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Hospitalist Happenings¶
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UNC Division of Hospital Medicine Newsletter¶
Volume 26, Issue 14¶
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| | | Clinical Operations Updates
A light at the end of the tunnel? Turning the corner? A ray of hope?! Many of you recall the days of Med H/J/L (this feels like forever ago). For a relatively brief period of time and through COVID surge, we had to expand into more teams- which then included MedZ and subsequently MedH1-6. Since 2021 we have been in a relative steady state with four tree teams. Despite the apparent end of the COVID surge, it certainly doesn’t feel as though we ever entered a period of true relief from constant capacity/surge conditions. We named our trees FIVE years ago.
| | | | | | | | | | | | Recent implementation of the surge team Willow and urgency to release our schedule have understandably distracted from some enormous bits of good news that were recently delivered. Permanent and sustainable help is coming on multiple fronts. We have approval for a fifth rounding team which means that Willow will likely be a permanent fixture of Lightning Bolt going forward (although I’m open to other tree names). To assist with this increase in daily rounding capacity, we also have approval to bring on a second night attending. In total, this means that our admitters and rounders will (hopefully) not have to continue to feel as though every shift is spent sorting through a long backlog of patients. This, along with last year’s addition of the second weekend APP, should bring relief to our providers on service and improve patient care.
Understandably, these changes come with several questions. How will we define these new roles? How will these changes affect our scheduling? Will office space be sufficient? Will we be able to hire sufficient FTE to staff these roles in time? These questions certainly require answers, and I’m confident we’ll get there. This shouldn’t distract from what a positive change this is for us and for patients.
-Andrew Donohoe, MD ; Associate Chief of Operations, Hospital Medicine
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Aaron Fried- Feb. 12Josh Garcia- Feb. 20Charlotte Baldwin- Feb. 22Magdalene Tukov- Feb. 25Beth Ann Brubaker- Feb. 26
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| | | DHM Scholarly Dashboard
It’s the time of year to see our progress towards the metrics we are following for our DHM Scholarly Incentive Dashboard. As you can see below in the image, we are doing well in several areas and are behind in others. I suspect we have under-reporting in some areas, particularly in didactic/teaching sessions. We will break down by sections.
| | | | | | | | | | | | Education IndicatorsWe have been tracking three metrics. First, noon conferences and didactics. Last year our division delivered a high volume of sessions, 323. We sought to match that this year, with a goal of 325. We have 50 documented so far, well off our past performance. As more people fill in the incentive tracking sheets in Sharepoint, we may be able to catch up some towards our goal. The second metric is % of faculty providing mentorship. Last year, we had 53% of faculty reporting mentor activity, so set a goal of 55% this year. So far, we have 32% reporting. The last education metric is invited talks and grand rounds. We delivered 67 last year, which was well above last year’s target goal, so we set a goal of 60 for this year. We are on track with 29 through Q2.
Research IndicatorsWe are tracking three research indicators, abstracts, active grants and peer-reviewed publications. Last year, our group faculty presented 76 abstracts, so we set a goal of 80. We have reported 24 so far, though NC ACP, SGIM and national SHM are coming up, so hope we can gain ground in the spring. We are well on track with grants, as already have 7, above our goal of 6, including Aaron Fried’s IHQI project and several grants Evan Raff received through the School of Medicine. We are doing particularly well in peer-reviewed publications. Last year we had 24 from with DHM faculty authors, so we set a goal of 25. We have 18 through Q2!Overall, our Division has done a lot of great work so far this year!
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| | | | | | | | | | | | -John Stephens, MD ; Associate Chief for Education and Faculty Development¶
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| | | Consults Updates
Hi everyone! Thankfully not too many updates from a consults perspective! Things continue to run relatively smoothly, albeit we have had higher censuses than prior on average. This is due to majority of Orthopedics comanagement coming to consults of late given the capacity constraints on the tree services.
| | | | | | | | | | | | Reminder that we cover Magnolia APP service (the long-term patients) whenever there is not a Magnolia APP provider. This is ALWAYS the case on weekends and during some of the next several months will be on weekdays as well given Kelly’s HBR transition. So please make sure to check the schedule!
It remains a challenge for accepted transfers from surgical teams to make it over to general medicine teams given lack of medicine beds. If you truly feel strongly that a patient needs to come over asap, I recommend letting the MAOs know it’s time sensitive and they subsequently re-prioritize to the best of their ability to make it happen. Let me know if you’re running into issues, please! Always consider backtransfer as an option to recommend to the surgery teams as well. This past week on service for myself we got several folks on surgical services back transferred before they were able to get a medicine bed here.
