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Browsing by Author "Burden, Marisha"
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Item Closer to or Farther away from an Ideal Model of Care? Lessons Learned from Geographic Cohorting(Springer, 2022-09) Kara, Areeba; Kashiwagi, Deanne; Burden, Marisha; Medicine, School of MedicineGeographic "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. Cohorting may also be associated with unintended consequences such as increased interruptions and increased indirect care time. Institutions may increase patient loads in anticipation of the efficiency gained by cohorting-leading to further increases in interruptions and time away from the bedside. Fragmented attention and increases in indirect care may lead to a perception of increased workload, errors, and burnout. As hospital medicine evolves, there are lessons to be learned by studying cohorting. 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.Item Language Matters: Is There Gender Bias in Internal Medicine Grand Rounds Introductions?(Springer Nature, 2024-05-18) Hanna, Reem M.; Grimm, Eric; Keniston, Angela; Khateeb, Rafina; Kara, Areeba; Burden, Marisha; Medicine, School of MedicinePurpose: We performed an exploratory evaluation of gender-specific differences in speakers and their introductions at internal medicine grand rounds. Method: Internal medicine grand rounds video archives from three sites between December 2013 and September 2020 were manually transcribed and analyzed using natural language processing techniques. Differences in word usage by gender were compared. Results: Four hundred and sixty-two grand rounds held at three institutions were examined. There were 167 (34.6%) speakers who were women and 316 (65.4%) who were men. The proportion of women speakers was significantly lower than that of women in the internal medicine workforce (34.6% vs. 39.2%, p = 0.04). Among 191 external speakers, only 57 (29.8%) were women. The use of professional titles was equivalent between genders. Despite equal mention of specific achievements in both male and female speaker introductions, there was a trend toward casting female speakers as being less established. Conclusion: There is a need to adopt processes that will decrease inequities in the representation of women in grand rounds and in their introductions.