitalist Scholars: The importance of shared mental models

Are care teams appropriately communicating plans for higher-acuity patients?


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.

Anton Garazha, a medical student at Chicago Medical School at Rosalind Franklin University in North Chicago.

Anton Garazha

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.

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