As always, for questions or to give feedback, please reach out 919-608-5633. Thanks, Ashmita -Ashmita Chatterjee, MD ; Physician Leader for Medicine Consult Service
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| | | | | | | | | | | | Upcoming Meetings:¶
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2nd Wednesday MeetingTopic: Secure Chat Improvements Presenter:Beth Ann Brubaker, MD Date: Wednesday, February 11th at noon Location: PECR1 & Webex
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3rd Wednesday Education Lecture SeriesTopic: Journal Club Presenter:Christina Kahl, MD, PhD Date: Wednesday, February 18th at noon Location: Webex
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Secure Chat Communication ProjectChristina Siems, Escher Howard-Williams, Beth Ann Brubaker
Wed 2/11/26 at our DHM Faculty Meeting I will present the work our group has completed over the past six months. This presentation will include the roll-out of 6 clear and practical habit changes called “Just Do It”. This initial step marks the beginning of our broader effort to develop secure chat guidelines, which we will continue to develop and refine over the coming months.
| | | | | | | | | | | | Our workgroup has taken a deep dive into the habits and culture that have evolved around secure chat use over the past five years since initial rollout. We interviewed MDs, APPs, nurses and many other teammates and conducted detailed analysis of secure chat data including volume and contents of secure chats messages.¶
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Many of you also participated in the recent survey, and we appreciate your engagement. We are grateful for the thematic analysis tools from Escher and the statistical analysis from Carlton Moore expertly applied to our data and findings. We are also grateful to Leo Marucci for helping us understand and navigate the IT changes that are coming in the next few years, allowing us to make meaningful change now that will not become obsolete in the years ahead.I am confident that when you see the data and findings we have gathered that you will feel validated in your frustrations with the culture and hardships that have developed around secure chat use. After the presentation, I look forward to opening a dialogue to include your ideas for meaningful improvement in how we use and relate to secure chat. Our ultimate goal is to create impactful guidelines that will inform lasting habit and culture change for secure chat use that reduces secure chat volume, interruptions in daily work and creates standardized messaging pathways that ensure communication urgency is directed through the correct channel.JUST DO ITs: Please, begin implementing these changes immediately. Some may feel silly or uncomfortable at first, but we believe that these simple things offer an important starting point for improving epic chat culture.
| | | | | | | | | | | | FACE-to-FACE communication is an important tool for clear communication AND reduction in epic chat volume -Attempt F2F with nurse during rounds to address issues and update on POC -We are interested in hearing your approach to maximize F2F time and workarounds (when nurses are unavailable) for communicating with nurses
IMMEDIATE CHANGES that YOU can do to immediately help cross cover and nighttime colleagues -Fully load PRN orders on admission and confirm fully loaded PRN orders when you receive new patients, to reduce requests-Provide anticipatory guidance to nurse around known problematic issues; request this guidance be handed off to night nurse; consider placing recs in sticky note or misc nursing order to easily share guidance across shifts
NEXT STEPS:We are interested in YOUR OPINIONS about next step changes toward impactful improvement in communication.
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| | | | | | | | | | | | OUR initial ideas for next steps:- create message formatting standardization- define urgency levels and appropriate channels: page vs epic chat vs nonurgent/FYI asynchronous site; - define acceptable timeframe within each channel: <30min / 30-120min / 6-12hrs- create epic location for non-urgent “asynchronous” communication; avoid epic chat for these non-urgent messages-address CM/SW and discharge day epic chat volume; we plan a dedicated workgroup around these issues-community standards around availability status - Available / Busy / DND / Offline
Our pilot study champions: 7BT: Louretta “Rita” Blood and Fajr Flannery7GMU: Jeremiah Foust and Brooke AsayCM: Janet WardOT: Katy MokanPharmacy: Ryan Merchant and Kristine Nguyen
If you have are attending on a TREE service with patients on 7BT and 7GMU, please be aware that we will be conducting some PDSA cycles on these units. We will communicate with you so that you can help socialize and provide feedback on some of our change strategies.
-Beth Ann Brubaker, MD; Physician Leader for MDU General Medicine Service
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| | | | | | Please email Sharon Baker ([email protected]) if you would like to recognize a fellow peer, share a personal work achievement, family/coworkers photos, or submit an announcement to be featured in future newsletters.¶
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| | Copyright (C) 2026 UNC Division of Hospital Medicine. All rights reserved.
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