Traditional hospital wards are not specifically designed as effective clinical microsystems. The feasibility and sustainability of doing so are unclear, as are the possible outcomes. To reorganize a traditional hospital ward with the traits of an effective clinical microsystem, we designed it to have 4 specific features: (1) unit‐based teams, (2) structured interdisciplinary bedside rounds, (3) unit‐level performance reporting, and (4) unit‐level nurse and physician coleadership. We called this type of unit an accountable care unit (ACU). In this narrative article, we describe our experience implementing each feature of the ACU. Our aim was to introduce a progressive approach to hospital care and training. Journal of Hospital Medicine 2015;10:36–40. © 2014 Society of Hospital Medicine

The hospitalist-consultant interaction is viewed as important for both hospitalist learning and patient care. Multiple barriers and facilitating factors impact the interaction, many of which are amenable to intervention.

No abstract

BACKGROUND: Gender inequities are documented in academic medicine. Within General Internal Medicine (GIM), there are fewer female division directors and first and last authors on publications. With gender parity in US medical school graduates and with Academic Hospital (AH) medicine being a relatively newer discipline, one might postulate that AH would have less gender inequity. DESIGN: A national survey of AH programs was developed via literature review and expert recommendations. Domains included program and faculty information. Gender of the leader was determined via website or telephone call. PARTICIPANTS: Leaders of AH programs associated with the American Association of Medical Colleges (AAMC). Programs without a primary teaching hospital or hospitalist program and those not staffed by universityaffiliated physicians were excluded. MAIN MEASURES: Description and characteristics of leaders and programs including a multivariable analysis of gender of hospitalist leaders and the portion of female faculty. KEY RESULTS: 59% response rate (80 of 135); there were no differences between responders/non-responders in NIH funding (p = 0.12), type of institution (p = 0.09), geographic region (p = 0.15), or year established (p = 0.86). Reported number of female and male faculty were approximately equal. 80% of hospitalist leaders were male; 37% of male hospitalist leaders were professors, no female leaders were professors. In univariate and multivariate analysis only the number of hospitals staffed was a significant predictor of having a female hospitalist leader. There were no significant predictors of having fewer female faculty. CONCLUSION: This study demonstrated gender inequality in academic hospital medicine regarding leadership and rank. Though there was equal gender distribution of faculty, among leaders most were men and all "full professors" were men. As diversity benefits the tripartite mission research on methods, initiatives and programs that achieve gender equity in leadership are needed.

No abstract